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- <text id=94TT0126>
- <title>
- Jan. 31, 1994: The Political Interest
- </title>
- <history>
- TIME--The Weekly Newsmagazine--1994
- Jan. 31, 1994 California:State of Shock
- </history>
- <article>
- <source>Time Magazine</source>
- <hdr>
- THE POLITICAL INTEREST, Page 87
- PAT'S HEALTHY GRIPE
- </hdr>
- <body>
- <p>By Michael Kramer--With reporting by Janice Castro/New York
- </p>
- <p> Slowly but surely, Bill Clinton's health-care plan is headed
- for the triage unit. Joining the growing list of doctors, economists
- and business leaders voicing objections to Clinton's proposals
- is Pat Moynihan, the influential chairman of the Senate Finance
- Committee. The Senator is quick to qualify his recent bombshell--"I regret having said there is no health-care crisis in America;
- there's a health-care insurance crisis"--but his modified
- critique of Clinton's plan offers the President scant comfort.
- </p>
- <p> Like Clinton, Moynihan wants a system that provides universal
- coverage, a scheme that will guarantee quality health care regardless
- of a person's income or employment status. The question is how
- to pay for it. "The linchpin is the employer mandate," says
- Deputy Treasury Secretary Roger Altman. "Without it you can't
- have universal coverage." Put simply, the Administration would
- force most employers to pay 80% of the cost of health insurance
- premiums. Workers would cover the rest. But small companies,
- and an increasing number of medium and large ones, contend that
- such mandates could bankrupt them. In an attempt to accommodate
- these concerns, the White House proposes 15 separate rates of
- medical-premium costs determined by company size and employee
- wages. These differences, Moynihan argues caustically, could
- cause a "massive shift" in U.S. employment patterns as companies
- replace full-time workers with part-timers and free-lancers,
- a tactic companies would embrace in order to shift a greater
- share of health-care costs to the government--which couldn't
- afford it without significant tax increases.
- </p>
- <p> "We don't envision any wide-scale switch away from full-time
- workers," counters Altman, "and trying to game the system by
- making full-timers independent contractors won't work. If you
- get 80% of your income from a single source, you can't qualify
- as an independent contractor under IRS rules, so you'd be covered
- for health care by the employer mandate." Yes, says Senate Finance
- Committee chief of staff Lawrence O'Donnell, "the IRS forbids
- tax dodging of any kind--but taxes are avoided just the same.
- The Administration thinks its health plan outfoxes every conniving
- operator out there, but who can seriously believe that?"
- </p>
- <p> At the very least, the desire to foreclose the kind of outcome
- Moynihan fears virtually guarantees that universal coverage
- would be phased in slowly--if it happens at all. "But we wouldn't
- cry about that," says a senior Administration official. "The
- President can still declare victory as long as universal coverage
- is promised at some point." Yet Clinton's plan could stall completely
- unless Moynihan's worries about the "collateral consequences"
- are addressed. Inexplicably, Moynihan and Ira Magaziner, the
- Administration's health-care guru, have yet to talk about employer
- mandates. "We want to get everything in order first," says a
- White House aide, who predicts the bipartisan Congressional
- Budget Office will "shortly endorse our financing assumptions"--an optimism other Administration officials don't share. The
- problem, says Moynihan, is that "anyone who thinks [the Clinton
- plan] can work in the real world as presently written isn't
- living in it."
- </p>
- <p> Where will it go from here? Moynihan seems charmed with a new
- approach being developed by Yale's James Tobin, a Nobel laureate
- in economics. No one will say what's coming, but "it can't be
- much," sniffs an Administration official. "Tobin's a great economist,
- but he doesn't know health care." Perhaps so, but it's the politicians
- who will fix America's health-care system, and dismissing someone
- Moynihan respects is a prescription for even more trouble than
- the President's plan already faces.
- </p>
-
- </body>
- </article>
- </text>
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