In Health Care Debate, U-Word Is Back

The Associated Press
Sunday, September 16, 2007; 2:26 AM

WASHINGTON -- It's been 14 years since first lady Hillary Rodham Clinton's health care reform plan sank like a stone, swallowed by fears of a big-government power grab. In the years since, wary presidential candidates at first avoided the issue altogether, then gingerly dipped one toe, then another, back into the pool.

This year, no self-respecting presidential candidate wants to be without a health care overhaul plan, and talk about "universal coverage" is back.

There is a stark difference between the medicine being prescribed by Democrats and Republicans.

Democratic candidates argue it is the government's job to make sure everyone has health insurance they cannot lose. Republicans are pushing more limited incentives and subsidies to help people obtain affordable coverage.

Both sides are trying to steer clear of anything resembling the 1993 plan. Clinton _ this time the candidate rather than the spouse _ comes out with her own plan Monday, adamant that "we're going to get it done this time."

Democrats in general and the New York senator in particular approach the debate this time with better bedside manners than in the last major go-around.

Even defenders of Clinton's 1993 effort to change the system say the process scared the patient _ namely, middle-income people who may want a better way, but have insurance and do not want to step into the unknown with health care.

Those fears were embodied by a middle-class couple named Harry and Louise, characters in an advertising campaign sponsored by the health insurance industry. The ads, targeting mainly opinion-makers in Washington and New York, showed the couple fretting over having to get their insurance through a new "billion-dollar bureaucracy" that would include mandatory health insurance purchasing alliances.

This time, the candidates are all "being very careful to say that, look, if you have health insurance today, you can keep it," said Kenneth Thorpe, a professor of health policy at Emory University. He has helped the top four Democrats crunch the numbers of their plans and was involved in Clinton's 1993 effort.

"The Harry and Louise ad was one of those things where people were concerned that people have to move from what they have to a plan they didn't really know." Thorpe said. "The lesson is, the less disruptive you make it, it makes it very difficult for Harry and Louise to come out and criticize it."

Already, the GOP candidates are branding Democratic proposals a step on the road to socialized medicine while they offer incremental steps such as tax breaks to expand coverage and make it more affordable.

"Let me tell ya, if we don't do it, the Democrats will," warns Republican Mitt Romney. "And if the Democrats do it, it'll be socialized medicine. It will be government-managed care. It'll be what's known as Hillary-care or Barack Obama-care or whatever you want to call it."

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