Will stalemated Clinton simply declare 'victory'?


WASHINGTON -- President Clinton and aides are working overtime denying that there has been any change in his position to seek universal health care coverage. But his statements at the National Governors' Conference sound very much like he is edging toward what is known hereabouts as "the Aiken ploy."

In the midst of the stalemate in the Vietnam War, Republican Sen. George Aiken of Vermont proposed, in vain, that the United States "declare victory and come home." In the absence of actually winning the war, Aiken suggested, the president ought simply to say that the limited goal of preventing a Communist takeover of South Vietnam had been accomplished and that he was pulling out all U.S. troops.

Clinton, in suggesting at the governors' meeting that he would consider "somewhere in the ballpark of 95 percent or upwards" coverage to constitute "universal," seemed to be suggesting that he would settle for less than he insisted on in threatening a veto in his State of the Union address in January. He seemed to be saying that he would "declare victory" even in the event that whatever Congress passes falls short of what he called for then -- "to guarantee every American private health insurance that can never be taken away."

The president and the first lady also appear to be sending out broad hints that they are willing to finesse the point implied in the word "guarantee" -- that the coverage will be available to everybody at the same date.

Before the governors, Clinton talked about "a phased-in, deliberate effort" to reach universal coverage, and indicated that he might be willing to drop his proposal for "employer mandates" -- bosses being required to pay 80 percent of the cost -- "if we had something that moved toward universal coverage."

Hillary Rodham Clinton, head of the administration's task force on health care reform, used the same basic construction in saying that she didn't think her husband would have to use his threatened veto, because Congress wouldn't "pass a bill that does not at least have some plan to get to universal coverage."

That sounded very much like a nod to the idea of congressional "triggers" -- not writing firm commitments for universal coverage now but providing for certain steps to be taken toward it later if it is not achieved.

Clinton, who is a master at playing with words, now says that "no one ever talked about a law which would set [95 percent] as a goal." Maybe so. But in talking about "moving toward" universal coverage instead of insisting on it now, he left the impression that he would swallow the lower figure for openers.

The notion of maintaining full coverage as a goal without achieving it at the start also was reflected in a damage-control comment by Harold Ickes, the deputy White House chief of staff. Ickes talked of "the right to health care coverage" while noting that as a practical matter something less than 100 percent could be accomplished.

Clinton himself noted that Social Security covers about 98 percent of Americans but is considered to be "universal."

In any event, the president appears to have injected some flexibility into his veto threat at a critical point. The two key men responsible for crafting the measures that will go before the full House and Senate -- House Majority Leader Richard A. Gephardt of Missouri and Senate Majority Leader George J. Mitchell of Maine -- can go about their business now with a sense that the president is not going to reject their handiwork out of hand if it does not reflect the seemingly categorical requirements of his State of the Union speech.

At the same time, however, Clinton's apparent new flexibility can complicate the task of the Democratic leaders rounding up votes for whatever they come up with.

Rep. Jim McDermott of Washington state, one of more than 90 House supporters of a Canadian-type, single-payer approach, says 95 percent coverage won't do because the same problem that exists today, of uninsured people showing up in emergency rooms for treatment, will put unacceptable costs on the system.

Another single-payer advocate, Sen. Paul Wellstone of Minnesota, says Clinton should be sounding a firm trumpet for true universal coverage as thousands of supporters prepare to board buses to Washington to back him up. And he warns the White House: "Don't take our votes for granted."

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