- The Washington Times - Saturday, November 23, 2002

Like a dateless and desperate guy who is calling up a girlfriend about two years late, Al Gore finally is expressing something approaching serious interest in the issue of single-payer health care.

Better late than never. How much better? That remains to be seen. Before we can examine Mr. Gore's plan, he has to come up with one.

For the moment, it's enough that he has put the issue on the table. Health care, like the economy and the environment, is one of the big issues to which polls show most voters look to Democrats for the best answers.

Yet, Democrats oddly avoided those issues and just about every other galvanizing theme in their recently disastrous midterm elections.

So, while many Democratic activists consider a second Gore presidential campaign to be about as exciting as yesterday's pizza, a larger percentage of rank-and-file Democrats think he deserves a second chance, especially if he can arouse grass-roots Democratic impatience with the Bush administration.

And, besides, with less than a year to go before 2004 campaigning starts getting serious, no other likely Democratic contender comes close to Mr. Gore in the polls.

So, you can't blame a guy for seizing an opportunity when he sees it around a big idea that seldom has been able to break out of the fog the health insurance industry has stirred up around it.

Basically, single-payer coverage would collect insurance premiums or tax dollars in a single agency, which would pay for comprehensive coverage for all citizens. Canadians have a form of it, which constantly rankles conservatives and the health insurance industry. They talk a lot about Canadians who come to the United States for health care. They talk very little about the Americans who go to Canada for cheaper drugs. Canada's program has its problems, but, while there have been many moves to improve it and even privatize parts of it, there have been few moves to scrap it.

Centrist Democrats, of which Mr. Gore has been a leader in the past, along with the Clintons, have been scared of it. Sounds too much like socialism, they say. But so did Social Security, Medicare and Medicaid, among the government's most popular programs of the past half-century or so.

So, now, as Mr. Gore ponders whether to run again, he has broken "reluctantly" with his former centrist position on health care, he says. In front of several hundred people at a Manhattan synagogue on Nov. 14, Mr. Gore said in response to a question that he had decided single-payer coverage is the best solution to the nation's health-care crisis.

More details to come, Gore spokesmen said, along with the former vice president's announcement of whether he's running. In the meantime, he's behaving like a man who plans to run, including a stint as host of "Saturday Night Live," a leading platform for reaching that coveted late-night youth vote.

Health care is no laughing matter for 40 million Americans who don't have insurance coverage. Nor is it a laugh riot to those who were frightened away from government intervention by the "Harry and Louise" TV ads in the early 1990s that warned of rationed health care.

Instead, growing numbers of covered Americans are receiving a different form of rationed health care under the name of "managed" health care.

So, if Mr. Gore, a former newspaper reporter, is as smart as he needs to be to win this time, he'll remember the four initials countless editors have passed on to young reporters: "K. I. S. S. Keep it simple, stupid."

First, he should stop using the clunky term "single payer" to describe his plan. Nobody except news junkies and policy wonks knows what that means.

Instead, he should describe it as a simple expansion of Medicare to cover everybody. Medicare is a program that most Americans understand comfortably and that most want to keep. Building on that popularity and comfort level, many experts over the years have advocated expanding Medicare to cover everyone, regardless of age.

Of course, funding and administering a health plan to cover all Americans will be anything but a simple matter. But, to start a national dialogue, grand ideas must be expressed in conveniently simple terms.

At least Mr. Gore is giving voters something serious to think about. I hope he keeps it up. Americans deserve to have a choice, not an echo. That was a slogan of conservative Republicans in the 1960s. They made a comeback. So can the Democrats, if they offer Americans something worthwhile to choose.

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