Clinton's Plan: DOA?

For a man who was watching two years' work go down the drain in about 48 hours, Ira Magaziner, the architect of Bill Clinton's health-care reform plan, had a strangely delighted air at the White House senior staff meeting last Thursday morning. The afternoon before, the Business Roundtable, a group of corporate executives, had supported the alternative plan drafted by Congressman Jim Cooper of Tennessee. In a few hours, the U.S. Chamber of Commerce would use harsher language to reject the Clinton approach. Earlier in the week, Clinton offered to trade away two key elements of Magaziner's design in order to win support from Republican Governors. But through it all, Magaziner was upbeat. Clinton, he reported with a tone of mock confidence, was at a prayer breakfast across town with religious leaders. "After 14 hours of protracted negotiations," he joked, "Mother Teresa will not endorse the Cooper bill."

It's easy to see why Washington has shied away from health-care reform for generations. Not even the eternal optimists at the Clinton White House, where the grand strategy of keeping intact as many provisions as possible for as long as possible has more or less collapsed, were prepared for the theatrical skirmishing that surrounded the unofficial start of the congressional health- care marathon. Clinton and his aides struggled last week to maintain their footing as business groups ridiculed the plan, the Governors stopped short of a full endorsement, and new questions emerged about who would pay more under the President's approach. Clinton, who in his State of the Union speech acknowledged that most of the details were negotiable, dismissed the opposition as a natural part of the legislative process. "I wouldn't read too much into it," he said. But as one West Wing official put it, "It's been a bad couple of days."

Some of the damage, typically, was self-inflicted; Clinton suffered another attack of premature capitulation. (He had a bad bout of it last year during the budget fight, junking his proposed BTU tax at the first sign of protest and backing off grazing-fee increases when Western Senators threatened to stampede.) The latest relapse hit, not coincidentally, when the National Governors' Association met in Washington last weekend. Clinton considers himself a lifetime member of the N.G.A. and sometimes forgets that Governors are not as important to him now, compared with members of Congress. In White House meetings, Clinton stunned allies when he hinted to his former colleagues that he was willing to cave on two central, and controversial, provisions of his reform plan: the spending caps on insurance premiums, and the large purchasing pools known as alliances that are designed to help drive down costs.