On June 15, for example, Clinton met with Sen. John Chafee of Rhode Island in the Oval Office. Chafee is a leader of the Senate’s bipartisan moderates, and an endangered species: a Republican who is (a) an expert on health care and (b) a true believer in universal coverage. He is not, however, a believer in the Clinton brand of universal coverage. The meeting started cool, Chafee listing his disagreements with the president’s plan, but quickly warmed as the discussion turned to Chafee’s proposal. “It was a positive, kind of wonkish meeting,” said a Clinton aide. Chafee certainly thought so; he walked out thinking he had a deal. He didn’t. “I’ve seen others go in there and walk out on cloud nine,” says a Senate staffer. “Clinton plays with them, humors them – but never quite agrees.” Or maybe he does agree, and the staff rushes to pull him back. Whatever. The effect is the same: nothing happens. “It’s really a despicable, candy-assed way of doing business,” says the Senate source.
It was worse – crueler – in the case of John Chafee, who has been one of the few heroes of the health-care debate. Chafee’s plan, released about the same time as the Clinton monstrosity last September, was a courageous bit of business. It was the product of four years of work by a Republican task force. It proposed universal coverage, though more slowly than Clinton’s did. It proposed a tax – rare thing for a Republican: the uninsured would be covered, in part, by taxing the (currently untaxed) health benefits most people now receive. It had 19 Republican cosponsors – and the active support of Sheila Burke, who is Bob Dole’s chief of staff. It also had the prospect of support from a broad range of Democratic moderates. But it never received the attention it deserved. And, though it’s probably too late to resuscitate now, it certainly warrants a second look – which was Chafee’s vain hope June 15.
There are, essentially, three ways to reach that state of grace known as universal coverage: the government can provide it (as most industrialized countries do), employers can provide it (the Clinton plan) or individuals can be required to buy it for themselves – the way auto insurance works. None of the three is pleasant. Americans don’t trust government to do it, and rightly so. Americans do like the notion of having employers do it, but it’s not a good idea. If anything, given the fiercely competitive global environment, we should be finding ways to relieve corporations of this unnecessary social burden. During the campaign, Bill Clinton seemed to understand that, often citing the competitive drag of health costs on American corporations.
Chafee favored the third route – individual responsibility. The system would remain the same for most people: their employers would continue to provide health-care benefits (although some of those benefits would be taxed). Those who didn’t get health insurance on the job would have to buy their own – with significant help from the government. The working poor, and much of the middle class, would receive subsidies; there would be voluntary purchasing cooperatives to help individuals make their choices. Everyone would have the moral – and legal – responsibility to buy in. There would be no free riders, no “cost-shifting.” More than a few legislators admit – privately – this would be the cleanest, fairest, most straightforward way to provide health insurance.
Publicly, though, it was almost immediately untenable. “It’s death,” said a top Clinton aide. “The message is “We don’t want your employer to pay. We want you to pay’.” Well, that became the message after the Clintons made it so. If they’d favored individual responsibility from the start, or quickly moved to support Chafee’s plan, they might have built the coalition needed to pass significant health-care reform. But they didn’t. Their motivation was both pragmatic and craven: an employer mandate seemed the shortest path to universal coverage; it built on the current system. But it was also the preferred path of organized labor, whose members had spent years fighting for gold-plated health coverage the AFL-CIO didn’t want to see taxed.
Chafee was soon abandoned by all sides. His Republican cosponsors melted away. Bob Dole, ever cynical, smelled blood after Whitewater and decided to play presidential politics. The Clintons, equally cynical, talked flexibility, but remained intractable. Indeed, they took advantage of Chafee’s good intentions, leading him on, assuming he’d be won over if patronized (which is the smarmy assumption at the heart of Clinton’s policy teasing).
A deal was still possible in June. Dole was long gone. Members of the Religious Left, like the incorrigible Jay Rockefeller, would have been lost. But a significant centrist coalition might have remained. Chafee returned from his June 15 meeting – on cloud nine. His “rump” group of moderate Finance Committee members were willing to stick their necks out for an “individual mandate” – if the president was. The moment passed. And with it, most likely, the last chance for responsible reform.
title: “Chafee At The Bit” ShowToc: true date: “2022-12-30” author: “Charles Harris”
On June 15, for example, Clinton met with Sen. John Chafee of Rhode Island in the Oval Office. Chafee is a leader of the Senate’s bipartisan moderates, and an endangered species: a Republican who is (a) an expert on health care and (b) a true believer in universal coverage. He is not, however, a believer in the Clinton brand of universal coverage. The meeting started cool, Chafee listing his disagreements with the president’s plan, but quickly warmed as the discussion turned to Chafee’s proposal. “It was a positive, kind of wonkish meeting,” said a Clinton aide. Chafee certainly thought so; he walked out thinking he had a deal. He didn’t. “I’ve seen others go in there and walk out on cloud nine,” says a Senate staffer. “Clinton plays with them, humors them – but never quite agrees.” Or maybe he does agree, and the staff rushes to pull him back. Whatever. The effect is the same: nothing happens. “It’s really a despicable, candy-assed way of doing business,” says the Senate source.
It was worse – crueler – in the case of John Chafee, who has been one of the few heroes of the health-care debate. Chafee’s plan, released about the same time as the Clinton monstrosity last September, was a courageous bit of business. It was the product of four years of work by a Republican task force. It proposed universal coverage, though more slowly than Clinton’s did. It proposed a tax – rare thing for a Republican: the uninsured would be covered, in part, by taxing the (currently untaxed) health benefits most people now receive. It had 19 Republican cosponsors – and the active support of Sheila Burke, who is Bob Dole’s chief of staff. It also had the prospect of support from a broad range of Democratic moderates. But it never received the attention it deserved. And, though it’s probably too late to resuscitate now, it certainly warrants a second look – which was Chafee’s vain hope June 15.
There are, essentially, three ways to reach that state of grace known as universal coverage: the government can provide it (as most industrialized countries do), employers can provide it (the Clinton plan) or individuals can be required to buy it for themselves – the way auto insurance works. None of the three is pleasant. Americans don’t trust government to do it, and rightly so. Americans do like the notion of having employers do it, but it’s not a good idea. If anything, given the fiercely competitive global environment, we should be finding ways to relieve corporations of this unnecessary social burden. During the campaign, Bill Clinton seemed to understand that, often citing the competitive drag of health costs on American corporations.
Chafee favored the third route – individual responsibility. The system would remain the same for most people: their employers would continue to provide health-care benefits (although some of those benefits would be taxed). Those who didn’t get health insurance on the job would have to buy their own – with significant help from the government. The working poor, and much of the middle class, would receive subsidies; there would be voluntary purchasing cooperatives to help individuals make their choices. Everyone would have the moral – and legal – responsibility to buy in. There would be no free riders, no “cost-shifting.” More than a few legislators admit – privately – this would be the cleanest, fairest, most straightforward way to provide health insurance.
Publicly, though, it was almost immediately untenable. “It’s death,” said a top Clinton aide. “The message is “We don’t want your employer to pay. We want you to pay’.” Well, that became the message after the Clintons made it so. If they’d favored individual responsibility from the start, or quickly moved to support Chafee’s plan, they might have built the coalition needed to pass significant health-care reform. But they didn’t. Their motivation was both pragmatic and craven: an employer mandate seemed the shortest path to universal coverage; it built on the current system. But it was also the preferred path of organized labor, whose members had spent years fighting for gold-plated health coverage the AFL-CIO didn’t want to see taxed.
Chafee was soon abandoned by all sides. His Republican cosponsors melted away. Bob Dole, ever cynical, smelled blood after Whitewater and decided to play presidential politics. The Clintons, equally cynical, talked flexibility, but remained intractable. Indeed, they took advantage of Chafee’s good intentions, leading him on, assuming he’d be won over if patronized (which is the smarmy assumption at the heart of Clinton’s policy teasing).
A deal was still possible in June. Dole was long gone. Members of the Religious Left, like the incorrigible Jay Rockefeller, would have been lost. But a significant centrist coalition might have remained. Chafee returned from his June 15 meeting – on cloud nine. His “rump” group of moderate Finance Committee members were willing to stick their necks out for an “individual mandate” – if the president was. The moment passed. And with it, most likely, the last chance for responsible reform.
