The attack was prompted by “Harry” and “Louise,” characters in a $6.5 million ad campaign sponsored by the Health insurance Association of America (HIAA), which represents a large chunk of the nation’s 1,500 health insurers. Harry is glad the president is “doing something about health-care reform,” but Louise keeps complaining that “there’s got to be a better way.” The Clinton forces worked up an artificial huffiness over these ads. Although one commercial wrongly claimed that the Clinton plan limits choice, it wasn’t anymore misleading than the average election-year spot. In fact, the industry’s opening salvos were rather mild, considering that HIAA members are literally struggling for survival.
But Hillary was smart to rip their heads off. Although it earned her a brief rebuke from Bob Dole (who is he to talk about “enemies lists”?) and the new nickname “Shrillary,” her aura on Capitol Hill remains mostly intact. After all, she’s right substantively: the industry has “brought us to the brink of bankruptcy,” it does “like being able to exclude people from coverage, because the more they can exclude, the more money they can make.” No other industrialized country puts up with useless paper shufflers taking such a large cut of their health budgets. She’s also right politically: health-insurance companies rank even lower in polls than members of Congress or reporters. They’re down there with used-car dealers, according to the president’s polltaker, Stan Greenberg. And she’s right tactically: if health-care reform is to live, the companies backing Harry and Louise must die. If 90 percent of those 1,500 insurers don’t die–if someone lifts the DO NOT RESUSCITATE sign off them–then the entire reform contraption will collapse.
Where the Clintons may have gone wrong was in not being even more aggressive in stigmatizing the powers arrayed against them. They’re attacking the beast without slaying it. The organizing political idea behind the Clinton Plan was to divide the big healthinsurance companies from the smaller ones. The half-dozen big boys would back the plan because they stand to win one of the sweetest shared monopolies ever; the smaller companies, which wreak havoc on the system with mounds of paper-work and cherry picking (insuring only healthy people without “pre-existing conditions”), would be driven out. But instead of backing the Clinton plan wholeheartedly, several of the big insurers have weighed in with the rest of the industry by attacking premium caps and other cost controls. A few even helped underwrite Harry and Louise.
Clearer enemies might have also meant cleaner legislation. The mad complexity of the Clinton bill sometimes seems like nothing more than an elaborate effort to avoid the fate the White House says would have awaited any singlepayer, Canadian-style plan. If it were called a Big Government plan, it would fail, the Clintons reasoned. But that’s exactly what it’s being called anyway. So why not use this period of compromise to throw some lobbyists out of work by moving back toward simplicity? One powerful senator joked last week that the 1,300-page bill could be reduced to one sentence that simply deletes the words “over 65” from Medicare.
Clinton’s “line in the sand” on health care is universal coverage. That’s good. But by saying so clearly that everything else is negotiable, he sends a message of weakness. One way to look strong again–as well as do the right thing–would be to embrace Sen. Daniel Patrick Moynihan’s efforts to tax ammunition to help pay for health care. The revenue raised would be small, but the payoff in political-courage points is potentially huge. Far from being a distraction from the Clinton health plan, it’s a chance to harness some of the passion surrounding crime to help it.
This is one of those issues that appear more risky than they really are. When House Speaker Tom Foley said last week that Moynihan’s bullet-control proposal is “remote from” the health-care debate, it was Foley who looked remote. Emergency-room physicians across the country are enraged about new kinds of ammunition, especially the Olin Corp.’s 9-mm Black Talon, that not only rip through tissue as never before but endanger surgeons. “Imagine sticking your fingers into the wound made by this bullet as it expands and forms razor-sharp projections. Cuts will expose us to bloodborne infections carried by the shooting victim, including hepatitis and the HIV virus,” Dr. Frederick T. Dennis, the president of the California Chapter of the American College of Emergency Physicians, wrote to Moynihan.
Hillary has already said that “personally” she is “all for” the general idea. Does her husband disagree? Good enemies are hard to find. A bullet that gun magazines praise as “nasty” and doctors say gives them AIDS should be an irresistible target. Fire away.
