
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: THURSDAY, August 11, 1994                   TAG: 9409090009
SECTION: EDITORIAL                    PAGE: A16   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium

PROFILES IN PASSIVITY

PRESIDENT Clinton's health-reform plan - at least in its original form, whatever that was - is said to be dead, and the prognosis isn't looking especially rosy for either of its chief substitutes, Senate Majority Leader George Mitchell's bill and House Majority Leader Richard Gephardt's.

We're not ready to give up hope quite yet. But neither, at this point, are we holding our breath until health-insurance coverage becomes a fact of life for all working Americans. Or until universal coverage is a force for the preventive medicine that helps forestall the need for costly acute care. Or until the playing field is leveled between employers who provide health insurance and those who don't. Or until the insured - particularly those lacking negotiating clout with insurers - will be relieved of having to subsidize the health-care costs of the medically indigent. Or until inflation in health-care costs comes under control.

The diminishing prospects for Clinton-style reform, as columnist Ray L. Garland writes on today's Commentary page, can be attributed to lack of popular support for the cause, to missteps of a president who entered office with 43 percent of the vote in a three-way race, and above all (in Garland's view) to the sheer complexity of the health-reform task.

Yet the cause was popular enough a year ago for a number of congressional Republicans to board, and in some cases to lead, the health-reform bandwagon. And the task of achieving universal or near-universal coverage is not so complex that other industrialized nations - not to mention the state of Hawaii - have failed to do it.

For more explanation, look in part to politicians more intent on placating and pandering than on leading. Indeed, look to the Virginians in Congress. Of the state's two U.S. senators and Southwest Virginia's three U.S. representatives, only Democratic Sen. Charles Robb isn't opposed to his chamber's leadership bill - and Robb's position on Mitchell's measure, that it contains elements necessary for passage, seems less endorsement than analysis.

Firmly in the GOP naysaying mold are Republican Sen. John Warner and 6th District Republican Rep. Robert Goodlatte. Warner favors portability, "freedom of choice" of physician, small-business relief and insurability of pre-existing conditions. He opposes new taxes and employer mandates. That's akin to making Fight Tooth Decay Day a part of National Candy Week.

As for the region's Democrats, 9th District Rep. Rick Boucher opposes the Gephardt bill for a shameful reason: because its proposed 45-cent-a-pack tax increase on cigarettes is "unfair and disproportionate" - as if tobacco were not a proven health menace. (Maybe it was the yogurt instead?) Fifth District Democrat L. F. Payne, who in committee fought to cut the proposed per-pack cigarette-tax increase from 75 cents to 45 cents, opposes the Gephardt bill because it contains employer mandates. (Anybody for jumping the cigarette-tax increase back to 75 cents?)

But you can't simply blame the politicians. Clinton has mismanaged the effort, but few have rushed to his aid. And the Virginia members of Congress aren't frauds or fools. Their positions on health-care reform, and the reasons for them, are telling reflections of what ails America's political culture today. One sympton: a fickle public opinion vulnerable to hysteria campaigns mounted by special interests protecting their piece of health-care profits.

by CNB