Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, October 11, 1993 TAG: 9310110032
SECTION: NATIONAL/INTERNATIONAL PAGE: A-5 EDITION: METRO
SOURCE: JILL LAWRENCE ASSOCIATED PRESS
DATELINE: WASHINGTON LENGTH: Medium
The risks of that course should be clear by now. To the glee of his rivals, Clinton already has had to temper, delay or scrap many of the pledges in his campaign tract, "Putting People First."
In fact, there was a widespread view during Clinton's first months that he was at least partially responsible for his own rocky performance and low approval ratings, because he had led people to expect too much from him.
That made it all the more damaging when he reneged on his promise of a middle-class tax cut, accepted a gasoline tax increase and pushed back the timetable on his health-care reform plan.
Yet from Florida to California to New Jersey, Clinton has been out promising jobs, personal safety and health care for all. The tone was typified last week at a televised town meeting in Sacramento, Calif.
There, a woman whose son had recently died of leukemia wondered if Clinton's health care reform plan would have covered the bone-marrow transplant her insurance company had refused to pay for. "Could people make the choice to have a procedure that could be considered experimental, if that's the only choice they have?" asked Shelly Chase.
"In most cases, the answer would be yes," Clinton replied. "The insurer will not take that option away."
However, his draft health plan flatly excludes "investigational treatments" unless they are part of a government-approved trial.
Clinton's wife gave a more realistic answer last month to a Minneapolis woman whose toddler has muscular dystrophy and a life expectancy of 20 years.
"We will not be able ever to fund every new idea or new cure that comes out broadly until it has some proven clinical efficacy," Hillary Rodham Clinton said. "Once it crosses that bridge, then it will likely be covered. But there will always be a period when it is not."
The president cast a misleading light on another aspect of his plan at a town meeting in Tampa, Fla., when he said doctors and patients - not insurers - would determine when it's time to leave the hospital. Yet managed-care plans, which would cover a vast number of Americans under the Clinton scheme, would be under heavy pressure to keep costs down and hospital stays short.
In Los Angeles last week, Clinton promised a group of senior citizens that they would get an array of new benefits. He said overall costs would be kept down, and patients wouldn't feel a thing. And he never mentioned anything they might not like, such as an aide's estimate that a new prescription benefit is expected to cost the elderly $12 a month.
When a man in the audience asked Clinton whether he really believed Medicare cutbacks wouldn't affect recipients, the president replied, "Absolutely." He added later that "the program explicitly provides that none of the benefits can be cut."
If it all sounds too good to be true, it may well turn out that way. Skeptical economists and lawmakers have hard questions about the fiscal foundation of the Clinton plan. Many experts also believe it would result in fewer choices and more expensive care for some people, despite Clinton's assurances to the contrary in one appearance after another.
Health care is not the only area in which Clinton is fostering high expectations. In San Francisco last week, he announced major science, highway and housing projects intended to revitalize the economy of a slumping, politically important state. He then suggested the rest of the country could expect the same treatment.
"What we try to do today for California is what we may be doing tomorrow for the New England region; for the South, where I grew up; or for the Midwest," Clinton said. "Is there any precedent for this kind of effort directed toward a single state or a single region? No, but I want this to set a precedent for my presidency."
The zealous health-care campaign is not surprising, given that Clinton considers reform vital to controlling the federal deficit and instilling security in Americans. But very recent history shows an overzealous pitch could end up as an arsenal for political opponents and a source of bitterness for people disappointed with the results.
by CNB