Poor Diagnosis, Bad Prescription
Gloria Borger explains how arrogance and naivete doomed Clinton's helath care plan
Inevitably, the special interests will get much of the blame. The White House will argue it could not battle the bloated budgets of powerful lobbyists such as small business and the insurance industry. The president's bully pulpit, says Rubin, cannot compete with a daily barrage of TV ads that "grossly misrepresent" his plan. That is true. But a dismal communications effort, along with the impact and distractions of Whitewater, Bosnia, North Korea and Haiti, all produced an opening large enough for the opposition to crash through with a Mack truck.
The lobbyists and congressional veterans also knew something the White House did not: Health care reform was a piece of legislation, not a crusade. Writing laws hardly ever produces outright winners or losers. When the Business Roundtable failed to endorse the plan, the White House made big business a demon instead of trying to deal.
At the start, Hillary Clinton wanted a war room for health care. "They don't understand this is not a war," said one top Democratic Senate aide. "No one in Congress ever surrenders." The congressional committees battled over who would get the first lady first. Next on the schedule was the Treasury secretary, but he refused to testify because he did not have all the numbers. So Shalala trekked to the Hill and was pummeled by Senate Finance Chairman Daniel Patrick Moynihan. It was, she said, the worst day of her professional career.
For months, Congress fiddled. Groups of Senate Democrats and Republicans retreated to the mountains to commune on community ratings and other concepts. West Virginia's Jay Rockefeller--who some say liked Clinton's plan more than Clinton did--was big on "male bonding" to help get a bill. The House convened a health care college. Magaziner made endless courtesy calls; everyone paid homage to Moynihan. It was friendly, but it was also without direction. "Who in the cabinet is in charge of this?" asked a top Senate Finance staffer at a White House session. The response: "Is that a trick question?"
In its enthusiasm for reform, the White House had forgotten the limits of Bill Clinton's 43 percent mandate. "They [the White House] are all dreaming of the things they want to do," mused Rostenkowski, "but they aren't talking to the pharmacist that's going to be against this bill who's going to scare the hell out of the congressman when he comes in to fill his prescription."
The problem, Breaux now says, was pretty obvious: "The policy focused on the 15 percent of Americans who did not have any health insurance rather than on the 85 percent who do." The public was uneasy about health care, but not enough to generate a consensus about what to do. House liberals, who backed a Canadian-style, "single payer" approach to reform, never climbed on board. Clinton's Democratic Leadership Council colleagues--the moderates he once led--were incredulous at the bill. "I always felt [employer] mandates were something he was not really comfortable with," says Breaux. When ally Rostenkowski helpfully suggested tax increases to pay for the plan, Clinton quickly phoned: "What are you doing to me?"
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