I actually took an entire class entitled the Clinton Presidency. It was awesome, taught by Dr. Margaret Scranton (a conservative), and while my opinions of Clinton might be less than stellar, the class rocked. I learned a lot about modern liberal agenda, policymaking in general, recent history, and, being an Arkansas resident, had access to some mind blowing original documents to use as research.
I'm telling you that to tell you this: The similarities of Clinton's proposal and Obama's are pretty parallel. I wrote this 3 years ago, dug it out, and felt 1) I had either successfully predicted the future, with names changed to protect the identities of the innocent; or 2) had actually witnessed history in the Democratic party repeat itself.
There are many, many reasons Obama's healthcare reform proposal won't work. Thanks to your friendly neighborhood Blue Dog Democrats, division within the President's own party is making it pretty hard for him to get a leg up (no pun intended) with this bill.
Here's an interesting link for reference: http://www.progressive.org/mag/rc072309.html
And from the mouth of me...(pardon the length, but for those of you who know the bill, you'll get my drift):
William Jefferson Clinton’s failed attempt to reform health care in the United States was one of the largest government overhaul attempts since Franklin Delano Roosevelt’s New Deal. While seeking to reform America’s health care system was a valiant effort, many factors were overlooked by Clinton’s administration that could have helped them better organize their party, resulting in better success with the Health Security initiative. A party that cannot be united in support of its own legislation has to carry much of the blame for failed attempts to change the health care system.
Long before Clinton ever introduced his health care reform plan, Republicans had anticipated this move and had contemplated ways to kill it. Newt Gingrich admitted to foreseeing health care reform as America’s next political brawl, and had planned on ways to use its introduction as a means for Republicans to take back control of Congress (Johnson & Broder xiii). The admittance of such an idea by the Minority-Whip-turned-Speaker-of-the-House illustrates the political landscape of this time. Republicans were hard set on regaining Congressional control, and the content of Clinton’s health care reform bill was not necessarily the issue. Republicans were going to find any weakness they could within the Democratic Party and attack.
What was Newt Gingrich’s plan to defeat the Democrats and their Health Care plan? Negative attitudes toward the government had been growing stronger preceding the 1990s; this deepening distrust of Washington was recognized by Gingrich and other Republicans. The assassinations of John and Robert Kennedy and Martin Luther King, Jr., and the demise of the reputations of Johnson and Nixon, all within the span of eleven years, plus the compounding of Vietnam and Watergate, had left a nation breeding of distrust toward American government (Johnson & Broder 206). Gingrich was able to recognize this distrust for the Federal government and consequently lead the Republicans toward an anti-“big government” campaign that would be focused especially on the destruction of Clinton’s plan for health care reform. These negative attitudes toward government were to be used by Gingrich and company’s advantage, spreading this wide distrust of government even further across the American demographic. As Gingrich put it, Clinton’s plan would “create greater public dependency on government and a government-run plan, and a stronger allegiance of voters to majority Democrats who provided them their benefits” (Johnson & Broder 11). A country so hard-pressed at the time to accept big government would undoubtedly be easy to sway away from approval of Clinton’s Health Security agenda.
Also, Gingrich realized that only by controlling Congress with a new conservative Republican majority could the final goals of their “Republican Revolution” be achieved: meaning that the public dependency on Democratic tax-funded programs would have to be broken (Johnson & Broder 11).
Exactly how threatening was this new health care reform plan to the Republican Party? Initially, the Clinton plan was expected to be enacted by Congress without any changes whatsoever. It was initially widely accepted as “an excellent staring point for the enactment of comprehensive national health care reform” (Skocpol 6). The Republicans realized this and mobilized their party to crush the public’s initial acceptance of Clinton’s plan. This is evidenced by the sharp turn of public opinion after the first year of the Health Security initiative’s launch (Skocpol 6). This was the first step for the Republicans to align themselves to gain Congressional control in 1994.
Research indicates that Americans did want health care reform, just not in the manner that Clinton envisioned. Polls taken during the time of Clinton’s first term showed that over 80 percent of Americans wanted the health care system completely rebuilt (Butler 3). However desiring of change Americans were, they still had concerns with Clinton’s plan, namely lack of portability, a high level of uninsurance, and rapid cost escalation (Butler 4).
The Republican opposition to Clinton’s health care reform bill was, therefore, ammunition to defeat the Democrats in the 1994 midterm elections. However, the Republicans had to have an alternative to purport their opposition. What was this alternative?
In general, the Republican Party wanted to follow George Bush’s health care plan that was used in his campaign. House and Senate Republicans endorsed plans featuring tax credits for low income individuals to go toward the purchase of health insurance, small group insurance reform, malpractice reform, and emphasizing “managed care” to enhance funding for certain elements of the public delivery system (Ebeler 6). In reality, however, President Bush’s policy approach consisted of proposed tax subsidies of private insurance companies, or “throwing good money after bad,” according to Clinton (Johnson & Broder 89).
In comparison to the Clinton administration’s health care bill, reverting back to George Bush’s alternative would allow the Republicans to portray Clinton’s health care bill as “another liberal Democratic plan”, using this negative connotation to spread public fear and opposition of the reform (Ebeler 4). Republicans were fiercely opposed to any government meddling, which eventually coincided with mainstream public opinion at the time of Clinton’s proposed Health Security legislation (Skocpol 133). Republicans were able to use this consensus in public opinion to further propel their anti-Clinton propaganda, making the backdrop for Clinton’s Health Security bill one of a socialistic nature. “The cost-cutting implications of President Clinton’s proposed Health Security legislation were so different from the generous new financial subsidies implied by President Franklin Roosevelt’s Social Security legislation of 1935 that many individuals and groups came to see comprehensive heal care reform as more of a possible threat than a solution” (Skocpol 134).
Clinton compared his own plan to that of Bush’s, stating that this “is a private system. It is not pay-or-play. It does not require new taxes. It will preserve what is best about the present health care system, but it will also incorporate what we have learned about what is wrong” (Johnson & Broder 89).
There is a clear contradiction in what the Republicans actually endorsed, and what their support for Bush’s plan revealed. That is, many House and Senate Republicans voted for tax breaks for lower-income individuals, while Bush’s health care plan favored tax cuts for private companies. Hiding behind the façade of supporting President Bush’s health care policy was just a tactic for Republicans to lead support away from President Clinton and his health care bill.
As if this contradicting support and opposition being thrown by the Republicans weren’t enough, the Democratic Party had their own worries. Democrats were failing to unite in support of Clinton’s Health Security bill, a fatal blow to the success of the legislation. What instances were keeping the Democrats from being unified in their support?
First, the introduction of the Cooper Bill divided the Democrats in their plan to pass a heath care reform bill. John Dingell had been introducing his H.R. 16 every year since he had come to Congress in 1955 (Johnson & Broder 306). He apparently saw the Clinton administration’s call for health care reform as his opportunity to finally see his legislation enacted. H.R. 16, however, was more than an attempt to reform health care; it was, essentially, Dingell’s attempt to achieve this reform as his claim on history (Johnson & Broder 306). H.R. 16 favored a single-payer, government-run insurance program. However, Dingell was willing to support the President’s proposal (Johnson & Broder 308).
At the same time, however, Jim Cooper, a Democrat from Tennessee, also had his own vision of health care that interfered with Dingell’s interests. Cooper had strong conservative instincts on fiscal matters (Johnson & Broder 309). Through Atul Gawane, the Harvard Medical School student who later advised Clinton, Cooper became educated on the Jackson Hole group’s work and its managed competition approach (Johnson & Broder 309). Cooper’s plan had no requirement for employers to pay for most of their employees’ insurance, and it also did not provide direct controls on insurance premiums. Also, it had no deadline for insuring all Americans, as the President’s plan did (Johnson & Broder 309).
To add to the confusion that was already ensuing over the President’s plan, several other options were thrown into the mix, and this was only on behalf of the Democrats’ plan for reforming healthcare. Various political perspectives, from Mitchell’s employment-based model to Pryor’s state approach, also added to the inability of Clinton’s administration to focus on “Clinton’s” vision (Ebeler 5).
Clinton’s vision was, unfortunately, extremely complicated and only further allowed the Republican Party to distract the public from the Democrat’s desired focal point. For instance, state-based Health Insurance Purchasing Cooperatives, or HIPCs, left an enormous gray area in the issues of health coverage. This campaign promise pledged by Clinton himself would “manage competition among private health care plans on behalf of at least small businesses and individuals who lack negotiating clout” (Magaziner 1).
Unfortunately, Ira Magaziner failed to specify in his Work Plan what exactly defined a small business, or how long these small businesses would be assisted by the federal government in their transition to the “new” health care. This left another gaping wound for the Republicans to interject opposition, introduce various “what-if” scenarios, and further detract from Magaziner’s focus.
The Democrats should have realized how conflicting ideas within their party would cause large divisions. Support that divides itself into different factions cannot provide the backing required to pass a particular piece of legislation, especially one as convoluted as Clinton’s Health Security initiative. Republicans, seeing the division with the Democratic Party, were only given more fuel for their anti-Clinton fire.
Why didn’t the Democrats fully back Bill Clinton? Not only were the Democrats divided on the subject of health care and which alternative was the most effective for Americans, Democrats had a good deal of general opposition toward the President. Clinton, already in deep political trouble for breaking several campaign promises, made himself into a polarizing figure (Berman 47). Therefore, it was difficult for the different factions of Democrats, such as the New Democrats and the New Deal Democrats, to accept his leadership and follow his health care reform plan.
Later in his presidency, this would become especially prevalent. “Although he still retained the advantage of incumbency and the power of veto, his future prospects were uncertain. Many congressional Democrats distrusted him, and the House Republicans believed that he lacked the political standing and will necessary to challenge their attack on government” (Berman 47). Not only were the Republicans vehemently opposed to Clinton, but so were many congressional Democrats.
A weakened presidency and lack of unity with the Democratic Party set the stage for Republicans to win back Congress in 1994. This was the final blow in the battle between the two parties, and was almost insulting in regards to what Clinton had been trying to achieve with his Health Security bill. Clinton’s impeachment, ensuing after the Lewinsky scandal, left its lasting mark on his presidency. “The country had little stomach for big government spending programs or initiatives, especially after the GOP victory in 1994” (Berman 124).
Clinton’s health care initiative was too complex, allowing the Republican Party to use this as a diversion. The creation of a National Health Board only added to this confusion of “too many chiefs and not enough Indians.” The National Health Board would have been in charge of budget decisions, adjustments to the Comprehensive Benefits Package, and quality assurance (National Health Board 1,2). The actual structure of the NHB was so complex it would have taken an additional agency just to oversee it. This would be more ammunition for the Republicans to, once again, accuse the Democrats of being too liberal and pro-“big government.”
The Heritage Foundation called Clinton’s health care proposal “seriously flawed” (Butler 1). This traditionally conservative Washington think-tank identified four major faults with the plan: 1) Clinton’s budget did not incorporate explicit rationing; 2) A standard benefits package for Americans was likely to encourage heavy lobbying, thus increasing the cost of the basic benefits package; 3) People who change employment often would constantly be changing plans and doctors; and 4) Without changing the tax treatment of health care, Clinton’s plan encompassed many of the existing inequalities of the current tax code (Butler 3).
These business and personal motives for attempting to undermine the Democratic Party should have been recognized by the Democrats and crushed. How could they have accomplished this? First, the Democrats must have realized a change that needed to occur in tax treatment of health care in order to make things more equal. Also, legislation should have been proposed to protect individuals who change jobs; otherwise, they would have to shift doctors and benefits packages frequently.
Clinton and his administration should have promoted a bill that would have been more appealing to Republicans. While Republicans probably would have opposed any Democratic legislation from the beginning, it would have at least been a good political move on behalf of the Democratic Party to attempt to find middle ground. Rather than having all sorts of government agencies established to enforce the Health Security initiative, the Republicans would have been much more supportive of a simpler, less-obtrusive method of reforming the health care system. For instance, Republican Dick Armey’s plan would have been “streamlined and simpler” and was opposed to the 79 new federal mandates and 59 new federal programs or bureaucracies that the Clinton health plan would create (Skocpol 143). In Armey’s words, “The Clinton plan is a bureaucratic nightmare that will ultimately result in higher taxes, reduced efficiency, restricted choice, longer lines, and a much, much bigger federal government” (Skocpol 144). This fell right in line with the Republican’s crusade against big government, as well as the public’s fear of it. The Republican Party could also try and convince the public that a health care crisis did not exists (Skocpol 145).
Furthermore, the Democratic Party should not have waited until the last minute to introduce legislation that might have actually appeased both the majorities of Democrats and Republicans. By the time Mitchell would have introduced his bill to Congress, Democratic unison was so weak that no amount of rekindling could bring the party together. Also, the Republicans had, by this time, aligned themselves with enough fuel to distract the Democrats from their goals.
In the long run, how did the regain of Congressional power aid the Republican Party and its key figures? After all, Congress was blamed much more than Clinton for failure to achieve systematic reform in the area of health care (Johnson & Broder 645). Subsequently, it is apparent that much harm resulted in the reversal of control within the legislature.
Newt Gingrich, initially, used this gain of power to propel his career. While his image might have been tainted down the road, the beginning of the Republican Congressional hold began with Gingrich, Dole, and others all possessing great power and being the first leaders of the now-empowered Republican Party. This sent out a message to the Democrats as well, one that was almost condescending. The Republicans were therefore able to successfully block the Democrats from further action in the legislature, whether it was Clinton’s Health Care initiative or otherwise.
The road traveled on this journey was a double-edged sword. On one hand, the Republicans could not have gained control of Congress if the Democrats would not have been distracted by Clinton’s Health Care initiative. On the same token, Democrats would not have lost the health care reform attempt if the Republicans had not thrown in their distractions and opposition. The major lessons that can be taken from this failed attempt at such a reform is better organization within the party promoting the change; better awareness of defense tactics from the opposing party; a clearer image projected to the public regarding the topic at hand; and being on-guard for “holes” in strategy that might be caused by too much emphasis on one particular area.
The Republican opposition to Clinton’s health care reform bill was, therefore, ammunition to defeat the Democrats in the 1994 midterm elections. However, the Republicans had to have an alternative to purport their opposition. What was this alternative?
In general, the Republican Party wanted to follow George Bush’s health care plan that was used in his campaign. House and Senate Republicans endorsed plans featuring tax credits for low income individuals to go toward the purchase of health insurance, small group insurance reform, malpractice reform, and emphasizing “managed care” to enhance funding for certain elements of the public delivery system (Ebeler 6). In reality, however, President Bush’s policy approach consisted of proposed tax subsidies of private insurance companies, or “throwing good money after bad,” according to Clinton (Johnson & Broder 89).
In comparison to the Clinton administration’s health care bill, reverting back to George Bush’s alternative would allow the Republicans to portray Clinton’s health care bill as “another liberal Democratic plan”, using this negative connotation to spread public fear and opposition of the reform (Ebeler 4). Republicans were fiercely opposed to any government meddling, which eventually coincided with mainstream public opinion at the time of Clinton’s proposed Health Security legislation (Skocpol 133). Republicans were able to use this consensus in public opinion to further propel their anti-Clinton propaganda, making the backdrop for Clinton’s Health Security bill one of a socialistic nature. “The cost-cutting implications of President Clinton’s proposed Health Security legislation were so different from the generous new financial subsidies implied by President Franklin Roosevelt’s Social Security legislation of 1935 that many individuals and groups came to see comprehensive heal care reform as more of a possible threat than a solution” (Skocpol 134).
Clinton compared his own plan to that of Bush’s, stating that this “is a private system. It is not pay-or-play. It does not require new taxes. It will preserve what is best about the present health care system, but it will also incorporate what we have learned about what is wrong” (Johnson & Broder 89).
There is a clear contradiction in what the Republicans actually endorsed, and what their support for Bush’s plan revealed. That is, many House and Senate Republicans voted for tax breaks for lower-income individuals, while Bush’s health care plan favored tax cuts for private companies. Hiding behind the façade of supporting President Bush’s health care policy was just a tactic for Republicans to lead support away from President Clinton and his health care bill.
As if this contradicting support and opposition being thrown by the Republicans weren’t enough, the Democratic Party had their own worries. Democrats were failing to unite in support of Clinton’s Health Security bill, a fatal blow to the success of the legislation. What instances were keeping the Democrats from being unified in their support?
First, the introduction of the Cooper Bill divided the Democrats in their plan to pass a heath care reform bill. John Dingell had been introducing his H.R. 16 every year since he had come to Congress in 1955 (Johnson & Broder 306). He apparently saw the Clinton administration’s call for health care reform as his opportunity to finally see his legislation enacted. H.R. 16, however, was more than an attempt to reform health care; it was, essentially, Dingell’s attempt to achieve this reform as his claim on history (Johnson & Broder 306). H.R. 16 favored a single-payer, government-run insurance program. However, Dingell was willing to support the President’s proposal (Johnson & Broder 308).
At the same time, however, Jim Cooper, a Democrat from Tennessee, also had his own vision of health care that interfered with Dingell’s interests. Cooper had strong conservative instincts on fiscal matters (Johnson & Broder 309). Through Atul Gawane, the Harvard Medical School student who later advised Clinton, Cooper became educated on the Jackson Hole group’s work and its managed competition approach (Johnson & Broder 309). Cooper’s plan had no requirement for employers to pay for most of their employees’ insurance, and it also did not provide direct controls on insurance premiums. Also, it had no deadline for insuring all Americans, as the President’s plan did (Johnson & Broder 309).
To add to the confusion that was already ensuing over the President’s plan, several other options were thrown into the mix, and this was only on behalf of the Democrats’ plan for reforming healthcare. Various political perspectives, from Mitchell’s employment-based model to Pryor’s state approach, also added to the inability of Clinton’s administration to focus on “Clinton’s” vision (Ebeler 5).
Clinton’s vision was, unfortunately, extremely complicated and only further allowed the Republican Party to distract the public from the Democrat’s desired focal point. For instance, state-based Health Insurance Purchasing Cooperatives, or HIPCs, left an enormous gray area in the issues of health coverage. This campaign promise pledged by Clinton himself would “manage competition among private health care plans on behalf of at least small businesses and individuals who lack negotiating clout” (Magaziner 1).
Unfortunately, Ira Magaziner failed to specify in his Work Plan what exactly defined a small business, or how long these small businesses would be assisted by the federal government in their transition to the “new” health care. This left another gaping wound for the Republicans to interject opposition, introduce various “what-if” scenarios, and further detract from Magaziner’s focus.
The Democrats should have realized how conflicting ideas within their party would cause large divisions. Support that divides itself into different factions cannot provide the backing required to pass a particular piece of legislation, especially one as convoluted as Clinton’s Health Security initiative. Republicans, seeing the division with the Democratic Party, were only given more fuel for their anti-Clinton fire.
Why didn’t the Democrats fully back Bill Clinton? Not only were the Democrats divided on the subject of health care and which alternative was the most effective for Americans, Democrats had a good deal of general opposition toward the President. Clinton, already in deep political trouble for breaking several campaign promises, made himself into a polarizing figure (Berman 47). Therefore, it was difficult for the different factions of Democrats, such as the New Democrats and the New Deal Democrats, to accept his leadership and follow his health care reform plan.
Later in his presidency, this would become especially prevalent. “Although he still retained the advantage of incumbency and the power of veto, his future prospects were uncertain. Many congressional Democrats distrusted him, and the House Republicans believed that he lacked the political standing and will necessary to challenge their attack on government” (Berman 47). Not only were the Republicans vehemently opposed to Clinton, but so were many congressional Democrats.
A weakened presidency and lack of unity with the Democratic Party set the stage for Republicans to win back Congress in 1994. This was the final blow in the battle between the two parties, and was almost insulting in regards to what Clinton had been trying to achieve with his Health Security bill. Clinton’s impeachment, ensuing after the Lewinsky scandal, left its lasting mark on his presidency. “The country had little stomach for big government spending programs or initiatives, especially after the GOP victory in 1994” (Berman 124).
Clinton’s health care initiative was too complex, allowing the Republican Party to use this as a diversion. The creation of a National Health Board only added to this confusion of “too many chiefs and not enough Indians.” The National Health Board would have been in charge of budget decisions, adjustments to the Comprehensive Benefits Package, and quality assurance (National Health Board 1,2). The actual structure of the NHB was so complex it would have taken an additional agency just to oversee it. This would be more ammunition for the Republicans to, once again, accuse the Democrats of being too liberal and pro-“big government.”
The Heritage Foundation called Clinton’s health care proposal “seriously flawed” (Butler 1). This traditionally conservative Washington think-tank identified four major faults with the plan: 1) Clinton’s budget did not incorporate explicit rationing; 2) A standard benefits package for Americans was likely to encourage heavy lobbying, thus increasing the cost of the basic benefits package; 3) People who change employment often would constantly be changing plans and doctors; and 4) Without changing the tax treatment of health care, Clinton’s plan encompassed many of the existing inequalities of the current tax code (Butler 3).
These business and personal motives for attempting to undermine the Democratic Party should have been recognized by the Democrats and crushed. How could they have accomplished this? First, the Democrats must have realized a change that needed to occur in tax treatment of health care in order to make things more equal. Also, legislation should have been proposed to protect individuals who change jobs; otherwise, they would have to shift doctors and benefits packages frequently.
Clinton and his administration should have promoted a bill that would have been more appealing to Republicans. While Republicans probably would have opposed any Democratic legislation from the beginning, it would have at least been a good political move on behalf of the Democratic Party to attempt to find middle ground. Rather than having all sorts of government agencies established to enforce the Health Security initiative, the Republicans would have been much more supportive of a simpler, less-obtrusive method of reforming the health care system. For instance, Republican Dick Armey’s plan would have been “streamlined and simpler” and was opposed to the 79 new federal mandates and 59 new federal programs or bureaucracies that the Clinton health plan would create (Skocpol 143). In Armey’s words, “The Clinton plan is a bureaucratic nightmare that will ultimately result in higher taxes, reduced efficiency, restricted choice, longer lines, and a much, much bigger federal government” (Skocpol 144). This fell right in line with the Republican’s crusade against big government, as well as the public’s fear of it. The Republican Party could also try and convince the public that a health care crisis did not exists (Skocpol 145).
Furthermore, the Democratic Party should not have waited until the last minute to introduce legislation that might have actually appeased both the majorities of Democrats and Republicans. By the time Mitchell would have introduced his bill to Congress, Democratic unison was so weak that no amount of rekindling could bring the party together. Also, the Republicans had, by this time, aligned themselves with enough fuel to distract the Democrats from their goals.
In the long run, how did the regain of Congressional power aid the Republican Party and its key figures? After all, Congress was blamed much more than Clinton for failure to achieve systematic reform in the area of health care (Johnson & Broder 645). Subsequently, it is apparent that much harm resulted in the reversal of control within the legislature.
Newt Gingrich, initially, used this gain of power to propel his career. While his image might have been tainted down the road, the beginning of the Republican Congressional hold began with Gingrich, Dole, and others all possessing great power and being the first leaders of the now-empowered Republican Party. This sent out a message to the Democrats as well, one that was almost condescending. The Republicans were therefore able to successfully block the Democrats from further action in the legislature, whether it was Clinton’s Health Care initiative or otherwise.
The road traveled on this journey was a double-edged sword. On one hand, the Republicans could not have gained control of Congress if the Democrats would not have been distracted by Clinton’s Health Care initiative. On the same token, Democrats would not have lost the health care reform attempt if the Republicans had not thrown in their distractions and opposition. The major lessons that can be taken from this failed attempt at such a reform is better organization within the party promoting the change; better awareness of defense tactics from the opposing party; a clearer image projected to the public regarding the topic at hand; and being on-guard for “holes” in strategy that might be caused by too much emphasis on one particular area.
Back to the present.
Now, we have seen strategically why partisan opposition in particular will prevent this current healthcare reform bill from coming to light. In coming days I'll talk about why the healthcare reform is a massive failure of an idea, even if both sides of the aisle, and Americans, were welcoming to the change with open arms.
Stay tuned.
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