Clinton and US Health Care in the 1990s
In the 1992 election, Presidential candidate Bill Clinton used the issue of health care, education, and education in his campaign against George H W. Bush, who was perceived to be the more popular candidate because of his victories in the Gulf War. During the campaign, Clinton said that he wanted to make health care affordable for every American family (Public Broadcasting Service (PBS), 2007). When he finally sat as the forty-second president of the United States in 1993, he began to concretize his health care reform proposal by setting up the Task Force on National Health Care Reform. To the consternation of his critics and other sectors, he appointed his own wife Hillary Rodham Clinton to head this Task Force. The appointment of Hillary was the first one in history for the office of the US President to give such power to a presidential wife (PBS, 2007). The United States has never established a universal health care system. Nonetheless, there are health care programs being supported by the finances of the government to provide such services to those who can hardly afford it (Moffitt, 1993). According to Clinton’s speech in the Senate however, he believed that there was a crisis in the American health care, particularly because millions of Americans do not have health insurance coverage while health care spending is rising (Clinton, 1993).
The Health Security Act, containing the proposed reforms was proposed to the US Congress toward the end of 1993. There were many debates, consultations and controversies about the bill, but in the end, the bill did not make it through. Since then, the US Congress has not earnestly dealt with any proposal for a universal health care program (Pantel & Rushefsky, 1997).
Agenda Setting and Policy Formulation: A Framework
There are three streams that contribute to the dynamics of policy formulation and agenda setting. It starts with the perception and quantification of a problem. This is then followed by the identification of the possible solution to the problems. To determine which of the possible solutions will be followed, the circumstances prevailing in the political system come into play (Longest, 2006).
These can be used as a framework in analyzing the events surrounding Clinton’s health care proposal in 1993. The dynamics, debates, and eventual disapproval of the proposal illustrate well the interplay of these three streams. During his campaign, Clinton was able to see health care as an important issue in the hearts and minds of the American people. He then identified problematic areas of the health industry which need to be reformed. Based on his perception, he formulated several ways in which these problem areas could be addressed. Hence, the Health Security Act.
Analyzing Clinton’s Health Care Proposal
The problem, which is healthcare and the costs associated it, is multi-faceted. Different viewpoints can generate different quantification and qualification of what the problem really is. Critics of Clinton’s proposal were actually questioning whether there was really a crisis in the American health care system (PBS, 2007). Others saw the need for reform but differed in the manner of solving the problem. Several sectors and stakeholders in the society had different ideas of solving the problem. If no compromise can be arrive at, most likely the status quo would be preserved.
The main criticisms in Clinton’s health care proposal is the way it empowers government to control almost every aspect of the health services sector—from the delivery of health care services, to the dispensation of medicines, and taxes that would govern health care providers. Instead of simplifying the system, critics claimed, it would rather create another bureaucracy, which will only complicate matters. In the long run, such reform would only exacerbate the financial conditions of low-income Americans and will severely impact the operations of small businesses (Moffitt, 1993).
On top of these criticisms, the prevailing political circumstances during that time also served to even decrease the passage of the bill in Congress. In pushing for the reforms of the health care program in the United States, Clinton drew upon several strategies. For one, the appointment of Hilary Clinton in the Task Force was seen by some of his cabinet members and detractors as a means of making the efforts at reform more personal. Moreover, since Clinton was involved in a sex-related scandal prior to his election, his move was seen as a means to put his wife in a position to defend him against such allegations (Kevin, 2007).
The power given to Hillary was also attacked by several critics, given the secret proceedings of the Task Force on Health Care, especially when Hillary became involved in meetings and consultations with the Federal Advisory Committee. When the defeat of the proposal was imminent, a compromise bill was offered by Clinton’s allies in the Congress. However, the compromise bill lacked the support of a sufficient number of congressmen and was defeated (PBS, 2007). The defeat of this proposal was a blow to Clinton’s political career because he banked on this issue during his campaign and it was seen as one of the issues that would have defined his first presidential term. Nonetheless, because of his performance in other areas of governance, he managed to get reelected for a second term in 1997.
Reference
Clinton, W. J. (1993). Address of the President to the Join Session of Congress. Retrieved 3 September 2007 from http://www.clintonpresidentialcenter.org/legacy/092293-speech-by-president-address-to-joint-session-of-congress-as-delivered.htm.
Kevin, P. (2007). All in the Family: Two Books Attempt to Get at the Real Hillary Clinton. Washington Post, 10 June 2007.
Longest, B. B. Jr. (2006). Health Policymaking in the United States. Chicago: Health Administration Press.
Moffitt, R. E. (1993). A Guide to the Clinton Health Plan. The Heritage Foundation. Retrieved 3 September 2007 from http://www.heritage.org/Research/HealthCare/tp00.cfm
Pantel, K. & Rushefsky, M. E. (1997). Politics, Power, and Policy Making: The Case of Health Care Reform in the 1990s. New York: M. E. Sharpe.
Public Broadcasting Service. (2007). A Detailed Timeline of the Healthcare Debate portrayed in “The System”. Retrieved 3 September 2007 from http://www.pbs.org/newshour/forum/may96/background/health_debate_page1.html
