Changes

=== Health Care Reform ===

=== Health Care Reform ===

In 1993, Clinton called for a national medical care system that would incorporate the 15% of the population that was entitled to emergency care but lacked broader insurance. Clinton decided on a plan using regional insurance purchasing agencies along with modest tax subsidies to combine universal coverage with cost efficiency. He and his advisors believed the plan would be acceptable to big business and the larger insurance companies, but the plan was opposed by a well-financed campaign.  The plan however, put a burden Small business, which feared it could not afford it. The insurance industry and doctor organizations also opposed it. Republicans argued that it was too costly and relied too heavily on government. Congressional Democrats were divided on the issue. Faced with public opposition, the Clinton plan failed without even having a vote in Congress.

 

In 1993, Clinton called for a national medical care system that would incorporate the 15% of the population that was entitled to emergency care but lacked broader insurance. Clinton decided on a plan using regional insurance purchasing agencies along with modest tax subsidies to combine universal coverage with cost efficiency. He and his advisors believed the plan would be acceptable to big business and the larger insurance companies, but the plan was opposed by a well-financed campaign.  The plan however, put a burden on small businesses, which feared they could not afford it. The insurance industry and doctor organizations also opposed it. Republicans argued that it was too costly and relied too heavily on government. Congressional Democrats were divided on the issue. Faced with public opposition, the Clinton plan failed without even having a vote in Congress.

Skocpol (1996) suggests the major mistake may have been in emphasizing the cost-reducing aspect of the plan, not realizing that Americans were willing to pay for a government program that would provide generous benefits to them. The fear that Clinton's proposals would lead to the sort of health care rationing prevalent in Canada and other countries further troubled the voters. Starr (1997) notes that Clinton sought to achieve liberal ends of universal coverage through the conservative means of managed competition among private health plans, with a backup cap on the rate of growth in average insurance premiums. This approach had a political as well as policy rationale. It was meant to be the basis of an alliance that could include conservative Democrats and moderate Republicans and thereby achieve the majorities necessary for congressional passage. But what we saw as compromise, they did not -- especially as the very locus of the political center shifted to the right during the debate. Health care reform that seemed "inevitable" to many serious observers at the start became unthinkable by the end. Polls showed strong initial support, but he never secured passage in either house of Congress and Republican victory in the 1994 elections doomed his plans.

Skocpol (1996) suggests the major mistake may have been in emphasizing the cost-reducing aspect of the plan, not realizing that Americans were willing to pay for a government program that would provide generous benefits to them. The fear that Clinton's proposals would lead to the sort of health care rationing prevalent in Canada and other countries further troubled the voters. Starr (1997) notes that Clinton sought to achieve liberal ends of universal coverage through the conservative means of managed competition among private health plans, with a backup cap on the rate of growth in average insurance premiums. This approach had a political as well as policy rationale. It was meant to be the basis of an alliance that could include conservative Democrats and moderate Republicans and thereby achieve the majorities necessary for congressional passage. But what we saw as compromise, they did not -- especially as the very locus of the political center shifted to the right during the debate. Health care reform that seemed "inevitable" to many serious observers at the start became unthinkable by the end. Polls showed strong initial support, but he never secured passage in either house of Congress and Republican victory in the 1994 elections doomed his plans.