Chatterbox

A Health-Care Bill Fantasy

If Sens. Hillary Clinton and Edward Kennedy ascended to liberal heaven and Saint Peter told them they could write up any health-care bill that they wanted, what would they ask for? Well, they might require businesses to pay three-quarters of the cost of health insurance for their workers. They might require the policies to cover not only doctor and hospital bills but lab work, mental health treatment, birth control, nursing home care–pretty much you name it. The federal government could fund the same health-care benefits to those not covered by employers or Medicare. Medicare recipients could get a prescription drug benefit, just as Congress is trying to provide today–and so could everybody else. To eliminate the burden of filling out forms and filing claims, the feds could provide one and all with an official “health card,” much like a bank credit card, that would be honored on sight by doctors, hospitals, pharmacists, and labs. Smaller companies that had difficulty paying for these extravagant health benefits could receive subsidies from the government.

Best of all, the two senators wouldn’t have to draft this fantasy bill themselves! That’s because the plan I just described was already drafted and sent to Capitol Hill by a Republican administration whose members included someone named Dick Cheney, someone named Donald Rumsfeld, and someone named Paul O’Neill; and the Republican Party chairman was someone named George Bush. Not recently, of course: The bill was submitted to Congress a quarter-century ago, during the waning days of the Nixon administration. “Nothing,” said Caspar Weinberger, Nixon’s secretary of health, education, and welfare, “should deter us from adding, this year, comprehensive health insurance protection to the basic security guarantees that America offers.” In transmitting the proposal to Congress, Nixon, arguably the most liberal Republican president since Theodore Roosevelt, declared, “Comprehensive health insurance is an idea whose time has come in America.”

It came fairly close. There were at least six health insurance plans in the hopper that year. Labor had one; the American Medical Association had one; the insurance companies had one; and so on. But Wilbur Mills, the Democratic chairman of the House Ways and Means Committee, was sympathetic to the White House plan, and the Kennedy and Weinberger staffs were closing in on a deal. On an unofficial show of hands at Ways and Means in the spring of 1974, Nixon’s Comprehensive Health Insurance Plan of 1974 (CHIP) actually prevailed. Before the deal could be sealed, though, the political careers of both Nixon and Mills collapsed in political scandal. Vice President Gerald Ford had lobbied for the Nixon bill in the spring, and reaffirmed his support on becoming president in August 1974, but more obviously urgent demands quickly swallowed up his attention. The No. 2 men on his staff and on the budget, Cheney and O’Neill (the current treasury secretary), don’t appear to have pressed the matter.

Four Republican administrations have now succeeded the one which declared comprehensive health insurance an idea whose time has come, and still it has not. Aside from prescription drugs for the elderly, no part of CHIP appears to be even at the bottom of the current administration’s list of priorities. This past week, to be sure, the Bush administration did authorize New York Gov. George Pataki, to whom Dubya is more than a little beholden, to extend the state’s Medicaid program to the working poor. How much of a breakthrough this represents remains to be seen. What’s already clear is that, on this particular issue, George W. Bush does not have to turn to obscure gurus for lessons in compassionate conservatism. His own party laid it all out for him three decades ago.

MartinPlissneris the author of The Control Room–How Television Calls the Shots in Presidential Politics