Special Report

Hard to Swallow

Hillarycare is back because Republicans failed to strangle it in its crib.

By 9.18.07

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In November, 2006, after Democrats won control of Congress, Sen. Hillary Clinton told the Associated Press, "Health care is coming back. It may be a bad dream for some." It's shaping up to be just that for everyone.

Sen. Clinton unveiled her universal health care plan yesterday. It was, like the plans of her Democratic rivals, heavy on tax hikes, government subsidies and other prods to get people to behave the way the Democratic candidates think people should. Now every Democratic candidate has a health care plan that promises universal health care. While Republicans recall the Clintons' 1994 health care reform train wreck, scratch their heads and wonder what in the world Democrats are thinking, the Democrats are getting the upper hand by promising to fix a health care delivery system most Americans see as broken. And Republicans have let them.

Four years ago, a Washington Post/ABC News poll found that Americans preferred "universal health care" by a two-to-one margin, and a majority (54 percent) was dissatisfied with the overall quality of health care in the United States -- the first time the poll had recorded that since 1993. That was four years ago, and Republicans still haven't gotten the message.

In February a Quinnipiac University poll found that 64 percent of Americans agreed with the statement that "It's the government's responsibility to make sure everyone in the United States has adequate health care." That's the same margin in favor of universal health care that the Washington Post/ABC News poll found in 2003.

In March a CBS/New York Times poll found that just 8 percent of Americans thought the U.S. health care system needed only "minor changes." But compared to the Democrats, minor changes are what Republicans have been offering, and 92 percent of the country disagrees with them.

Polls also show that Americans tend to like their own health care coverage. But like polls that show Americans hating Congress but loving their own congressman, that discrepancy does not mean Americans really don't want change. They do, and in overwhelming numbers. In his inaugural address in 1993, Bill Clinton said, "The American health-care system costs too much and does not work." Most Americans agreed with him then, and even more do now.

This issue has been percolating for more than a decade. Health care consistently ranks among the issues Americans care about, and want Washington to address, most. "This is an issue that scores high on the public's agenda -- trailing only Iraq and terrorism, as a priority for Congress to address in early 2006," according to a Gallup analysis of polling data two years ago. But instead of giving Americans that reform when they had the chance, and making sure that it was good, old-fashioned market-based reform, Republicans still jubilant over the defeat of Hillarycare wrote the issue off and instead gave America No Child Left Behind -- even though education does not and did not then rate a higher priority than health care. (The 2006 Gallup analysis called education a "sleeper" issue, noting that only 4 percent of the public considered it the nation's No. 1 priority. Health care, on the other hand, ranked so high that Gallup called it a "mandate.")

Republicans at the national level have all but ignored the mandate. Governors such as Mitt Romney and Arnold Schwarzenegger, however, got the hint and addressed it. Their reforms are more heavy-handed than most Republicans would like. There are other ways to take health care away from the left. But Romney and Schwarzenegger at least have begun the process of trying to neutralize the issue. And if anyone thinks Romneycare is awful, just wait until we get Hillarycare.

THE FAR LEFT EXCORIATES Senator Clinton for not advocating a single-payer health care plan. But she has not ruled it out.

The left hates Clinton for saying, as she did last month in Manchester, N.H., "I think you don't want to take choices away from Americans. We're big on choice here. But you've got to have some framework so the choices work better." Clinton has repeatedly said she wants to implement a choice-based plan that would build on what is good about America's health care system, not replace it.

But that is not because she believes in what little consumer choice the American system still provides. She just knows she can't propose a single-payer system and get elected.

In April a board member of the Community Service Society of New York asked her why she supported a system based on private health insurance instead of a single-payer system

"Well, I didn't say that," she said.

As Politico.com's Ben Smith reported:

But she added that "for the short term, it'll probably have to build on the employer-based system, but with a lot of changes in how it operates and what the insurance companies are expected to do."

She also proposed providing "options to people to buy into government health care."

A far broader program known as "Medicare for All," she said, "would be something to be considered" if Democrats can win at least 55 seats in the Senate.

"I just feel it's unfair to tell people we can do something politically when we don't yet have the votes to do it."


If she had the votes in Congress to push single-payer health care, she'd do it before you could turn your head and cough. This is nothing new, either. She made much the same point seven years ago.

And don't think Hillary is the only one who will take away your freedom if she gets half a chance. John Edwards told a crowd in Iowa a few weeks ago that his plan "requires that everybody be covered. It requires that everybody get preventive care. If you are going to be in the system, you can't choose not to go to the doctor for 20 years. You have to go in and be checked and make sure that you are OK."

He would force women to get regular mammograms, he said. If the prospect of President Clinton restricting your choice of doctor weren't bad enough, President Edwards would make it illegal for you not to go to the dentist. Suddenly, your body is no longer your own. It belongs to the state.

This is the logical endpoint of "universal health care." It is the inevitable conclusion to the theory that "health care is a right." If health care is a right, then the government is compelled to provide it. So too are physicians. No more deciding that you don't want to treat a patient. That patient is entitled to the benefits of your $120,000 education.

When Clinton said yesterday "We can talk all we want about freedom and opportunity and life, liberty and the pursuit of happiness. But what does all that mean to a mother or a father who can't take a sick child to the doctor?" she was contradicting her dozen-plus utterances of the word "choice" or "choose." She directly attacked the idea that freedom was more important for the government to provide than health insurance. She could do that because conservatives, represented primarily by Republicans in Washington, have not contradicted such nonsense.

REPUBLICANS HAVE FAILED TO REALLY engage Democrats on their health care populism. Building a coalition of interested parties to defeat the Clintons in 1994 was a tactical victory. But Democrats have devised the winning strategy while Republicans have abandoned the field of battle. Their failure to propose and vigorously promote an ideological alternative to the "health care is a right" mantra has helped Democrats gain total control of this issue. Democrats are so confident of victory on health care that Clinton feels free to directly attack the Declaration of Independence while announcing a health care plan that would eviscerate it.

There is, however, some hope. Clinton knows that she cannot get elected by dictating, Soviet-style, an entire health care system. Which is why she said her plan "is not a government takeover of health care." Other Democratic candidates have been careful to avoid that label as well. Even though Americans want Washington to do something about health care, they are not ready for Washington to provide it. Mitt Romney and Rudy Giuliani have recognized this opening and taken it. But all Republicans need to get a lot more aggressive about it, and now. Americans want Washington to tackle health care. Republicans need to do so by offering better plans than the Democrats are offering.

Meanwhile, Clinton's assurance that her plan is not a government takeover is no comfort. Laurie Rubiner, Clinton's top health-care policy adviser, told the Washington Post that Clinton would let Congress work out the details. "We're going to leave a lot of this to the congressional committees," she said.

So the Senate Committee on Health, Education, Labor and Pensions, chaired by Sen. Ted Kennedy, and the House Committee on Energy and Commerce, chaired by Rep. John Dingell, will get to devise America's new health care system if Clinton becomes president. You can take two aspirin, but this headache is not going away anytime soon.

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About the Author

Andrew Cline is editorial page editor of the New Hampshire Union Leader. You can follow him on Twitter at @Drewhampshire.