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So to govern as he ran, as a centrist who can help create tools to improve American lives, Clinton will have to stop talking about compromise and begin forging it. He could begin by staking out bold positions on the thorniest problems he can actually do something about: reforming Medicare and Social Security, the middle-class entitlement monsters that will consume the budget if left unchecked. According to research conducted for the centrist Democratic Leadership Council by Clinton pollster Mark Penn, "more than 85% of voters would favor Clinton's making Social Security and Medicare reform his second-term priority.'' Clinton shows no sign of doing so, because he believes that taking a position merely invites partisan attack. Sniffs one of his advisers: "'Bold' is a journalist's trap." What would T.R. say about that?
Clinton's risk-averse strategy was on display last week as his approach to Medicare reform began to emerge. To an urgent problem--the hospital trust fund is due to go bankrupt in about five years--he is expected to offer a nonsolution: the accounting gimmick of moving home-health-care costs out of the hospital fund and paying for them with general revenues.
The gimmick is the key to Clinton's slick Medicare math. It's true: he will offer somewhere between the $124 billion in Medicare reductions he proposed in 1995 and the $168 billion, one of several figures the Republicans suggested. But the first $80 billion to $100 billion in cuts are relatively easy to find, says Medicare trustee Marilyn Moon. They come from shaving Medicaid payments to doctors and hospitals and reducing the fees paid to managed-care companies for the 5 million Medicare patients who have enrolled in those plans. (These cuts are made possible because the market itself has begun to rein in health-care costs.) After that, the options start to draw blood: they include means testing, hiking premiums and capping payments. Instead of considering these fixes--and making a real attempt to avert the looming crisis--Clinton will resort to his trick of moving money around. Republicans will howl, but the White House isn't terribly worried about that. The math is too complicated to get people's attention, Clinton aides say, and anyway the Republicans are too damaged on the Medicare issue to make the case after being hammered last year by Clinton's relentless "Mediscare" campaign. Besides, his advisers argue, adding five years to the life of Medicare is accomplishment enough, since the program has for decades teetered on the brink of insolvency. While that's a bit like saying, "I can bounce checks because my daddy did," it's the best Clinton--and Congress--seem willing to do. So, instead of taking a position, the President will appoint a bipartisan commission. Bully!