When Vermont Republican Jim Jeffords bolted his party last week, the power base in Congress shifted in more ways than one. Not only will Democrats take control of the Senate when they return from their Memorial Day recess next week [ed. June 4], but the powerful Kennedy-Clinton health care base also will be back in power. After suffering an ignominious defeat in 1994 as First Lady, Senator Hillary Clinton has her agenda in tact and a new power base with membership on the committee that writes health care legislation in the Senate – the Health, Education, Labor, and Pensions Committee or HELP (which Jeffords chaired until his defection). Mrs. Clinton will be working closely to plan hearings with the returning chairman of the committee, Massachusetts Democrat Ted Kennedy. They will try to quickly move their health care agenda through the committee – especially a more aggressive patient’s bill of rights and a government-run prescription drug entitlement for Medicare. The HELP committee’s hearing schedule will be accelerated to highlight the problems in the health sector, including the large number of uninsured, the high rate of medical errors, and the outrages of HMOs. All deserve the attention of Congress and are worthy topics of investigation, but the approach that the liberal Clinton-Kennedy duo will take is one that would continue the steady march toward government control over the health sector and trample on free-market initiatives that have been gaining attention. But while the power shift in the Senate will certainly impact the debate over health policy, it will not necessarily lead to a flood of new legislation on President Bush’s desk. What it will do, however, is give liberals a new platform to make the case for their agenda. In the six years after her sweeping health care plan was defeated, Hillary Clinton was remarkably successful in implementing parts of her plan piece by piece. This new platform for headline-grabbing hearings will be crucial in determining the shape of future legislation. The White House and the Republican congressional leadership had put health care on the back burner thinking that they had more time to take action. Unless the White House and conservatives gear up to make a better case for free-market solutions to the problems in the health sector, they will once again be on the defensive against Hillarycare. Congress cannot depend upon the president to stop the tide when the going gets politically tough. For example, Bush caved on the medical privacy regulations, allowing the incredibly intrusive rules written by the Clinton administration to take effect earlier this year. And Bush took a pass in helping American companies protect their intellectual property rights abroad, deciding not to side with pharmaceutical companies in a politically-charged battle over patent protection in South Africa. Liberals have learned they can make giant strides if they just do it in small steps. They rightly believe that health care is their strong suit, and the closer the country gets to an election, the more the health care debate heats up. For many members of the closely divided House up for re-election next year, it is more important politically that something pass called a Medicare prescription drug benefit and patient’s bill of rights than what the legislation actually says and does. That is a danger sign for further government expansion into the health sector. Still, neither liberals nor conservatives has a mandate for their approach. That means political leaders will need to do much more work to make a convincing case to the public for one plan or another before any legislation can have a chance of being enacted. The president will have to work to heal the wounds and reach out to the other side to genuinely make progress on his initiatives. Acting on a seniors’ drug benefit is an important first step: Bush promised immediate help to low-income seniors, and he needs to begin shaping a plan that can realistically be expected to pass Congress – without bankrupting the country or putting the pharmaceutical industry and its promises for tomorrow’s cures out of business. Because Washington works in small steps, especially on major new initiatives, the president would be best advised to build a big case for a small new initiative to have the best chance of explaining the plan to the public and gaining support in Congress. Further, he could take action on providing tax credits for the uninsured to purchase private health coverage – an idea that already has broad bi-partisan support. Both present an important opportunity to begin to change the conversation by using the megaphone of the White House to make the case for free-market solutions.
Grace-Marie Turner is president of the Galen Institute that promotes public education on free-market health policy ideas. She can be reached at P.O. Box 19080, Alexandria, VA, 22320 or via e-mail at galen@galen.org.