Brad Bannon is president of a political consulting and polling firm that works with Democratic candidates, labor unions, and progressive interest groups.
Early in his presidency, Bill Clinton was famous for the mulligans he took on the golf course and for his failed healthcare reform plan. Now under the leadership of a new president, Democrats get a do-over to heal the nation's ailing healthcare system. The work begins in Washington this week with President Obama's healthcare summit. We will soon see how much he learned from the Clintons' reform effort.
There's little doubt that President Obama will have to fix healthcare to repair the nation's broken healthcare system. One of every six dollars in our gross national product pays medical bills and it could be one out of every five dollars in 10 years. Democratic strategist Pat Cadell used to say that demography is destiny and the federal healthcare bill and the budget deficit will steadily climb as more and more baby boomers retire and become eligible for Medicare.
Now that the Obama planning process is beginning, it's a good time to examine what went wrong with Clinton Care. You have to give Bill and Hillary Clinton a lot of credit for aggressively tackling the healthcare crisis, but they suffered a number of self-inflicted wounds in the process.
Hopefully, Barack Obama's plan will avoid the secrecy, bureaucracy, and obstinacy of the Clinton effort.
President Obama has already avoided the secrecy problem with his promise to hold a number of "conversations" on the issue and also with his summit. The Clinton healthcare reform task force limited the access that concerned parties had to the formulation of policy.
The infamous iron triangle of federal bureaucrats, interest groups, and members of Congress were out of the loop, and the only way can make policy is to work your way into the good graces of this formidable trio. The secretary of the Department of Health and Human Services, Donna Shalala, had limited access, as did the Health Insurance Association of America.
Now, the health insurance industry was never going to support the program, but involvement in the task force may have lessened the intensity of the companies' opposition. As Lyndon Johnson used to say, it's better to have enemies "inside the tent pissing out, than outside the tent pissing in." The group's "Harry and Louise" ads devastated the public support for reform.
The secrecy also deprived the Clintons of a tool that they could have used to sell the program to the public: the media. Since there was a press blackout of the task force proceedings, Americans knew very little about the kind of reform that was coming down the pike. Americans were hesitant about fundamental changes in the traditional healthcare system and in the absence of other information, they believed Harry and Louise and feared the worst.
Supporters of healthcare reform trust Barack Obama will design a plan that is simpler and easier to explain than the Clinton Rube Goldberg contraption. The Clinton reform task force produced a report with 1,400 pages, which is not surprising since there since there were 600 people on the task force divided into 35 clusters and six working groups. A camel is a horse designed by a committee, and the plan was so bureaucratic that no one could explain it to the public with the same simplicity that Harry and Louise did with the slogan "They choose. We lose." According to Haynes Johnson and David Broder in their book The System, the Harry and Louise ads along with other efforts produced 450,000 congressional calls, letters, or visits in opposition to the Clinton plan.
We shall also see whether President Obama is more flexible than President Clinton. There was a stubborn streak to the Clinton approach to reform. President Clinton promised to veto any bill that he and the first lady didn't think was up to spec. Because the Clintons did not have a Plan "B," there was hardly any kind of reform at all while Bill Clinton was president. Sen. Edward Kennedy often tells people that he will settle for crumbs and get the loaf later. The Clintons should have acted accordingly.