DaytonDailyNews.com

If you listen to the presidential campaign, you might get the impression that if the Democrats win the presidency and strengthen their control of Congress next year, the country will finally get universal health care or something like it.

In truth, however, roughly the same could have been said about the 1992 election. But after that election went their way, Democrats weren't able to get anything enacted.

Actually, one big difference between then and now is that the Republicans were not in lockstep opposition back then. That only changed in 1994, when the issue finally came before Congress.

In that year, the health care industry convinced a lot of average Americans that an overhaul of the system would jeopardize what was good about it now. (Polls showed that most people were satisfied with their own coverage, even if they liked the idea of universal coverage.)

As everybody knows, the Clinton plan that failed was the special project of Hillary Clinton. She has a plan this year, too. Inevitably, the Hillary-bashers are saying this is just Hillary back at it again. In fact, however, her new plan is very different.

She starts with the idea that people must be able to keep insurance that they like. Also, she creates no big new bureaucracy (though, obviously, she does create more work for government).

Her plan exempts small businesses from the requirement to provide insurance, instead offering them tax incentives to do so. But she would require individuals to have insurance, and she would help poor people pay for it.

The idea behind that requirement is that many of the 45 million-plus people who don't have insurance could afford it. They just don't feel the need, because they are young and childless. As a result of their absence from the system, others pay more, even as the uninsured get treated in emergencies.

The Clinton plan is much like that fostered by Republican presidential candidate Mitt Romney when he was governor of Massachusetts. It also has much in common with Republican J. Kenneth Blackwell's plan when he ran for governor of Ohio.

Speaking of the states, there's something to be said for letting them continue to experiment with various approaches to universal coverage. However, the truth is that if Ohio wants it, the federal level is the most promising. Gov. Ted Strickland has made clear his tendency to hew near the political center, rather than make proposals that set teeth on edge in the other party.

A mandate on individuals has some merit, but needs to be approached carefully. Think about the young people. The law already requires car insurance. Many also face college loans and/or family responsibilities at a time when their income is at its lowest.

How far do we want to go in making the first years of adulthood — which might be relatively carefree — more rule-ridden and costly?

Another question: Do Democrats really want to jeopardize their recent gains with young people by being seen as the party that imposed a serious new obligation on them?

Mr. Blackwell had an alternative worth considering: letting young people stay on their parents' insurance through their 20s.

Sen. Barack Obama, another presidential candidate, would not require insurance. So his plan would fall short of universal coverage. As time goes by, think tanks and other specialists will weigh in about just how far short. That needs to be known.

Sens. Clinton and Obama and former Sen. John Edwards all propose building on the current system of employer-based insurance. They are not calling for socialized medicine, where the government employs everybody in health care, or even the "single-payer" system, under which government pays all the bills. They propose only to fill in the gaps through various combinations of mandates, tax breaks and subsidies.

That ought not be beyond the limits of American ingenuity. Many other democracies provide universal coverage. Their systems aren't perfect, but you seldom hear about them wanting to move dramatically in the American direction.

President George W. Bush has done his opponents a favor: By cutting taxes on the wealthiest people, he has allowed Democrats to claim they can fund their health plans largely by eliminating those cuts.

However, if the Democrats think the task at hand is simple, politically or otherwise, they are making a huge mistake. A Democratic victory in 2008 would be an indication that the public is willing to consider universal coverage, not that people are insisting upon it. The lesson of 1994 is that people want something that works or seems likely to work.

Otherwise, they will — again — be perfectly willing to leave things much as they are.