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It took a while for G.O.P. leaders to warm up to a campaign that not only violates the party's core aversion to Big Government fixes but also alienates the business interests that are the party's political and financial lifeblood. Senate majority leader Trent Lott and whip Don Nickles put out the word last October that their party was on the side of the insurers, and it was time to strike back. "The message we are getting from House and Senate leadership is that we are in a war, and need to start fighting like we're in a war," an insurance-industry lobbyist wrote in a memo to her boss. When Clinton released his recommendations for legislation weeks later, the leaders issued a statement warning, "We should not allow the President to do through the back door what failed through the front door."
Defiant talk in Washington, however, was little comfort to Republicans who saw how well the issue was playing on the campaign circuit. Democratic attacks caught them unawares in special elections in California and New Mexico. John Linder, who chairs the House Republican campaign committee, warned G.O.P. candidates that while strangling the tobacco bill wasn't hurting Republicans, giving aid and comfort to the managed-care companies would. So G.O.P. candidates have been taking cover where they can find it. In the House, Norwood counted 90 Republicans among the 232 sponsors of his reform legislation; in the Senate, no less a bulwark of the right than North Carolina's Lauch Faircloth climbed aboard a similar bill when his challenger began claiming the Senator was in the pocket of insurance companies (see box).
By the time House Republicans announced the broad outlines of their bill two weeks ago, the party's leaders were scrambling to catch up with their own members. However late, their still-to-be-written bill was the tactical success they needed as lawmakers returned to face their constituents over the July recess. It put the party on record with an alternative to Clinton's bill while silencing more liberal proposals within the party's membership. It also set the formidable Clinton message machine off balance for a news cycle or two. Clinton senior adviser Rahm Emanuel was hailing it as "a pleasant surprise" even as Vice President Al Gore was dismissing it as nothing more than "a bill of goods." And it got just enough criticism from the insurance industry, which called it "a mishmash of cobbled-together ideas that are guaranteed to raise consumers' costs, reduce choice and generate more federal bureaucracy," to sound credible with everyone else. Still to come is a Senate plan.
If what both parties really want is a deal, it is not difficult to find one in what is already on the table. Both Clinton and the Republicans would give patients new outside avenues for appeal when their health plans deny them care, more information to help them select doctors, and assurances that they won't be stuck with the bill when the chest pains that send them to the emergency room turn out to be indigestion. Women are guaranteed the right to see a gynecologist; doctors, the right to advise their patients when expensive new procedures are better than the ones allowed under their health plan.