Analysis: Selling reforms piece by piece

OLGA PIERCE, UPI Health Business Correspondent

WASHINGTON, July 24 (UPI) -- Future healthcare reform packages will be sold to the American public piece by piece, two former presidential press secretaries said Monday, but given the public's growing insecurity about healthcare, it might not be such a hard sell.

Senator Hillary Clinton's, D-N.Y, attempt at healthcare reform as First Lady "taught us that fundamental healthcare reform was going to be difficult to achieve in Washington," said Ari Fleischer, President Bush's former White House press secretary.


"I don't think anyone's going to make a full frontal run at it again," he said, "but it will always be an issue."

"A lot of lessons were learned about how to get things done in this difficult town," agreed Mike McCurry, former press secretary to President Clinton. "Since then, candidates for national office have all had healthcare plans ... but nobody seems to use it to make a really definitive, distinctive issue in a campaign."

The two former White House spokesmen discussed the difficulties in gaining public support for healthcare change at the latest in a series of discussions called Ceasefire on Healthcare. The forums, which bring together representatives of opposing ideological views -- Sen. Hillary Clinton, D-N.Y., and former House Speaker Newt Gingrich once famously shared the podium -- were begun by former Sen. John Breaux of Louisiana to find consensus on healthcare issues.

The failure of Clinton's reform proposals was related to a lot of causes, like a lack of consultation with Congress, public discomfort with the unprecedented policy role for a first lady, and a public relations counter-offensive launched by powerful opposing interests, McCurry said.

But one of the main reasons it did not resonate with the public is that at the time, most felt they could rely on having access to healthcare in the future -- something that is not true today in light of pension renegotiations and the ever-decreasing number of companies offering benefits, he said.

"Even though people recognized a crisis with the uninsured, most people were still satisfied with their own arrangements. Right now, people are very worried they're going to lose the (healthcare) arrangement they have. We're in a very different place now than we were in 1993 and 1994.

"Healthcare is a very emotional issue for people," McCurry noted.

That climate of concern about healthcare is allowing for some progress, Fleischer said, pointing to the Patients' Bill of Rights, Medicare Part D prescription drug benefit and Medicaid experiments currently underway in several states.

It is not a matter of getting the entire minority party to agree, he said, but instead finding enough middle ground to lure a sufficient number of Democrats to get bills passed.

"A lot of chunks are getting done," he said, "the problem is those chunks don't create the same splash as one big failure (of the Clinton plan) that happened nearly 13 years ago.

"Nothing can get passed without some agreement from both parties, but ten, 20 or 30 years from now, no one's going to look back and say, 'What was the margin on that?' They're going to ask 'What did you get done?'"

In today's increasingly polarized political climate, however, that kind of behavior has become less and less common, McCurry said. "There's not a blessed thing that's going to happen in Congress now, because no one wants to give advantage to the other side.

But all is not lost, the panelists agreed.

"There is the potential for compromise here -- a grand bargain," McCurry said. "If that gets codified in some fashion, we can put together elements of reform that will really make a difference."

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