Hillary’s Health Care Remodel

WASHINGTON — The genius of Hillary Clinton’s presidential campaign has been her skill at turning liabilities into assets and weaknesses into strengths. By putting out a detailed health care plan on Monday, Clinton embarked on this year’s most daring act of political jujitsu.

Compared with Barack Obama and John Edwards, who have already issued well-reviewed proposals of their own, Clinton comes late to the health care sweepstakes. But there is a message in that, too. Her approach, she says, has been “very deliberate.” That’s why she offered ideas on curbing health costs and improving the quality of care before she got around to her plan to cover everyone.

She mixes self-deprecating laughter with meticulous analysis of interest-group politics to send one clear message: The Hillary Clinton of 2007 is a wiser, shrewder and more realistic politician than the first lady who tried and failed to pass her husband’s health plan in 1993 and 1994 — which, because of her high-profile role, is now inevitably called “Hillarycare.”

In a telephone interview Monday shortly before she gave her Iowa speech, Clinton listed the tips she picked up at the Health Care School of Hard Knocks. “I learned in 1993 that people who have coverage need reassurance that they can keep their current plan,” she said, noting that her new proposal offers exactly that. In her address, she repeatedly invoked the words “you choose” — with the emphasis on you — as a litany that could drive away the evil spirits of the past.

“This is not a government-run system,” she went on in the interview, responding pre-emptively to the assaults she knows will come her way. “There will be no new bureaucracy, no mandatory alliances.”

And then came the most telling moment in the interview. At the mere mention of the word “alliances,” she broke into laughter.

The “alliances” were purchasing cooperatives that constituted a genuinely innovative part of Bill Clinton’s 1993 plan. But they were easy to parody as big government monstrosities. Hillary Clinton’s chuckle — there seemed to be real mirth in it — says she now knows the word “alliances” is political kryptonite.

There’s another message: She knows a lot more than she used to about voters and how to persuade them — and about herself. Leaders who can laugh at their own failures are usually more trustworthy than those who can’t.

Again and again, Clinton went back to what she knows now that she wished she had known then. “You can have a great plan on paper, as I have learned the hard way,” she says, and still fail. Individuals and interest groups will always ask, “What’s in it for me?” She brings up the question herself. Gone is the moralist who might once have bridled at such a query. This time, she insists it’s “a fair question in our system.” And so her new plan has incentives for small businesses, special help to companies with high “legacy” costs for retired employees, and a lot of assistance for the middle class.

This time, she will coax and charm the country toward universal health coverage. Cold analysis has given way to warm persuasion.

The next phase of the campaign, now that the health plans are on the table, will not hinge on the dueling details. It will instead be a bigger argument among front-runners Clinton, Obama and Edwards over how they would govern.

Over the weekend, a campaign lieutenant argued that Obama was more likely to get health care reform passed because he has a fresh approach to Washington, an ability to bring parties together, and the tools to inspire the country. Implicit was a critique of the old Hillary, and her past failures. With Obama, the past would be the past.

Edwards is the visionary who by sheer force of commitment will shake Washington up, and has set the pace for his opponents on issues ranging from poverty to health care.

And then there is Clinton, who can say: Been there, done that, won’t be fooled again. The assumption behind her offensive on health care was nicely described by one her advisers on the eve of her speech: “In Washington, it’s: ‘You lost, you failed, goodbye.’ In the rest of the United States, it’s: ‘You fail, you learn from your mistakes, and you do it right the next time.’ “

“It’s not just about health care,” said this adviser. “It’s about her.” So it is. It could turn out that Clinton’s strongest argument is that someone who is aware of her own shortcomings, laughs about them and works at them, has the character to be president.

E.J. Dionne’s e-mail address is postchat(at)aol.com.

© 2007, Washington Post Writers Group