Let's Play Doctor

Politicians of both parties say managed care is an increasingly hot issue. The question now: Will they just fight over it or actually try to do something?

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You have probably never heard of Robert A. Bonifas, but you may be seeing a lot of him in the next few months. Bonifas, the owner of an Aurora, Ill., burglar-alarm company, is the star of a 30-sec. spot that the HMO industry is considering rolling out across the U.S. this summer to keep Congress from imposing new regulations on them in a burst of election-year populism. "We work hard to make people safer, and we work hard to offer our employees health insurance," Bonifas says in rich Middle American earnestness. "Higher health-insurance costs may not be a big deal to some politicians, but to our employees and their families, it's a very big deal." The camera scans Bonifas and his office of contented, healthy workers, toiling away as a message on the screen warns that Washington could leave 2 million people like them without health insurance. "When politicians play doctor," a voice concludes, "real people can get hurt."

So can politicians. In 1994 President Clinton learned what happens when government tries to do too much, and almost lost his presidency over it. When that disaster propelled the Republicans into control of Congress for the first time in 40 years, they tried to go too far in the other direction, with a proposal to cut Medicare-spending growth so they could raise money for tax cuts. That forced the 1995 government shutdown that put Clinton back on top of the game. Thus it would be understandable if neither party ever wanted to go near the issue again.

But in this season of contentment, the calculation in Washington is that managed care, and its shortcomings, may be the only issue compelling enough to get voters to look up from their barbecue grills. Just back from his trip to China, Clinton plans this week to step up his road campaign for the measure he calls a Patients' Bill of Rights, which would offer a wide new array of protections to the more than 150 million Americans in managed care. House Republican leaders, though late to the issue, are offering a proposal identical to Clinton's in many respects. What remains to be seen is whether politicians are serious about passing a law or would just as happily settle for a campaign slogan.

That there is a new opportunity for action is largely due to an irony that Hillary Clinton would surely appreciate: much of what people feared from her massive and intrusive health plan has actually come to pass without it. Americans gave the private sector a chance to come up with an answer, and it turned out to be not so different from the one government was accused of offering four years ago: a big, complicated bureaucracy. While most Americans with health insurance say they're satisfied with their coverage, 35% of those surveyed in a TIME/CNN poll complained about the growing hassle involved with their coverage, and a wide majority expressed support for such reform proposals as the right to choose one's own doctor (79%) and the right to appeal HMO decisions to a neutral third party (70%).

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