The Obama Health-Care Express is underway

What Democrats learned from the fall of HillaryCare

A charismatic Democratic President takes office promising to extend health insurance to all Americans. His party enjoys majorities in Congress, and the GOP is at sea. The press corps finds policy a bore and instead files stories that draw facile analogies to the heyday of FDR. Yes, all that will be true next year -- but it was also true in January 1993. Fewer than two years later, the grand health-care ambitions of Bill and Hillary Clinton were reduced to tatters. No one is more attuned to this memory than today's Democrats, who aren't about to let history repeat itself. And since the lessons they learned from the HillaryCare fiasco are political, and not substantive, they are already moving full-speed ahead.

This mentality is nicely captured by Tom Daschle, the former Senate Majority Leader who Barack Obama has tapped to run Health and Human Services. "I think that ideological differences and disputes over policy weren't really to blame," he writes of 1994 in his book "Critical," published earlier this year. Despite "a general agreement on basic reform principles," the Clintons botched the political timing by focusing on the budget, trade and other priorities before HillaryCare.

President-elect Obama will not make the same mistake. Congressional Democrats are already deep into the legislative weeds, while Mr. Daschle is organizing the interest groups and a grassroots lobbying effort. Mr. Obama may be gesturing at a more centrist direction in economics and national security, but health care is where he seems bent on pleasing the political left.

According to Mr. Daschle, because of the Clintons' hesitation, "reform opponents succeeded in confusing and even frightening Americans about what change might mean," and this time the Democrats mean to define the debate. Consider the December 2 letter to us from Senator Max Baucus, who is upset that a recent editorial on his health-care plan did not use his favorite terms of art (his style being surrealism). "It will require affordability, but premiums will not be set," he writes. So the government will merely determine "affordability" -- which might as well be the same thing.

Much as Mrs. Clinton insisted that her health bureaucracies were "alliances," Mr. Baucus says his new entitlement "will not be 'managed by the government,' but by an independent council of Presidentially appointed health-care experts." The Senate Finance Chairman wants us to believe that a government commission to determine benefits and subsidies will somehow be above politics.

Shrewder moves are being made to co-opt should-be opponents. The Clintons decided to go to war with "proponents of the status quo," as Mrs. Clinton put it in a bare-knuckled speech in May 1993. This meant vilifying business, especially insurance companies guilty of "unconscionable profiteering" and even drug makers like Merck, which Mr. Clinton had courted during his campaign. This time, Democrats are trying to seduce business with subsidies and other bribes.

They may succeed, which is no surprise given that many corporations would be only too happy to dump their health liabilities on the government. The "Divided We Fail" coalition, which advocates "universal" coverage, includes not only usual suspects like unions and AARP but also the Business Roundtable and the National Federation of Independent Business, the small-business lobby that led the charge against HillaryCare.

America's Health Insurance Plans, the industry trade group, recently said its members would accept all comers regardless of health status or previous illness -- i.e., guaranteed issue -- but only if the government requires everyone to buy insurance. The individual mandate will expand their business in the short term, but it won't be long before Congress is also regulating premiums, cost-sharing and administrative expenses. Dr. Faustus, call your internist.

Another opening for Democrats is the new director of the Congressional Budget Office, a post vacated when Peter Orszag joined the Obama Administration. CBO totes up the official cost of legislation and thus is one of those obscure Beltway outfits that frames the political argument. A "score" that is too costly make a bill harder to pass.

In the 1990s, CBO director Robert Reischauer knee-capped HillaryCare by pointing out its true costs and giving little credit to claims it would generate savings. With good reason: Putative cost "offsets" never seem to materialize when Congress tries to plan the insurance markets. Now Democrats will try to install a CBO director who can be more easily rolled.

Most disturbingly, Democrats are talking up "budget reconciliation" to pass a health overhaul. This process was created in 1974 and allows legislation dealing with government finances to be whisked through Congress on a simple majority after 20 hours of debate. In other words, it cuts out the minority by precluding a filibuster. Mr. Daschle writes that reform "is too important to be stalled by Senate protocol," and Mr. Baucus has said he's open to the option.

Any taxpayer commitment this large ought to require a social consensus reflected in large majorities, but Democrats are determined to plow ahead anyway. They know that a health-care entitlement for the middle class will never be removed once it is in place; and that government will then dominate American health-care choices for decades to come. That's all the more reason for the recumbent GOP to get its act together.

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300 babies exposed to tuberculosis in Australian public hospital

What a disgrace! The old story of imported doctors again. Government hospitals will take just about anyone as a doctor

About 75 babies under three months will be given antibiotics after they were exposed to tuberculosis by an infected doctor at an Adelaide hospital. SA Health says about 300 children in the Neo-natal Intensive Care Unit and the Special Care Baby Unit may have come into "close and prolonged contact" with the doctor between September 28 and November 28 this year. About 75 of these children are too young to diagnose, and will be treated with antibiotics to minimise the chances of infection.

The doctor was screened for TB by immigration authorities when he arrived in Australia in March this year. His chest X-ray found no trace of TB - but a routine follow-up test by SA Health last week returned a positive result. Tests for TB are ineffective in babies under three months of age. The overseas-born doctor is on sick leave, but hospital authorities expect him to return to work after he is cured.

SA Health chief medical officer Professor Paddy Phillips said the risk of transmission was low. "However, as a precautionary measure, those people identified as possible contacts are being offered screening and some are being offered preventative antibiotics," he said.

However, Professor Phillips said the risk of infection was assessed as being at the low end of the spectrum. "Those babies in the NICU will be offered a program of preventative antibiotics as a precaution until they reach three months and are able to undergo a screening test, with a further precautionary test offered at six months," he said. Other babies treated in the SCBU will be offered a screening test when they reach three and six months of age. "Doctors from the Women's and Children's Hospital have been contacting the families today."

Older children and other visitors to the hospital are not believed to be at risk of infection. There were 59 new cases of TB diagnosed in South Australia last year. About 1000 new cases are detected in Australia each year.

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