Open mouth, insert foot

Bill Clinton possesses great command of policy. He prefers to speak extemporaneously. And he knows how to connect with an audience by using everyday terms in a casual and conversational way.

It amounted to winning politics for him back in the day. But it resulted in awkward and perhaps damaging politics last week for his wife, Hillary, who is so close to the presidency that she can taste it.

It might help her close the deal if, for the next few weeks, her husband would emulate Donald Trump and start reading campaign-vetted words from a teleprompter.


Last week Bill was speaking in Flint, Mich., when he commenced riffing on health insurance. He started explaining the issue as only he can.

Hillary, he said, had done a good job when he appointed her to lead a reform effort. But the special interests and the Republicans blocked her, he lamented. Then, he said, the health insurance market grew steadily more volatile, expensive and unfair.

Then the Obama administration pushed through the current reform, which, Clinton said, had worked well by expanding Medicaid for the poorest, subsidizing private premiums for the low-middle class, preserving Medicare for seniors, and smartly relying on the employer-based group system.

But the problem, Bill said, is with people not on Medicaid, not on Medicare, not on company group plans and making too much money to qualify for the premium subsidies for individual policies purchased on Obamacare exchanges.

He mainly meant small-business people and the self-employed and sole proprietors. They have been left to shop without subsidies on the exchanges for policies with premiums that have risen sharply and which threaten to continue rising sharply as some carriers have pulled out of exchanges in some states.

Sensing his audience connection, Bill improvised, as is his wont, to say those nonsubsidized individual buyers were working 60 hours a week to pay higher prices for less coverage.

He called what he'd just described the "craziest thing in the world."

Two things: (1) These people indeed might be getting less coverage in terms of their out-of-pocket costs, though not in benefits, if they are opting for the highest-deductible policies on the Obamacare exchanges, and (2) Clinton did not say what Republicans leapt to assert that he'd said, which was that Obamacare was the "craziest thing in the world."

Clinton said that the treatment of people falling in the gap he had described--an element of Obamacare--was the craziest thing in the world.

That's not hard to understand. For generations we've accepted that a bad apple doesn't spoil the bunch.

What he was saying in an impolitic and colloquial fashion was what President Barack Obama and Hillary have been saying more cautiously. It is that Obamacare needs a fix or two, like anything else, and that adding a "public option" to the exchanges, meaning a government plan, would be a good idea.

But Republicans won't even entertain a thought about fixing any marginal element of Obamacare. They remain strung out on promises to irrationally enraged constituents to repeal all of it.

Actually, Hillary's plan is two-fold. It is to provide federal tax credits to insurance-buyers in the gap her husband described. Then it is to add the government plan to the exchanges to compete for business with the private plans.

That could be as simple as allowing those left-out persons, regardless of age, to pay a simple buy-in rate to participate in Medicare. It could be to establish a new and separate federal insurance pool, one that presumably could use its leverage to hold down provider costs and produce a more stable premium.

That conceptually would lead to lower and less volatile private premiums as well.

Conservatives and Republicans will resist because they oppose public-private competition except when they don't, such as in regard to public schools. They also fear that a public health insurance option in the exchanges would overpower private plans and lead the nation ever closer to full government health care.

But that's a debate for another day, one that depends on Hillary's election. We have no good idea what Trump's election would do for, or to, health insurance or, for that matter, life as we know it.

In the old days, when the parties worked together, members of Congress would accede to laws and fix the inevitable problems in the more complex and sweeping of them.

But this is a strange new day, when, among other oddities, a former president can speak recklessly in regard to the signature program of a successor of his own party, and, in the process, throw for a loop his own better half's presidential campaign.

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John Brummett, whose column appears regularly in the Arkansas Democrat-Gazette, was inducted into the Arkansas Writers' Hall of Fame in 2014. Email him at jbrummett@arkansasonline.com. Read his @johnbrummett Twitter feed.

Editorial on 10/09/2016

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