Some say it's shades of 1992, when then-Gov. Bill Clinton won the presidency in part by promising to reform the nation's healthcare system and find a way to offer health insurance to all Americans.
Clinton tried, but his 1994 plan failed to garner the support of Congress and the American public.
That hasn't deterred three of the four leading contenders for the presidency in 2000, each of whom is formulating his own proposal for healthcare reform. And this time, supporters of universal coverage say, there's a good chance something will get done.
"We feel gratified that the question is so front and center in the campaigns," says the Rev. Michael Place, president and chief executive officer of the St. Louis-based Catholic Health Association. "It's helping transform the awareness of the American public."
"I don't think the drive for universal coverage is unrealistic," says Whitney Addington, M.D., a past president of the American College of Physicians-American Society of Internal Medicine, which has 115,000 physician members. "You can't just fault employers. There's an overall apathy that has caused the delay (in getting something passed). We're trying to get this on the agenda again."
It's certainly on the agendas of Vice President Al Gore, former Sen. Bill Bradley (D-N.J.) and Sen. John McCain (R-Ariz.), all of whom have released rough sketches of what healthcare reform should look like.
In September, Gore unveiled his plan, which closely resembled the leftovers from Clinton's agenda (Sept. 13, 1999, p. 8).
Gore's plan focuses on insuring more children by expanding the Children's Health Insurance Program, a federal-state initiative designed to insure low-income children who don't qualify for Medicaid coverage.
A few weeks after Gore released his plan, Bradley, Gore's chief rival for the Democratic nomination, rolled out his own healthcare proposal. As if taking his cues from Washington, Bradley put his own spin on some of the hottest healthcare issues facing Congress, including:
* Supporting managed-care reform.
* Giving Americans "access to affordable healthcare," guaranteeing that as the first step, 84% of the nation's children would receive a full or partial subsidy of their health insurance. The remaining 16% would get help to buy healthcare coverage through tax breaks.
* Improving healthcare quality by using objective measures.
* Strengthening the position of healthcare consumers by providing them with accurate healthcare information and a right to know about all aspects of their medical needs.
McCain waited until December to release his healthcare reform plan, which features:
* A federal-state partnership to provide prescription drug coverage to low-income seniors.
* Tax breaks for the uninsured.
* Coverage for all children.
* The right to sue HMOs.
"This is exactly what we hoped would occur," says William Pierce, a spokesman for the Blue Cross and Blue Shield Association, of the competing proposals. "We always felt it would take this level of dialogue to get something done."
The national Blues association outlined its version of universal coverage last year.
Addington and Place say all the interested parties have learned valuable lessons from the Clinton administration's failure to pass a universal coverage plan in 1994.
"It can't be a partisan effort," Addington says. "We have to bring this to everyone's attention. Everybody's got to be at the table."
"Mainstream, middle-class America did not see it as their issue," Place says. "If middle America doesn't want it, it will be difficult to achieve."
Possibly the greatest lesson from Clinton's failure is that something must be done-or the number of uninsured Americans will only continue to rise.
"There's been nothing done since that 1994 attempt at reform, when the number of uninsured was 37 million. Now it's 44 million," says Maureen McCullough, vice president of public policy and advocacy at the CHA. "And if nothing is done, it could reach 55 million."