 | Samuel Goodstein Grand Illusion |
In August 1994, as Congress debated the most profound proposed addition to the welfare state since the Great Society, Sen. Phil Gramm (R-Tex.) stood before his colleagues {ï in the Senate chamber. Holding high a copy of the moderate health care reform proposal offered by Democratic Majority Leader George Mitchell (D-Maine), Gramm delicately placed the large bill on a scale he had brought for the occasion. Hundreds of pounds of taxes, many ounces of regulation, proclaimed Gramm, reading imaginary numbers off the scale.
An unusually quiet chamber held its breath, waiting for the response of Mitchell to this non-collegial attack. Mitchell pounced. Borrowing Gramm's now-empty scale, he examined it. Zero pounds, zero ounces, the weight of the Republican bill, noted Mitchell.
It didn't weigh anything because it didn't exist. According to Mitchell, the Republicans had a strong defense, but no offense. Most Republicans simply weren't concerned with the more than 40 million uninsured Americans.
History has proven Mitchell prophetic. After more than two years in control of Congress, the Republican health care reform plan still weighs zero pounds, zero ounces. What is more disturbing is what few predicted: President Clinton has been a co-conspirator in the plight of the working poor, the small business employees and children of America who continue to go without - or with inadequate - health insurance. The Clinton administration's position on health care reform since the death of the Clinton plan in August 1994, provides a window into the soul of the president of the United States. The view inside has to sadden even the most dedicated Clinton supporters.
Our story begins in the wake of the administration's health care debacle. After the election of the Gingrich majority, it was more than understandable that the president chose not to resubmit to Congress a gargantuan expansion of the welfare state. With Dick Morris running the show once again, as he had done years before for an embattled governor of Arkansas, the president chose to govern by increment. Baby steps, said the soulless pollster to the soulless politician.
There have been three major developments in health care policy since that time, none positive, and all partially the president's fault.
The first was the so-called Kennedy-Kassebaum legislation, purporting to prohibit insurance companies from denying individuals with pre-existing conditions health insurance. The president took endless credit for this bill, claiming it to be an incremental reform that would help millions of Americans. Mr. President: As they say in Arkansas, "that dog won't hunt." Kennedy-Kassebaum allows health insurance companies to continue to charge prohibitively high prices to individuals with pre-existing conditions. It's a meaningless technicality to say insurance companies must offer coverage to those with pre-existing conditions without regulating the price of that insurance.
This hogwash, however, paled in comparison to the president's campaign statements about the GOP Medicare proposals; I do not doubt that Gingrich and Majority Leader Dick Armey (R-Tex.), who has publicly argued that the minimum wage has no place in a free market economy, would love to do away with Medicare over time - let it "wither on the vine." However, the Medicare cuts proposed by the Republicans in their budget would have helped Medicare, not hurt it. For once, the GOP had submitted a plan that would place a higher benefit on affluent recipients, and yet Clinton balked. Now, he is proposing cuts almost as large, but would do so in less desirable ways. The president's proposed premium increases are much more likely to disproportionately hit the middle class and the working poor.
Finally, the president has proposed cuts to Medicaid in his balanced budget plan. These cuts would either directly throw poor people off the insurance rolls, or would indirectly do so by cutting already-low Medicaid reimbursements to health care providers, thus insuring that these providers will be even less likely than they are now to treat Medicaid enrollees.
Incremental solutions abound that would significantly reduce the number of Americans with no access to health care. Most of these proposals center around raising revenue through changes in the tax code, and using that revenue to subsidize insurance for the working poor and children. One in five children in America live in poverty, Mr. President. Millions of hard-working adults go without necessary health care, or are bankrupted by the care they do receive. Show us your soul.
- Sam Goodstein can be reached over e-mail at faygo@umich.edu. He wishes to thank Flint Wainess for his assistance with this column.