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Greenberg's Lessons From the Clinton Health Plan

As the high-stakes battle over health care reform gets very serious in Washington, we have a well-timed reminder from TDS Co-Editor Stan Greenberg at TNR today about what happened to the Clinton administration's health reform plan in 1993 and 1994, when he was Clinton's top pollster.

Greenberg stresses the exceptional similarity of public opinion on health care then and now:

Then and now, the country proclaimed its readiness for bold reform. In both instances, one-quarter say that the health care system "has so many problems that we need to completely rebuild it"; half the country sees "good things" in the current system but believes "some major changes are needed." Then and now, about 60 percent of the public feel dissatisfied with the current health insurance system. Yet three-quarters are satisfied with their own health insurance--once again eerily parallel numbers.

And yet again, says Greenberg, cost-containment arguments for universal health coverage will be difficult to make on a macro level, and essential to win on an individual family level, where calculations of the net effect of reform will be made sooner or later.

One ironically positive factor for Obama's health plan is that the fear of losing insurance coverage due to unemployment is higher than it was 16 years ago. Another is that union members, who are often happy with their own health insurance, are feeling a lot more insecure.

But in the end, Greenberg argues, it's the President's advocacy for his plan that most needs to rise to the occasion:

At the moment, the country is tilting toward enacting Obama's reforms, and it will do so more enthusiastically if Obama learns from the Clinton experience and rises to the educative role that he relishes. He must respect the thoughts, feelings and calculations of ordinary citizens who are not easily spun on important issues. People will take out their calculators when he lays out his plan, and he can't avoid speaking candidly about its costs and consequences. And he can't forget that he has a big story to tell about a changed America, one in which health care is but a pile of bricks in the new foundation he is laying.