President Bill Clinton ascended to the highest office in the land at a time when the country had earned a notorious distinction of having the largest healthcare costs in the world. Before Clinton’s presidency, the United States congress had on several occasions tried to adopt universal health coverage. However, in most of the cases, a determined opposition consisting of big businesses, health industry players and right-wing politicians would block the proposals as they came. Clinton’s Presidency offered some hopes of reforming the healthcare industry because a large majority of the public termed healthcare as one of the most pressing problems in the country. Buoyed by the support of the public, who supported efforts to offer comprehensive medical cover to all Americans, President Clinton made healthcare a priority, and was even willing to put so much at stake for the passage of healthcare reforms.
Bill Clinton’s election into office came at a time when all the signs seemed to favor major reforms. This was quite clear when business executives and the medical community (two players who had previously opposed healthcare reforms) seemed to relax their conventional stands in a bid to allow for reforms. The business community knew very well that the high cost of healthcare would make American goods more expensive in the world market, and this would ultimately push them out of some competitive markets. With this knowledge, most business executives were now willing to support a plan which would shift the burden of health costs to the government. On the other hand, the medical community, tired of offering free medical services to the uninsured, was also willing to consider health reforms which would lessen their burden. All these factors combined with the public goodwill emboldened Bill Clinton to make health care reforms the centerpiece of his campaigns.
After his election, the president remained true to his word and assembled a multidisciplinary team (in the early 1993) to come up with a plan that he would present to the Congress. The president even went ahead to name his wife Hilary as the task force head. Several months later, the team came up with a complex plan that would ensure all Americans had access to health care. Under this plan, the employed would be covered by their employers through payroll taxes, while the government would pay membership costs for the unemployed. The Clinton plan also proposed the creation of new public associations under the banner health care alliances, which would mostly be involved with advocacy issues such as negotiating on behalf of consumers.
On September 22, 1993, the president announced the new health care plan to the congress. The plan received favorable publicity and a large majority of the public supported it. However, the initial appearances were quite deceiving because one year later, opinions shifted and initial supporters of the plan backpedalled. After numerous committee hearings, majority senate leader George Mitchell termed the plan as dead. Although opinion pollsters showed that the ingredients of reforms still had strong support, the complexity of the plan compounded with sudden criticism had left many supporters uncertain of the next course of action.
As Americans ushered in a new year, 1994, opponents of reform were busy mobilizing their forces, and it was a matter of time before the political mood changed. Supporters of the health care plan led by the Chamber of Commerce and other business organizations began back-track their support and soon reversed their endorsement. Even the AMA (American Medical Association) changed their terms of support limiting their endorsement to firms with more than 100 employees; this move left out many of their private doctors, most of whom did not cover their employees. However, the president advisors missed these subtle changes and remained overly confident.
The president’s team falsely assumed that Republicans and interest groups, with a track record of supporting reforms, would be pulled close to their bargain. However, as they came to realize later, by the spring of 1994, no one would be interested in any deal since the midterm elections were around the corner. The Republicans were already expecting major gains in the elections, and killing the reform was the only rational thing. Also, the low levels of unemployment conspired against the reform momentum because no one was now worried about jobs and health cover; instead, Americans were now more worried about crime. With the low inflation levels, the business community was also less concerned about containing health care costs. The focus now shifted from the details of the health care plan to the government, and this was a debate the government would lose for sure.
The secret deliberations inside the White House, and the fateful choice of putting the president’s name on it also partly contributed to the collapse of the health care plan. The administration had ignored political cooperation in coming up with appropriate health reforms. Successive administrations have leant the lessons, and when a legislation affecting a large number of people is proposed, the administration not only engages the Congress, but also engages the people directly. By following this criterion, the media, interests groups and the public get to participate in the process and this avoids misinformation and faulty reasoning. Through this process, all the non-issues can be trashed out and the controversies reduced to the essential questions. Nevertheless, President Clinton’s failure in reforming the heath care is comparable to other presidents before him.
For instance, President D Roosevelt’s, plans to include health cover in the 1935 Social Security Act were bitterly fought by the AMA (American Medical Association), which also killed President Harry Truman’s efforts (in 1945) to have a universal health cover program run by the federal government. The AMA and its affiliates attacked President Roosevelt’s plan as compulsory health insurance and in the end health care provisions were removed from the bill. However, President Lyndon Johnson administration outsmarted the physicians and managed to establish Medicare and Medicaid. Medicare, run by the federal government, caters for the elderly people, while Medicaid, run by combined efforts between the federal and state governments cater for the poor. Nonetheless, the final terms of both programs were friendly to physicians and hospitals, and this could explain why the AMA fought the programs frivolously.
President Richard Nixon also sought to unveil a comprehensive health care plan, but resigned before it was realized. President Jimmy Carter, Nixon’s successor, proposed a plan similar plan albeit watered-down, but the plan did not go far. By the time President Clinton was elected into office, he fully understood the insurmountable challenge he had before him but, with the support of the public, business executives and physicians, it was a risk he was willing to take. However, the president’s plan, like others before him, came face to face with strong opposition from interest groups. The medical community and business organizations backpedalled on their initial support and within sometime, the Clinton’s health care plan collapsed.
During the 20th century, healthcare reforms took the centre stage of politics in the United States. Successive governments tried introduce suitable health plans without much success. Before President Clinton took office, the only president who achieved significant success in reforming the health care was President Lyndon Johnson who managed to establish Medicare and Medicaid. Despite these odd statistics, President Clinton’s administration took the challenge and tried to come up with a new health care plan. However, the president’s plan could not go past opposition politics and negative criticism, which caused the collapse of the plan. Nonetheless, the lessons learnt would be useful for future administrations which intend to introduce major reforms.
Works Cited
Hacker, Jacob S. The Road to Nowhere: The Genesis of President Clinton's Plan for Health
Security. Princeton, NJ: Princeton University Press, 1999. Print.
Johnson, H and D. S Broder. The system: the American way of politics at the breaking point.
Boston: Little Brown, 1996. Print.
Laham, Nicholas. A Lost Cause: Bill Clinton's Campaign for National Health Insurance. New
York, NY: Greenwood Publishing Group, 1996.
Starr, Paul. Remedy and Reaction: The Peculiar American Struggle Over Health Care Reform.
New Haven. CT: Yale University Press, 2011.
