Unveiling Health Care 2.0, Again





Rarely does a politician, a party or a political system get a chance at a do-over.

Yet when Senator Hillary Rodham Clinton rolls out her comprehensive health plan in Iowa on Monday, it will be just that: Mrs. Clinton, or whoever the next president might be, has a second chance to fix a system that has, in many ways, deteriorated in the 14 years since the Clintons’ last attempt at an overhaul....

It was almost inconceivable, in the spring of 1993, when nearly three-fourths of Americans said they supported the Clinton plan and political consensus seemed easily within reach, that everything would collapse in the end.

The Democrats, and especially Mrs. Clinton, promise that this time will be different. Like Vietnam, the failure of the last health initiative has been endlessly analyzed by those who lived through it, and its proponents say they have learned some lessons. First and foremost: That the last plan was doomed when middle-class Americans came to see it as more risk than benefit — a 1,342-page restructuring of the health care system, creating vast and confusing new bureaucracies, in an effort to extend benefits to everyone.

Those fears were symbolized by Harry and Louise, two nervous 40-somethings created for a devastating advertising campaign by the insurance industry. Between 1993 and 1994, support for the Clinton plan dropped to 43 percent from 71 percent, according to Robert J. Blendon, a Harvard professor and expert on health. The plan literally lost the support of the middle — the middle income, the middle aged, political independents.

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