The most important politician in America?: It's not Barack Obama

It is the junior United States Senator from New York, Hillary Rodham Clinton.

The Obama presidency will be measured by the success or failure of the next congress in delivering universal health care. Not only will national health incalculably improve the lives of most Americans and rescue literally millions of retiring baby boomers from spending their declining years in poverty, but also it will change forever the nature of the debate over the proper role of government.

Republican balderdash about the dangers of "socialism" has traction only because Americans think they have no experience with it. If you want an idea of what it will be like when our medical system is "socialized," ask any die-hard Republicans over 65 two questions: First, what is their opinion of the proposal to establish national health coverage? In most cases, mention of national health will lead to railing about the predations of big government and the imminent arrival of Fidel Castro. Then, after the spittle stops flying, ask them what they think about Medicare? Socialist medicine, you will discover, is not so bad after all.

If the Obama administration indeed inaugurates a new progressive era, it will because real health care reform was delivered during its term. In the House of Representatives, health care is a done deal; all that needs to be worked out is whether it is single-payer or if some portion of overhead will be reserved to guarantee the profits of insurance companies. But the Senate is another matter. I am second to none in my admiration for Ted Kennedy; but in a lifetime in Congress, he has failed to deliver national health -- not without good cause, but there is little reason to think that the addition of a few moderate senators to the majority will be enough to make a difference.

As Kennedy is fully aware, the Senate needs someone of Hillary Clinton's stature, clout, expertise and ambition to make the passage of universal health care a certainty (see, Ted Kennedy asks Hillary Clinton to head Senate healthcare team). Once she wins the health care fight, who thinks she won't run for majority leader, and win.

It's hard to see that Clinton has any particular qualifications to be secretary of state, other than her travels. Please don't think I'm advocating this, but if Obama wants to appoint a strong woman with lots of foreign policy expertise, why not choose California senator Dianne Feinstein who has displayed keen interest in foreign affairs, trade, defense and security matters throughout her congressional career. There are thousands of others in government, politics, business and academia who also have more executive experience and far more knowledge about international affairs than Clinton.

On the other hand, there is no one in political life who has thought longer and harder about health care.

It isn't hard to figure out what Obama is up to. By choosing Clinton, he neutralizes a possible rival power center; offers a gesture of conciliation to those Hillary supporters still unreconciled to his victory; sidelines Bill Clinton; and makes an appointment that will be greeted with general approval (except, maybe, in New Mexico).

But what can Hillary be thinking? Politically, she will be much weakened -- cabinet members are not called secretaries for nothing. In the Senate, still hidebound by seniority, she is known to be frustrated by that junior business. But if she doesn't like standing a few steps behind Chuck Schumer, wait'll she has to take instructions from some junior aid in the west wing.

Getting something done in the Senate will require hard work. But she made a promise to the people of New York to work for them. Nobody said it was going to be easy.

Some wags are saying she wants to complete the collection of visited countries she started as first lady, but come on. Was she so busy running for president that no one had time to fill her in on junkets? She could legitimately visit every country in the world that delivers national health, which, come to think of it, is pretty much all of them.

The rap against the Clintons is that they have always put their own interests ahead of People and Party. During her run for senator, she was charged with being motivated by no more than ego and ambition. Were those of us who favored her election as senator naive in believing that she truly wanted to serve? If she still does, she should stay in the Senate and fight for single-payer universal health care. She will make a difference in our lives in a way no one else can; she will give support to an administration every patriotic American hopes will bring real change; and she will alter the future forever.

Today she is Hillary Rodham Clinton, U.S. Senator from New York. Tomorrow, does she really want to be Madeleine Albright instead?