If you're trying to pin down a moment from 1994 when the fate of the Clinton health care plan was sealed, you could do worse than January 25. On that night, then-Senator Bob Dole responded to the president's State of the Union address. Clinton had hoped to use the speech to help sell his proposal; Dole used his response to help kill it. And he did it primarily not through what he said, but what he showed on camera.
Dole brought with him a chart, depicting how American health care would work if the Clinton plan came into effect. And it was not a pretty picture. Lines were all over the place. The boxes were full of confusing acronyms and scary-sounding institutional titles like "National Health Board" and "Regional Health Alliance." The chart had actually come from a colleague, then-Republican Senator Arlen Specter, who'd asked a staffer to draw it so he could better understand what Clinton had in mind. But Specter--and, soon enough, his Republican colleagues--quickly saw the chart as an effective propaganda weapon.
The impression of the chart was accurate enough: The Clinton plan was tremendously complicated. And given how many of the old Republican arguments against health reform are resurfacing this year, it's likely we'll be seeing a similar chart sometime this summer. But these charts leave out one key fact: The U.S. health care system is already a mind-numbing web of institutions, agencies, and businesses. And, while that may be self-evident to anybody who's ever had to handle a billing dispute between insurer and hospital, it's easy to lose sight of that in the scrum of congressional debate. So, just to keep this very relevant piece of information in mind, we've drawn up our own chart--of American health care, as it is now. And, just to make sure we weren't getting it wrong, we got some help from our friends at the Henry J. Kaiser Family Foundation. (Click the map to enlarge or download the file.)
Jonathan Cohn is a senior editor at The New Republic.