President Obama hosts the White House Forum on Health Reform Thursday. The last time Democrats tried to overhaul the nation's health care system was in 1994.
That's when, with a Democratic majority in Congress, President Bill Clinton laid down a challenge in his State of the Union address: "If you send me legislation that does not guarantee every American private health insurance that can never be taken away, you will force me to take this pen, veto the legislation, and we'll come right back here and start all over again."
Clinton never had to veto a health care bill because Congress never sent him one. The Clintons' health care reform effort failed.
A veteran of that fight says 15 years later things have changed. Chip Kahn, the president of the Federation of American Hospitals, says, "The environment is much different. It's different economically. I think, it's different politically."
In 1993, Kahn ran a health insurance trade association that sponsored the famous Harry and Louise ads attacking the Clinton plan. He will be at the White House summit.
Also at the meeting will be Karen Ignagni. She is president and CEO of America's Health Insurance Plans, a trade association representing the nation's health maintenance organizations. She says her group has moved to a different place politically. "We opposed the plan that was introduced 15 years ago, and we did so because we were very concerned about the role of government in that plan," she says. Ignagni's group now wants to help craft, not kill a health reform bill.
Obama is selling his health care overhaul as a fiscal imperative, not just a moral imperative: "The crushing cost of health care causes a bankruptcy in America every 30 seconds; and by the end of this year, it could cause 1.5 million Americans to lose their homes. It's a crisis punishing families, battering businesses, squeezing our states, and increasingly, imperiling our own budget."
This White House is not demonizing the health insurance industry. Instead of sending a 1,342-page bill to Capitol Hill, the way first lady Hillary Clinton did in 1993, it has sketched out a minimalist plan and is letting Congress take the lead.
The White House is careful to say it is open to any ideas that meet its goals of controlling costs, improving quality and expanding access. That even includes a John McCain idea that Obama attacked during the campaign: reducing or eliminating the tax break for employer-sponsored health coverage. It's a sign that all the players are — at least for the moment — trying to see how long they can stay at the table together.