Careful Hillary

Sen. Hillary Rodham Clinton’s (D-N.Y.) return to the subject of healthcare 14 years after she tried reforming the system for her husband’s administration brought inevitable jeers.

Democratic presidential rivals took largely ineffectual shots, saying “the real key to passing any healthcare reform is the ability to bring people together. …” (Sen. Barack Obama, D-Ill.), and “the cost of failure 14 years ago …” (former Sen. John Edwards, D-N.C.).

Leading Republican hopefuls were more pithy — dubbing her proposal “Hillarycare 2.0” (former Massachusetts Gov. Mitt Romney) and “Hillarycare Redux” (former New York City Mayor Rudy Giuliani) — but had the same purpose as the Democrats: to remind voters of the nadir of Clinton’s policymaking career and suggest, as Ronald Reagan might have put it, “There she goes again.”

But neither the plan nor the criticisms yet amount to much. Clinton offered scant detail except that she would try to avoid the compulsory aspects (and, therefore, the political doom) of her 1993 plan, and would pay for it by raising taxes via the sunset of President Bush’s tax cuts.

Mostly, however, the senator’s proposal was a necessary first step in rehabilitating her public image in an area of government that is properly of great concern to voters. Clinton could not get from here to November 2008 without laying out her views on healthcare, and it was certainly better to do so sooner rather than later.

She is certainly right to believe that the system needs reform, just as President Bush was right in 2005 that the Social Security system needed fixing. The fiscal crisis in healthcare is five times the size of that in Social Security, but both are unsustainable. With 78 million baby boomers due to retire in the next 20 years, with health costs rising twice as fast as inflation, and with America spending twice the proportion of its economy on healthcare as other developed nations, there is an urgent need for a better system.

No politician who ignores the issue deserves to be taken seriously as a presidential candidate. It is long since time that a genuine leader made Congress and the public stop writing unredeemable IOUs issued in the name of their children and grandchildren.

David Walker, head of the Government Accountability Office, is touring the country trying to drum this message into the heads of his fellow citizens by saying things such as, “I’m going to show you some numbers … they’re all big and they’re all bad.” But it’s so much easier for politicians to avoid such difficult subjects and offer warm reassurances rather than details to address adamantine facts.

The test for Clinton’s proposal, as for all healthcare fixes offered by candidates who claim they have the right stuff to be in the White House, is whether it is genuine reform or just another crushing fiscal burden being laid casually on the shoulders of the nation’s future.