Gore's gutsy gambit on health care for all American citizens
Published November 20, 2002
WASHINGTON -- Like a dateless and desperate guy who is calling up a girlfriend about two years late, Al Gore finally is expressing serious interest in single-payer health care. Better late than never. But before we can examine Gore's plan, he has to come up with one.
For the moment, though, it is enough that he has even put the issue on the table. Health care, like the economy and the environment, is one of the big issues onwhich polls show most voters look to Democrats for the best answers.
Yet Democrats oddly avoided these issues and just about every other galvanizing theme in their recently disastrous midterm election campaigns.
So while many Democratic activists consider a second Gore presidential campaign to be about as exciting as yesterday's pizza, a larger percentage of rank-and-file Democrats think the former vice president deserves a second chance, especially if he can arouse Democratic impatience with the Bush administration.
And besides, with less than a year to go before 2004 campaigning starts getting serious, no other likely Democratic contender comes close to Gore in the polls.
So you can't blame the guy for seizing an opportunity when he sees it.
Basically, single-payer coverage would collect insurance premiums or tax dollars in a single agency, which would pay for comprehensive coverage for all citizens. Canadians have a form of it and it constantly rankles conservatives and the health-insurance industry. They talk a lot about Canadians who come here for health care. They talk very little about Americans who go to Canada for cheaper drugs. Canada's program has its problems, and while there have been many moves to improve it and even privatize parts of it, there have been few moves to scrap it.
Centrist Democrats, of which Gore has been a leader in the past, along with the Clintons, have been scared of it. Sounds too much like socialism, they say. But so did Social Security, Medicare and Medicaid, which have been some of the government's most popular programs during much of the past half-century or so.
So, now, as Gore ponders whether to run again, he has broken "reluctantly" with his former centrist position on health care. In front of several hundred people in a Manhattan synagogue on Nov. 14, Gore said that he has decided that single-payer is the best solution to the nation's health-care crisis.
More details to come, Gore spokesmen said, along with Gore's announcement of whether he is running for president. In the meantime, he is behaving like a man who plans to run, including doing a stint as host of "Saturday Night Live," a leading platform for reaching that coveted late-night youth vote.
Health care is no laughing matter for 40 million Americans who don't have coverage. Nor is it a laugh riot for those who were frightened away from government intervention by the "Harry and Louise" TV ads in the early 1990s that warned of rationed health care.
Instead, growing numbers of covered Americans are receiving a different form of rationed health care in the name of "managed" health care.
So, if Gore, a former newspaper reporter, is as smart as he needs to be to win this time, he will remember the four initials countless editors have passed on to young reporters: "K.I.S.S. --Keep It Simple, Stupid."
First, he should stop using the clunky term "single payer" to describe his plan. Nobody except for us news junkies and policy wonks knows what that means.
Instead, he should describe it as a simple expansion of Medicare to cover everybody. Medicare is a program most Americans understand comfortably and want to keep. Building on that popularity and comfort level, many experts over the years have advocated expanding Medicare to cover everyone, regardless of age.
Of course, funding and administering a health plan to cover all Americans will be anything but a simple matter. But to start a national dialogue, grand ideas must be expressed in simple terms.
At least Gore is giving voters something serious to think about. I hope he keeps it up. Americans deserve to have a choice, not an echo. That was a slogan of conservative Republicans in the 1960s. They made a comeback. So can the Democrats--if they offer Americans something worthwhile to choose.