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Health reform goals sharpen

Medical, political and business interests seem to agree now that bold federal action is necessary.

December 01, 2008|Noam N. Levey | Levey is a writer in our Washington bureau.

Fifteen years ago, there was much less agreement about preserving an employment-based system that now insures about 177 million people.

Opponents of President Clinton's plan were able to sink it by raising the specter that government would take away consumers' choices in a new system that would force them into inferior health insurance.

But now the prospect of bold government action to address the healthcare crisis appears to have been accepted far more broadly by many of those involved in the debate.

Even business leaders traditionally wary of government intervention now are pushing for the federal government to act decisively to reshape the healthcare marketplace -- in large part because of the increasing burden imposed on them by rising costs.

"Doing this piecemeal is not going to work," said Todd Stottlemyer, president of the National Federation of Independent Business, which was also instrumental in defeating the Clinton plan.

Many involved in the healthcare debate, including Democratic lawmakers and members of Obama's team, also see healthcare reform as part of a broader economic picture.

Democratic leaders on Capitol Hill have begun sketching out plans for healthcare reform that, like Obama's plan, preserve the employer-based system and create a new system for those without insurance.

Last month, Senate Finance Committee Chairman Max Baucus (D-Mont.) outlined such a plan in an 87-page white paper titled "Call to Action." Similar approaches have been endorsed by House Democrats.

In contrast, the Clinton administration drew up its healthcare reform plan with little involvement from congressional Democrats. In the Senate, then-New York Democrat Daniel Patrick Moynihan, who was chairman of the finance committee at the time, actively resisted the idea of sweeping change in healthcare.

There are no signs of a similar rift today, said Jacob Hacker, a political scientist at UC Berkeley who has written a book about the failed Clinton effort.

"Possibly more important than policy agreements," Hacker said, "is the fact that the political forces now are in alignment."


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