Credit Where It Is Due Will Benefit Uninsured.(ISSUES & INSIGHTS)(BRAIN TRUST)

Byline: MERRILL MATTHEWS JR.

In 1992, Bill Clinton turned the issue of the uninsured and health care reform into a national debate. President George H.W. Bush, caught unprepared, responded half-heartedly with an unworkable plan that no one took seriously.

Clinton was elected and tried to implement a grandiose scheme that polarized the country and led to a humiliating defeat -- and the uninsured are still waiting for a workable plan.

Now the issue is back. Health insurance premiums have been rising by double-digit rates for four years in a row, though indications are that future increases will be much smaller.

Most states cut back their Medicaid programs in 2003, and may do so again in 2004 -- although those cuts came after many states expanded Medicaid coverage in the 1990s beyond the poor to the middle class.

The weak economy, higher insurance premiums, state cutbacks in Medicaid and other public programs, and a presidential election means we will once again debate the best way to cover the uninsured.

However, President George W. Bush learned a lesson from that earlier battle over health care reform and doesn't plan to repeat the mistakes of either his father or Bill Clinton.