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Hillary on Health Care

Sen. Hillary Clinton (D-N.Y.) announced the details of her health care plan this morning in Iowa, a moment that reinforced the idea of her as the central mover in not only the Democratic primary but the broader 2008 race. The announcement also underscores how much is at stake for the former First Lady as she addresses the issue that brought her low in the 1990s.

"It's a fascinating moment because the health care debate, of course, will become a proxy for the whole contrast between [Sen. Barack] Obama and Clinton," said Carter Eskew, a senior adviser to t former Vice President Al Gore's 2000 presidential bid. "Idealism versus pragmatism; new versus experience."

The importance of Clinton's speech was clear even before she announced her plan as her rivals were already positioning themselves against it.

"I commend Senator Clinton for her health care proposal," said Obama (Ill.). "It's similar to the one I put forth last spring." ZIng! Obama added that the key to passing any sort of comprehensive proposal is "an open transparent process that builds a broad consensus for change" -- taking a subtle shot at Clinton's first attempt to overhaul health care in the 1990s, a process broadly criticized for its secrecy.

Former Sen. John Edwards (N.C.), who was the first of the frontrunning Democrats to unveil a health care plan and has made it a centerpiece of his campaign, took the Clinton criticism a step further. As he has done in the past few months, Edwards sought to link Clinton's acceptance of campaign donations from lobbyists as anathema to truly reforming health care; he upped the ante by announcing that on his first day in the White House he would propose a bill that would take away all health care coverage for the president, Members of Congress and political appointees until a bill is passed that delivers on the promise of universal care.

Even former Gov. Mitt Romney, who passed a plan during his four year term that covers all Bay Staters, got into the act, denouncing Clinton's plan. "Well, if you've seen the reports this morning on the latest version of HillaryCare, you'll see that version 2.0 is not likely to have any more success than 1.0. HillaryCare continues to be bad medicine," he said.

Former New York City Mayor Rudy Giuliani communications director Katie Levinson offered this gem: "If you liked Michael Moore's 'Sicko,' you're going to love HillaryCare 2.0."

All of this activity shows how Clinton -- both her personality and her policy proposals -- drives the conversation in the race. Like her or hate her (and there are plenty of people who feel both ways), the race revolves around Clinton and likely will continue to do so all the way through the Iowa caucuses and beyond. That's an opportunity and a burden for Clinton. On the one hand, she gets huge attention when she rolls out a major campaign plank; on the other, she faces incredible scrutiny for just about everything she does in the political arena.

The way in which Clinton rolled out the plan over a series of months speaks to her campaign's profound understanding of the helath care issue's make or break possibiilities for the race.

Early in her candidacy, Clinton pointedly refused to roll out a comprehensive plan, insisting that her experience during the 1990s had taught her that simply throwing more money at the problem would not solve it. On the stump, she regularly refers to the scars she bears from that 1990s experiences as a reminder to voters that she is someone who has long been fighting in the trenches on the issue.

Instead of introducing a comprehensive plan in a single speech, Clinton's campaign adopted a three-part strategy. Early in the summer she addressed health care costs at George Washington University; late in the summer she gave a speech in New Hampshire on the need for better quality health care. Today's address on coverage closes the loop for Clinton.

The thinking behind that tripartite strategy was, according to Clinton aides, to ensure the vast majority of Americans, who do have health coverage, understand what is at stake in the debate. That's why Clinton started off with a speech on the rising costs of healthcare -- a problem almost every American can relate to -- before unveiling her proposal for mandated universal coverage.

Slow-walking the proposal also gave Clinton a chance to make sure that the full details of the plan were worked out and checked (and then double-checked) so that there no obvious holes existed. Because of Clinton's failed attempt to overhaul the health care system as First Lady, she and her campaign aides are well aware that her plan will be studied and re-studied more closely than the proposals of either Obama and Edwards and, therefore, even the smallest misstep will be greatly magnified.

The fight over health care is a microcosm of the broader fight for the Democratic nomination. Obama and Edwards are casting themselves as change agents, ready to shake up the status quo and remake politics -- a transformation, they argue, Clinton is unable to bring about. For her part, Clinton is casting herself as the lone top-tier candidate whose experience as First Lady and during her seven years in the Senate position her to not only propose real change but enact it.

"More than any other issue, health care is where she puts her experience on the line, both in terms of lesson learned from the past and the prospect of real progress in the future," said Anita Dunn, an unaffiliated Democratic media consultant.

How health care plays out over the coming weeks and months will be critical to determining the identity of the Democratic nominee. As Dunn argues, health care is the best example for Clinton to make her experience/change argument while also serving as a terrific opportunity for Obama and Edwards to paint her as a politician trapped within a Washington, D.C. mindset and unable to bring about real change.

Whoever wins that argument will have a leg up in winning their party's nod.

By Chris Cillizza  |  September 17, 2007; 12:50 PM ET
Categories:  Eye on 2008  
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