European Stars and Stripes (Newspaper) - August 25, 1994, Darmstadt, Hesse                                Thursday August 25, 1994commentary the stars and stripes Page 17 cursed be the tie binding Clinton Congress David s. Broder historians of the Clinton presidency will i think focus on the great irony that appeared during this summer of his second year in the White House. Bill Clinton has increasingly tied his Fate to that of the democratic Congress at the very moment when its leadership seems to be losing its  signal of the change came this summer with the selection of Leon Panetta former chairman of the House budget committee As the new White House chief of staff. Earlier this month Clinton and Panetta chose Tony Coelho formerly the House whip and chairman of the democratic congressional Campaign com Mittee As special adviser to the democratic National com Mittee de Facto the head of the party for the midterm Campaign. Finally Clinton and pan Etta chose judge Abner Mikva former Illinois congressman and former member of the House ways and Means committee Ashe new White House counsel. The common thread among those three appointments is that they could Well have been  by House majority Leader Richard Gephardt d-mo., had he instead of Clinton been elected president in 1992. In fact it was Gephardt who recommended to president elect Clinton that he pull Panetta a Macclinton barely knew out of the House and make him director of the office of management and budget at the Start of Clinton s term. Gephardt was among those urging that Coelho be sent to the embattled democratic National committee. And he cheered the selection of his old ways and Means buddy Mikva a Habitude of the House gym during All the 15 years he has served on the court of appeals for the counsel s Job. With former Gephardt aides George Stephano Poulos and David Dreyer already in sensitive White House policy and communications posts you could Call this the Gephardt nation of the Clinton presidency. Equally historians could say that in this hour of dangerous political weakness with his polls Down and his major legislative initiatives in jeopardy outsider Clinton decided to try to make himself an insider. The changeover could not be More dramatic. Panetta s predecessor was Clinton s boyhood pal Thomas Mack Mcclarty a Man devoid of Washington experience. The resigning chairman of the democratic National committee is Young David Wilhelm an agree Able Chicago Campaign consultant More accustomed to courting candidates than Selling strategy to senators. And the first White House counsel was the politically naive Bernard Nussbaum a new York lawyer whose main credential was his Friendship with first lady Hill Ary Rodham Clinton. Lambs everyone inside the Beltway would agree that in Panetta Coelho and Mikva the president has acquired meaningfully greater experience judgment and get me Panetta 6 organizational Chart. Tor1cal political acumen. But it comes at a Price. It is hard to recognize this Bill Clinton As the Man who campaigned against the brain dead politics of Washington the Man who beat the stuffing out of All his democratic rivals who had served on Capitol Hill and then walloped that consummate insider George Bush. During the democratic convention of 1992, Clin ton was so careful to keep his distance from the party congressional leaders that for weeks afterwards House speaker Thomas Foley from Washington had to re mind people that he had actually been sitting on stage in the front Row during almost All the. Sessions. Such turnabout Are not unprecedented of course. Ronald Reagan ran against Washington then Lef insider Jim Baker run his White House. What is Dif Ferent about Clinton is that he has tied into a congressional cadre that shows evident signs of Battle fatigue. Senate majority Leader George Mitchell a Maine is bailing out at the end of this year worn Down by the grind. And the House democratic leadership which scrambled frantically to save Clinton s budget by a sin Gle vote last year saw so Many democratic defection that it was recently unable to pass the procedural Rule to bring the crime Bill up for a vote. In a leadership meeting a week before that vote an exasperated Gephardt steaming about the reluctance of his party s membership to Back the president report edly said Damn it if we can t pass the Rule on the crime Bill maybe we ought to let the republicans run this  no one in Washington not even this president works harder at his Job than Dick Gephardt. But he is a prisoner of the very system he is trying to direct. Last year at the Behest of organized labor the Mai source of Campaign funds for House democrats Gep Hardt joined House democratic whip David Bonior from Michigan in opposing Clinton on another priority the North american free Trade agreement. Having broken ranks themselves they could hardly threaten to punish democrats who went with the National Rifle association rather than the president on the crime Bill. It s Only one example of a larger problem Clinton came to town full of ideas for changing Washington and the country. But the House democrats to whom he has increasingly tied himself have been in Power for 40 years and they not Only like the status quo they Are the status quo c Washington Post headaches abound with Universal health care in responding to criticism by re publicans and some democrats that uni Versal health care proposals constitute socialized Medicine president Clinton asks whether critics consider medicare in that  question should be followed by these has medicare produced the re sults its supporters claimed it would an will government mandated Universal health care do likewise it should be noted that the Bills under consideration in Congress have been written by staff people who the Newyork times reports have years of experience analysing How to regulate health costs How to pay doctors and hospitals How to provide More care to More peo ple but they have no experience in de livering real Medicine to real  r. Annis m.d., does. He is a past president of the american medical association and has debated the proper roles Between government and Medicine for More than 30  his important Book code Blue health care crisis regnery publishers or. Annis lays out the philosophy and failings of government managed  Cine and blames government for rising  medicare he writes our system is subject to the perverse incentives of arbitrary Price fixing utilization review concurrent review retrospective review and retroactive denial of payment making health care the most heavily regulated Industry in the history of our nation. Govern ment decides whether or not a patient will be admitted to a Hospi Tal whether or not surgery will be performed whether or not a assistant will be used in surgery Cal Thomas when a patient will be Dis charged and what and How often procedures and diagnostic studies will be performed All without Ever examining the patient. Imagine the bureaucratic enormity of annually monitoring 22 Mil lion admissions and discharges at 7,000 hospitals with 467 diagnostic related groups plus 350 million charges from Halfa million doctors with 7,000 different encoded  the primary cause of High medical costs argues Annis is government regu lation which now accounts for 26 percent of the Price of visiting a doctor or Hospi Tal. Malpractice insurance adds significantly to the Bill. Up to 95 percent of the Cost of a child s vaccine can go to Legal liability expenses he says. Those backing the House or Senate Bills argue they will be Able to control costs even though president Clinton has repeatedly promised that health care re form would reduce costs. Since medicare was born 30 years ago the Cost of health care has been driven up. In 1965, when Congress passed medicare medical inflation Rose just 2.1 percent. But after just one year medical inflation had shot up to 6.5 percent. What about the poor and others unable to afford health insurance before  care the typical physician writes Annis spent one fifth of his or her working time caring for the poor today the typical Pri Mary care physician spends on fifth of his or her time on regulatory paperwork the average patient visit necessitates the execution of 10 document pages. Administrative costs Are now rising at More than twice the rate of health care in general making it the fastest growing component of health care costs. Look for. Things to get worse under Universal health care unless the bureaucrats reduce the Quality of services available. Medicare which pays the Bills of even those who can afford their own treatment has been in crisis almost since the begin Ning. Four years after implementation workers were socked with their first Quick fix tax hike. Congress had promised that medicare part a would Cost $3.1 billion in1970, but the real Cost was $5.8 billion. In the 1960s, the Public was told medicare would Cost no More than $9 billion by 1990.the actual Cost was $95 billion. There Are ways to fix what is wrong without bigger and costlier government doing damage to the health care system. The record show that government can t fix poverty crime or mail delivery should we expect it to fix Medicine in fact the administration and con Gress Are break Rig the Law by further tin Kering with health care. Section 1801 of the Law creating medicare says nothing in this title shall be construed to Autho Rize any Federal officer or employee to exercise any supervision or control Over the practice of Medicine or the manner in which medical services Are provided or Over the selection tenure or compensation of any. Person providing healthcare services. If socialized Medicine Means the effective takeover and opera Tion by government of american health care then the process begun by medicare and medicaid is about to be completed under Universal health  c los Angeles times