Something very new is stirring in American politics. It is a new competition. The old competition was over who could cut government, taxes--and the deficit--most deeply. The new competition is over who will use government more effectively to solve problems.
Yes, doing that involves government spending. There is no point in playing rhetorical games and hiding the word "spending" behind the word "investments." All of which is to say: two cheers for presidential candidate Bill Bradley. Bradley has finally broken through the code talk and said Tuesday what needs to be said about health care: Extending coverage to the more than 40 million Americans who are uninsured will cost money. Bradley puts an annual price tag of $55 billion to $65 billion on his proposal.
And while we're at it, at least one cheer for Vice President Al Gore, who on Wednesday challenged Bradley to a series of debates. The Gore campaign thus finally acknowledged publicly the seriousness of Bradley's challenge. Debates would provide Democrats what they badly need--a focus on what happens after President Clinton leaves office, in place of the obsession to rehash his travails.
If you want to understand why Bradley is making headway, just look at his health plan. It would provide subsidies for poor and lower middle-class families to buy health insurance, guarantee the coverage of all children, open the federal employees' health plans to all Americans who want to join and give tax breaks for health coverage to everyone.
Bradley's plan is not without pitfalls. Opening up the federal employees' health system is an attractive idea, but it will be hard to set fair premiums for new entrants while protecting federal workers from rate increases. And, as Gore advisers pointed out, the tax breaks in the plan that benefit the well-off would channel cash to many who already have health coverage while doing little to reduce the pool of uninsured.
In the long run, the most direct way to cover all children would be to create a system parallel to Medicare. Kids would be covered from birth to 18, just as all adults now know they'll be covered from age 65 on. Still, Bradley's plan is bold in proposing to eliminate Medicaid and the Children's Health Insurance Program passed by Congress in 1997 and rolling them into one new plan that would encourage the poor to buy private policies.
The benefit is that Bradley would eliminate overlap and confusion and flatly proclaim a federal responsibility for covering kids. The problem, says Judy Feder, a health care specialist at Georgetown University, could be the elimination of Medicaid, which provides "quite comprehensive benefits and a real safety net for the poor." But Feder praises Bradley for a serious proposal that "puts real dollars on the table."
The biggest achievement is this: The health care issue, deemed dead after the failure of President Clinton's plan in 1994, is very much alive. Gore has his own proposals to expand coverage, somewhat more modest than Bradley's, and the Gore and Bradley camps quickly fell into an exchange of charges over whose plan was better. Bradley called Gore's approach "definitely timid," while a Gore adviser labeled Bradley's plan "wildly expensive."
It was the first clear ideological clash between the two men, and a prelude to what could be the most interesting intraparty debate since George McGovern and Hubert Humphrey faced off against each other as the 1972 primaries closed.
The trick for Gore and Bradley will be to win an edge without dividing the party the way McGovern and Humphrey did nearly three decades ago. If they care about winning in November, they'll need to use the debates to lay the basis for a consensus on governing in the post-Clinton era.
Signs of a new activist consensus are multiplying. Gore has proposed making preschool available to every child. Texas Gov. George W. Bush is proposing $8 billion, mostly in tax breaks, to help faith-based charities assist the poor. Bush's proposals are modest compared with Gore's and Bradley's. But Bush's acknowledgment of a government role in fighting poverty points to the sea change occurring in public life.
Sometimes, big transformations in politics arrive with thunder and lightning. Both the New Deal and the Reagan Revolution lit the sky. This time around, the changes involve a more subtle shift in the wind.
The fascinating thing about the coming struggle between Gore and Bradley is that while one must triumph over the other, both have a powerful interest in nurturing the turn to social activism that each would make the hallmark of his presidency. Rarely have candidates faced a more daunting task.