“I want to be a President who again sets goals for our country,” Hillary Clinton told a ballroom full of supporters at the midtown Hilton on Monday morning. “Here at home, I want to set the goal of universal health-care coverage.”
The fact that Mrs. Clinton puts health care at the very top of her eventual to-do list—more than a dozen years after her disastrous first attempt to overhaul the country’s health-care system—is no small matter.
But just when and how she should do that has been a source of debate among Mrs. Clinton’s campaign staff and advisors, who are worried not only about their candidate’s complicated history with the issue, but about being outflanked by the health plans of her rivals.
That all changed last week, when Mrs. Clinton’s closest rival, Barack Obama, presented his plan.
Mr. Obama’s proposal, in the form of his much-anticipated first major policy address, had much to recommend it to liberal proponents of health-care reform. But unlike the plan unveiled by John Edwards—and the one Mrs. Clinton is expected to present some time in the coming weeks—it lacked one thing: a cut-and-dry requirement that all Americans have health insurance.
Suddenly, Mrs. Clinton had an opening. “She does have an opportunity now to really distinguish herself,” said Dr. Irwin Redlener, a professor at the Mailman School of Public Health at Columbia University and an advisor to Mrs. Clinton on health-care policy. “It’s going to be universal. I don’t know how the mandates will be expressed, but there will be absolutely no ambiguity about the universality.”
Other, more politically neutral experts agreed.
“If Obama was exactly where Edwards was, then it really would be more difficult for her to have something slightly more moderate,” said Robert Blendon, a professor of health policy and political analysis at the Harvard School of Public Health. “So she has room to go on either side here.”
Mrs. Clinton will roll out her next health-care proposal, focusing on the quality of care, later this month, according to Dr. Redlener. Some components of that proposal, he said, would include expanding the use of electronic patient records to reduce life-threatening medical errors, such as different doctors prescribing potentially incompatible medicines to the same patient—a defect in care more common with older people who visit many specialists. Dr. Redlener said he also expects Mrs. Clinton to propose a dramatic change to the current incentive system by rewarding doctors and hospitals for keeping patients healthy rather than compensating them for the number of tests or surgeries they performed.
She will address the question of universal coverage later. According to Dr. Redlener, that, too, has been a subject of animated back-and-forth within the campaign.