Everybody knows that President Obama has learned the lessons of 1994. But what about the lessons of 1988? That's when the Catastrophic Medicare Act passed with broad bipartisan support, only to suffer a backlash that led to its repeal within two years.
The trouble was that the law didn't offer immediate, tangible benefits, so that seniors started questioning whether the initiative was really worth it--particularly since Congress, in its determination to make the initiative self-financing, imposed both new taxes and premiums.
In order to make sure reform can pay for itself, lawmakers are talking about slowing down implementation, so that the program is not fully on line until 2014. They're also talking about offering fewer subsidies to help people obtain insurance. In a nod to centrists who don't like the idea of too much government, there's a strong push to gut or even eliminate proposals for the public insurance plan, which was supposed to provide security for individuals and competition for private insurers.
The parallels are not exact, but I think there's a lesson here: Make sure health care offers clear, tangible benefits--not only to the poor but also the middle class:
The lesson of the Clinton health care fight is that Congress won't embrace reform if there aren't some compromises. The lesson of the Medicare Catastrophic Care Act is that the public won't embrace reform if it has too many compromises.