Poor Diagnosis, Bad Prescription
Gloria Borger explains how arrogance and naivete doomed Clinton's helath care plan
Magaziner remained--and did the opposite of what the chairman had advised. His secretive, 500-member "Tollgate" process to write the plan made politicians wince and convinced the rest of the world that he was hatching a Rube Goldberg scheme. Many now call the deliberations a complete waste of four months. "We don't speak the same language," Louisiana Democratic Sen. John Breaux complained at the time. "He is a technician; we are politicians. It doesn't work."
The real problem was inside the Clinton White House. The White House solicited advice throughout the administration but ignored much of it. Last summer, with the plan nearing completion before its September send-off, then chief of staff Mack McLarty tried to nudge the Clintons into opening things up a bit. So did Gergen. But what might have been a final debate about ideas became an 11th-hour stab at finding out what was in the plan--and fixing it.
By August, the cabinet was in a frenzy. "We were in terrible trouble," says one White House official. "And we knew it." Health and Human Services Secretary Donna Shalala was worried: She had already cornered Mrs. Clinton at a July social event, gently warning of possible disaster. Others did the same. Like orphans, the cabinet bonded: They told one another about meetings they had not been invited to, about proposals they might need to know about. Some held rump meetings; a black market in Magaziner-held documents even sprouted.
Divide and conquer. Magaziner's idea was to put together a version of reform for the Clintons to consider. But he wanted each department to contribute its piece--and allow no one to see the whole product. The plan drove Bentsen crazy, and he bluntly told Hillary Clinton: "We have a staff staying up 24 hours a day through the weekend. We have got to have access to all the information." Mrs. Clinton agreed. Later, she got a memo from Council of Economic Advisers Chairman Laura Tyson urging a more modest benefits package; National Economic Council chief Bob Rubin agreed. Bentsen delivered a 38-page, single-spaced memo arguing that Congress would never go for huge Medicare cuts, among other things. Rubin now says that "by the time it got finished, people had enormous input and we wound up with a structure everybody agreed with." Others disagree.
The principals' strategy was to build not from the center out, but from the left to the center, so "impassioned allies" would get the debate off to a good start. But there were no impassioned allies: Although Magaziner had expected otherwise, big groups such as the U.S. Chamber of Commerce fought the bill. Even the elderly lobby was lukewarm. Panetta, in a meeting with Magaziner, dumped the plan on a table: "No one is going to be for this." Shalala told Magaziner he had built a "negative coalition." Gergen argued that the Republicans would never accept a plan with employer mandates or with big health care alliances. The Clintons were about to call for a revolution that neither the public nor the Congress wanted. Nebraska Democratic Sen. Bob Kerrey calls the plan an "academically correct" piece of legislation--all structure, no constituency.
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