Hillary Clinton is smarter than her rivals in many ways, and a good example would be her approach to health care. As Barack Obama and John Edwards promote massive reform plans that would require major tax increases and wrenching changes in how many Americans obtain medical services, Clinton is proposing smaller-scale programs that make political sense in the short run and policy sense (from her perspective) in the long run. The Associated Press attributes Clinton’s reticence to the failed 1993 reform, which is certainly true up to a point, but leaves out why large-scale reforms fail. Americans may talk in abstract terms about the need for change in the health care system, but most are not dissatisfied with their own arrangements and providers, they are not willing to give up access and convenience, and they will not stomach major tax increases to subsidize lower-income recipients of a new federal program.
Clinton still has the same goal, but decided more than a decade ago to approach it through gradualism (the State Children’s Health Insurance Program, Medicaid and Medicare expansion, benefit mandates, etc.) Gullible, clueless Republicans have played right along. Full-blown health care socialism will come not with a bang, but a whimper.