Stayin' alive: health, wealth, and wise guys.

• Author: Hazlett, Thomas W.

Just as Ronald Reagan's red ink made the electoral world safe for a Balanced Budget Amendment, the Clinton administration's greatest gift has been to discredit the notion of sweeping health care reform. That is a considerable consolation prize to the American people, who have - thanks largely to Republican dirty tricksters - had to vote not once but twice for this student council prankster from Hot Springs.

The lure of health care legislation for the fledgling Clinton administration was not simply that it got the Ms. out of the White House. The chief draw was that cute little plastic card Mr. Clinton loved to wave: Don't leave home without it!

At the time it oozed of genius. In 1991 and 1992, Democrats feeling the pain of middle class folks downsized out of their health insurance were hitting nerves. They were zeroing in on people's fears of financial insecurity better than at any time since the New Deal.

Mr. Clinton's health care card would not only sweep your risk away, but the administration's policy wonks had ingeniously rigged a mechanism to control skyrocketing health care costs to boot. Wasn't it time that we tackled this great problem? "Experts from across the political spectrum agree," wrote the esteemed National Journal in July 1994, "that doing nothing would have the direst consequences.... Costs would continue to rise rapidly."

Well, the Clinton plan couldn't even sneak by a Democratic Congress, helping in fact to turn that body Republican. And "experts from across the political spectrum" were proven wrong: The health care cost trend went flatline in the 1994-96 period. Sorry, National Journal. We did nothing - and it worked!

The trick, of course, is that doing nothing in the public policy world allows much more to be done in the real world. Today, thousands of smart people work overtime trying to shave medical costs. Some of these are the dreaded HMO procedure-approval dragons; but others represent consumers, businesses, unions, even prison systems (New Jersey, witnessing a 500 percent rise in state-provided prison health care in the last 10 years, has just started letting contracts to per capita plans). The pressure is forcing people to face up to the trade-offs imposed by real constraints.

The golfing doctors who gripe about managed care are wrong to see it as the end of the free world: It is the end of the free lunch. And the editorial hustlers who crow that the HMO game is the same as the one inspired by HillaryCare are in...