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Clinton's health plan reveals smart politics

I can't tell you whether Hillary Rodham Clinton's latest Big Idea on health care lives up to the first half of that elegant equation "good government makes good politics" and solves the increasing problems of cost and coverage. At least not yet.

While her overly big, bureaucratic Bad Idea as first lady ran a forest-killing 1,300 pages, the Hillary Care II of her front-running presidential campaign is only a sketchy 10 pages. It's impossible to assess the full impact of the plan without at least a few more dead trees of data.

But I will tell you Clinton's plan to cover every American is, if not demonstrably good government, adroitly good politics. Not only for her but for a Democratic Party that still leaves many swing voters skeptical. And if its details survive scrutiny, it is good for a country where bold, ground-breaking ideas get headlines but only pragmatically leavened proposals become law.

Bottom line: Clinton's plan has a chance. Whoever becomes president, the final product that makes it through the lobbyist-pounded crucible of Congress will look fairly much like it — not the government-run "single-payer" system loved by many liberals, not the "market-driven" status quo dominated by health insurers that is preferred by many conservatives.

And it has a chance because Clinton's proposal addresses the key concerns of middle-class voters, especially the swing constituency in the suburbs. It is these moderate voters whose defections after Hillary Care I devastated her party and her reputation and, worse, squandered momentum for reform.

It would be silly to say urban and rural residents don't face or care about the lack of affordable, portable and pervasive coverage. But more than most suburbanites, city and country folk likely have coverage that meets at least minimal needs. That's because of the large numbers of rich and poor in urban centers and poor in rural hamlets. The rich can afford insurance if their employers don't supply it. The poor have access to government-funded coverage.

But it's suburbia's dense concentration of the middle- and upper-middle class, including small business owners, with their measured skepticism of big-government schemes to spend their money, that soured on Clinton's health folly in 1993.

Suburbanites, who often get insurance through their employers, didn't like the way Clinton would have denied them the choice of their own plan and doctor. Now, she says they can see anyone they want.

Suburbia's proportionately larger population of entrepreneurs didn't like their small businesses being forced to buy coverage. Now she says they won't have to; they'll get tax credits if they do and employees will get coverage through cost-shrinking insurance pools if they don't.

No doubt you'll see some degree of opposition from the insurance industry that devoured Clinton's first plan with a $100 million ad campaign. And already, opposing GOP candidates have rushed in with tactical, if superficial, ripostes aimed at reminding voters of Clinton's worst failure as a policy-maker.

But Clinton has them beat, certainly on the politics. That her plan is similar to those of rivals Barack Obama and John Edwards and of groups such as the American Medical Association suggests it has mainstream appeal.

Since she began rehabilitating her image for her run for the Senate in 2000, Clinton has liked to say she matriculated in the "school of smaller steps." That made sense after she'd flunked out of the college of ill-conceived initiatives and, as a result, contributed mightily to the failure of the Democratic congressional class of 1994. And polls show that at least the Democratic electorate believes she is far better qualified and likely to actually reform the health care system than her opponents.

Clinton has earned her master's in politics. With a plan that plays centrally in one of the most breathtaking political comebacks in U.S. history, Clinton has shown she understands not only the art of the possible but the value of the pragmatic. In tailoring her proposal to fit the needs and finesse the concerns of suburban voters, Clinton has decided the way to victory — in the election and eventually in Congress — is down moderate Main Street.

Lawrence C. Levy heads the National Center for Suburban Studies at Hofstra University and is a columnist for Newsday.

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