Just say no to 'Clinton lite'

WHEN it comes to health-care reform, Bill Clinton has certainly united the country. It isn't even 11 months since he urged Congress to overhaul the existing system, and already a majority of Americans agree: Clinton is wrong.

Evidence is plentiful. Those bus caravans that set out for Washington from all over the nation this week expected to build momentum for a Clintonian health-insurance plan. What they accomplished was the reverse. Everywhere, they were greeted by crowds of protesters dead set against ClintonCare. Opponents gathered at Faneuil Hall, where Hillary Clinton appeared on Sunday. They were at the First Unitarian Church in Louisville, Ky. They were in Portland, Ore. In Arlington, Texas. In Topeka, Kan.

When the president met up with the buses in Liberty Park, N.J., and Independence, Mo., dissidents were cordoned off several blocks away. Even from that distance, they got on Clinton's nerves. Blasting them in New Jersey as "demagogues," Clinton grew so agitated that he pounded his lectern with such force he knocked the presidential seal to the ground. Now there's an omen.

For months, polls have traced Clinton's evaporating credibility on this issue. According to the latest CBS/New York Times poll, 50 percent of the public disapproves of Clinton's performance on health care. The NBC/Wall Street Journal poll finds 52 percent disapproving. CNN/Gallup, 59 percent.

This is why Democrats, anxious to pass some version of ClintonCare before they lose their working majority in the House of Representatives this fall, insist fervently that their health-care plans aren't Clinton's plan.

Representative Martin Meehan of Massachusetts is one of many Democrats who have taken up the chorus:

"The Clinton health care plan is dead," he said on television Sunday. "The Clinton plan is not even going to come up for a vote before the Congress. It's over. It was perceived by the American public as too bureaucratic. Just having the name 'Clinton' on it caused all kinds of problems. It's over. There will be no vote on it. It's dead. It's dead."

Well, not quite. True, the plans unveiled this past week by the Democratic leaders in the House and Senate -- Representative Richard Gephardt and Senator George Mitchell -- don't include the byzantine maze of new government agencies the original Clinton bill proposed. But at bottom, the Gephardt and Mitchell plans are merely "Clinton Lite" -- slimmed-down versions of the Clintons' 1,342-page original.

Both raise taxes. Both establish expensive new entitlements. Both impose new mandates on employers, either right away or eventually -- which means both make it more expensive to hire a new employee, which means both kill jobs. Both dictate some form of price controls. Both limit individuals' freedom to choose. And both proceed from the myth at the heart of the Clintons' scheme: That the number of uninsured Americans represents a "crisis" that only government intervention can solve.

Frankly, no law can compel universal coverage. Forty-one state laws mandate universal auto-insurance coverage for drivers, yet one in seven motorists is uninsured. Hawaii has had a universal health insurance law for 20 years. Nevertheless, between 6 and 11 percent of Hawaiians remain uninsured. But they don't add up to a "crisis," and neither do the 38 million other Americans who don't have health insurance.

I should know. I'm one of them.

When I left a job earlier this year, my health insurance didn't travel with me. My new employer -- this is not uncommon -- doesn't provide insurance until a new hire has been on the payroll for several months. If I had been willing to pay the full cost out-of-pocket, I had the option of maintaining my old insurance policy until a new one kicked in. But the price was something like $ 275 a month, and I decided it wasn't worth it.

My case is typical of the uninsured. We're mostly healthy, mostly young (under 35), mostly working, mostly not going without health care, and mostly going to be insured within a few months. Above all, we're mostly uninsured at present because of a change in job status.

I lost my insurance because I wasn't responsible for buying it in the first place: I got it through my employer. That is precisely what's wrong with the existing system -- the linking of one's health insurance to one's job. It explains nearly all the horror stories the Clintons like to tell. And it is a problem the Clinton plan and its Democratic progeny would only entrench.

The explanation, and the remedy, lie in the tax code. US tax laws grant employers a full deduction for providing insurance to their employees. That $ 86 billion subsidy generates a powerful incentive for workers to let their employers buy insurance for them. But it also generates a steep "insurance penalty" for the self-employed, the unemployed, those working for very small firms, and those between jobs.

Real health reform starts with tax reform. Take the deduction away from employers and give it to employees instead. Make individuals responsible for arranging their own insurance -- and let them enjoy the tax benefit. Set up refundable tax credits or vouchers to enable even low-income workers to buy insurance.

At once, the incentives would change. Nearly all citizens would buy insurance, because it would be to their financial detriment not to. All would be free to choose the level of care they wanted. Most important, nobody's insurance would hang by the thread of their boss' whim.

Intelligent reform is possible. But it means getting over the "universal" obsession. And it means saying no to Clinton Lite.

(Jeff Jacoby is a columnist for The Boston Globe.)