Hillary Clinton's 1993 Health Care Plan- Why didn't it pass?

[EmilyAnne]

Both houses were in control of the Democrats, so what happened? Also, why didn't Hillary present a second plan that addressed the criticisms of the first?

[depakid]

1. What happened was that Hillary did the same thing Obama is doing

trying to be all things for everyone, rather than standing up and making the tough and rational policy choices in a manner that people can understand- and that deals with most of the root causes of the gross inefficiencies in the fragmented American healthcare "system."

The end result was that no one ended up liking the plan- and it was easy fodder for a Harry & Louis attack (the likes of which is going to happen no matter what sorts of bones are thrown at insurers, private hospitals and PhARMA).

[EmilyAnne]

3. So you think that Obama's health care plan is not rational?

I've been trying to compare their plans and I'm having a hard time making heads or tails.

[EmilyAnne]

4. And here is Harry and Louise for those of us too young to know the reference.

http://www.youtube.com/watch?v=Dt31nhleeCg

[Asia Expat]

9. Thanks for that link.

Better to have the insurance companies decide.

Unfortunately, we will probably have to wait at least another four years.

[depakid]

6. In the sense that it doesn't address the root problems that have led to the current debacle, yes.

Then again, to an extent- so were the other candidates plans.

The only rational approach- is to cover everyone in a basic benefits package and create the largest risk pool possible, lowering everyone's costs- and preventing adverse selection (cherry picking the healthy- or otherwise keeping them out of the pool) while streamlining fair reimbursement for providers has to cut insurers out of the equation.

These groups are parasites on the system. Not only do they fail to "produce healthcare," but in many cases, they actually suck money out of the system to deny people care and harass providers through all sorts of schemes.

Any plan that doesn't recognize this very basic fact is irrational (at least to the extent that the goal is to improve health outcomes, prevent personal bankruptcies and do so for less money than goes out with the status quo.

[cyclezealot]

7. Yes. the Harry and Louise ads were the biggest factor

Insurance companies will put up whatever to takes to have solely a plan they approve. Any plan they approve of is not one the public will desire. One acts here as if the Congress really objects to legislation. Those fickle people object to whatever special interest money is put up for TV time. / I assure you the insurance companies will equally oppose any plan that does anything but subsidize their already overly expensive premimums. Should it regulate their right to cancel your policy should you be overly sick or if government regulations cuts into their 20% Administrative fees. / Any plan that does such will again be subjected to Harry and Louise. / What we need are politicans who do not cower to insurance companies, because there is no compromising with them.

[depakid]

12. "there is no compromising with them."

Truer words have rarely been spoken- and that applies to extremists and robber barons of any sort.

Better to recognize that upfront and make the case simply and directly to the public, in an easy to understand us vs. them sort of way. These are not exactly popular entities- but it takes some courage and fortitude to take on their money and insider influence.

[cyclezealot]

14. Reason we love our Dennis Kucinich

He will take them on at peril to his own career. / Show the connection to those who oppose insurance companies. Look how Michael Moore got treated when he tried to be just a visitor to Wall Street, just from the observers platform. . We don't run the US. It's a triangle of banks, Insurance companies, and Investment firms. But, they run it , only because the voting public lets them. / Should Obama's healthcare plan be some kind of compromise with Insurance companies, it won't be worth a dam. / And it will end up making the US as an economic entity less competitive , not more. Maybe Obama has guts. we shall see. So far, he does not demand universality. Makes us skeptical.

[Occam Bandage]

16. LMAO. The only difference between their plans are the mandates.

[elixir]

17. Agreed. She tried to answer everyone's needs and couldn't get it off the ground.

[Avalux]

22. You're off base with you analysis.

The Clintons did not properly market the plan; they developed it in secret, did not open it up for the input of others and did not share it with the American people. There was an organized effort by Republicans (William Kristol was instrumental) in killing the plan which was easy to do - Harry and Louis worked because there was no previous knowledge of the plan to counter it.

To say Hillary did the same thing Obama is doing is silly.

[CTLawGuy]

26. she wrote the thing herself, down to the last detail, in private

with no input from the people who would have to put their necks on the line to pass it.

This is the problem with being obsessed with details. No president will be able to pass a very detailed plan as is, because it has to get through congress first.

In 1993, Congress decided they didn't want to risk it on a huge plan written in secret without their input.

[Hart2008]

2. There is another thread about this here. In short it wasn't really important to them.

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=132&topic_id=4659677&mesg_id=4659677

[bluestateguy]

5. It was too mystifyingly complex

Nobody understood exactly how it worked. And yet, a single payer system probably would have been less bureaucratic, more efficient and easier to explain to people than Hillary's nonsensical DLC, third way, policy wonkish gibberish.

[ramapo]

8. Republicans couldn't let it pass

Had Clinton succeeded, the Republicans would've handed the Democrats a huge victory. So they did what they do best, run a campaign of fear and misinformation. Conservative Democrats united with Republicans, afraid to do what was best for the people vs. what was best for the lobbyists.

More to the point, the people did not demand the health care system be fixed but instead bought into the fear campaign.

There was no second plan because Washington does not work on compromise. Had that not been true, an effective one would've been agreed to during the first round.

[IADEMO2004]

10. Long but worth the read, Before this election year drama

http://www.upenn.edu/pnc/ptbok.html

The health care debate of 1993-94 provides an instructive, albeit a somewhat extravagant case through which to ponder these questions. Much space and time were devoted to the issues by newspapers, TV stations and radio talk shows. More than $100 million is said to have been spent on the legislative campaign by the many interest groups concerned with health care reform. Most of this amount was devoted to media efforts to communicate with the public. Innumerable fliers, TV spots, newspaper advertisements, and direct mail appeals were directed to citizens by interest groups on every side of the question. If there was ever a "marketplace of ideas" for public policy, the health care debate was surely a spectacular example.

Yet in the end, this vast effort at persuasion exhibited all of the weaknesses already identified and more besides. The debate was confused throughout by the large number of participating groups in Congress. Instead of simplifying the discussion by developing a single Democratic plan, several committees and even individual Senators and Representatives took it upon themselves to introduce separate reform plans, creating a daunting array of options for the public to follow and understand. By the end of the Congressional debates, 27 different legislative proposals were advanced, which in turn were identified in the media by 110 different names


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Our son was starting his 5th year with diabetes and every night the evening news would have the health plan of the day. Everyone wanted MY MY MY plan. No Democrat unity at all. Guardians Of Privilege did what they always do. Don't forget the house post office and banking scandals were in the courts then too.

[karynnj]

13. The reason why there were so many competing Democratic plans

is that HRC and the task force did not make an effort to bring the various Senators and Congressmen with alternative ideas into the process. Had they been in the process, the plan could have become a consensus plan and their involvement would have made them stakeholders and possibly advocates.

The Clintons, between them, managed this very badly - leading to a situation where key Democrats were completely against their plan. This is why it was never even submitted to Congress. There was not a single Democrat on the Finance committee for it. They then refused to back any alternative Democratic or bipartisan plan. (I trust Senator Bradley on this issue more than HRC.)

[QC]

19. And, of course, there were many Democrats owned by corporate interests then, as today.

Jim Cooper is a good example. I know he is being lionized by some of the Obama crowd now, but those of us with actual first hand memory of the early 90s remember Cooper as one of those alleged Democrats who always happened--surely by the purest coincidence!--to vote with the Republicans, bleat their talking points, campaign like them, etc.

[karynnj]

27. I did not mention Cooper, who I know nothing about other than what was said in competing threads

The politician that I mentioned was Senator Bradley, my former Senator. He was and is an upstanding guy who has very strong liberal credentials. He's a harder target for you and he didn't vote with the Republicans. I do have first hand memories of the 1990s, having first voted for McGovern!

As I said, I trust Bradley far more than I trust HRC, who I admired when she first was First Lady - as I said she ignored the culture of the Senate and Congress and she and Magaziner created a plan without involving them. That is not the way to get support.

[eridani]

11. It was a plan crafted in secret by Clinton and large insurance companies

Smaller insurance companies would have been out of the picture. They struck back with the Harry and Louise ads. Did the big boys then bother to defend their own plan? Hell, no! They were delighted that real reform would be postponed for a good long time, and stabbed HRC in the back. The scary thing is that she thinks they won't do it again if she's president.

[Armstead]

15. Here's a really good detailed timeline of what happened

http://www.pbs.org/newshour/forum/may96/background/health_debate_page1.html

It gives the details and the context of what happened in chronological order.

[QC]

18. The entire health care industry rose up against it, along with the GOP.

Doctors, big hospital chains, insurance companies: all of them banded together and put literally hundreds of millions of dollars into defeating the plan. The Republicans did their part, since they have been fighting universal health care since Harry Truman first proposed it.

We are getting a lot of revisionism here lately, so the story you will get is that it's all Hillary's fault: she just wouldn't reach out and offer hope to those nice Republicans and corporations. She shares in the blame for the failure of her health care plan, but let's not leave out the role of Big Business Inc. and its loyal functionaries in the GOP.

[jasmine621]

20. You folks keep erroneously believing that the Dem elites supported the Clintons.

What foolish thinking. They were never liked or supported by the Dem elites like Kennedy, Kerry, and others. They were not and still are not INSIDERS. It is a myth perpetuated by the media to get more and more ordinary citizens to turn against them at the polls. They are outsiders to most political elites. They were relatively poor sub-bred and unworthy of invading the DC political space. How did they do it? Much the same way as Obama is doing it now with messages of hope, the future, change, and putting the government to work for the people. Bill Clinton's speeches were every bit as inspirational and moving and even more substantive than Obama's are now. But how soon we forget. It is a modern marvel that he could have been elected twice to the Presidency with all the obstacles and hate facing them but they did it. And contrary to the rewritten history that some would have you now believe, they accomplished some damn good things for the American people and raised the status of America around the world to levels not seen since right after WWII. How soon we forget. The promise of NAFTA was not relized largely because the Republicans stood in the way of enacting the legislation that would have corrected much of the problems we now face by requiring environmental and wage agreements that would allow the US to remain competitive. The corporations won that battle and began to move away to become foreign entities benefiting from the law. How soon we forget. Welfare reform had many protection built into the law and Clinton was ready to put forth more changes to the law that was finally passed to protect needy women and children but the Republicans began the impeachment movement and anything of meaning by the Clinton administration on social programs was lost forever. But how soon we forget. I wonder how soon we will forget the 2008 primary season?

[Recursion]

21. It was as transparent as Cheney's energy policy meetings

She met with a bunch of industry reps in closed-door secret meetings and came up with a fait accompli that most of the big party figures thought was simply a handout to big insurance companies.

Gingrich had essentially encouraged her to do this and was ready to attack it from the right; meanwhile, its tilt towards insurance companies dried up its support on the left so nobody jumped in front of the bus for it.

[Ino]

23. Hillary's campaign called me...

right before the Missouri primary. The woman was going on & on about how we need universal healthcare and Hillary was the one who was going to bring it to us. I said, "Well, she had 8 years to set it up and failed." The woman said, "You know why it failed? Because Ted Kennedy killed it." I said that was ridiculous, but is there any truth to it? This was right after Kennedy endorsed Obama, remember.

She thanked me for chatting with her instead of hanging up like most people do. I didn't bother to point out that the longer I kept her on the phone, the fewer people she could call. :)

[union_maid]

24. Ahead of its time

Many of the reasons in this thread are valild, but there's one important reason that made all the others resonate so well. It was designed to head off a problem that was going to blow up huge in the not so very distant future, more than to fix a huge problem that had already reached a crisis point. Americans aren't so crazy about that. Many, if not most, full time employees had decent health coverage and low or even no cost to them. The poor ususally had Medicaid (mileage varying according to where you were poor) and seniors had Medicare, which seemed adequate at the time. You had to be a little bit forward-looking to see what was coming. It wasn't an emergency so the public had the luxury of being scared off by the massive campaigns waged by the special interests that didn't feel they'd be well served by national healthcare.

[Exilednight]

25. In a nutshell -

Her ego got in the way.

She put together a package that was long and complicated and believed that no one would question it. She believed that with the party controlling Congress, all she had to do was present it - they would pass it, and Bill would sign it. No questions asked. She wasn't expecting the Republicans to put up a serious fight. She thought they would roll over and play dead.

Here's the problem I see now. She's watched Bush ram legislation down the throat of Congress and Democrats never questioned a single piece of it. She thinks the same thing will happen if she were to win the White House. She underestimates the power of Republicans to organize corporate lobby groups and put commercials on the air to distort reality.

This time around she shortened the package, but she still isn't prepared for the firestorm that would come. I can already see the ads attacking her plan if she were to win.

The problem wasn't in the package. It was in the way she presented it and then didn't defend it.

Bottom line - same thing will happen.

Those that don't learn from history are doomed to repeat it.