Living History by Unknown (best non fiction books of all time .txt) 📕

nation and explain how the Republican leadership had tried to derail reform. He could talk about his attempts to build a consensus and ask why Dole, Gingrich and others were so unwilling to come to the bargaining table. His message would be a presidential challenge to Congress to get the job done. Another group argued vehemently that it was more prudent to let the bill die without fanfare. In advance of the elections, they believed we didn’t need another controversy and worried that a presidential statement would draw greater attention to a political failure.

I thought that the country needed to see the President fighting, even if he lost, and that we should try for a vote in the Senate. The Finance Committee’s compromise had been voted out of the committee, and Senator Mitchell, as Majority Leader, could bring it directly to the floor. Even if that strategy resulted in a Republican filibuster, as some in our camp predicted, I thought it could work in our favor. Members of Congress would be more accountable to their constituents come the November elections. And Democrats would not be left in the worst of both worlds: the Republicans never having to vote against reform, and the Democratic majority failing to pass new legislation. The more cautious strategy won out, and health care faded with barely a whimper. I still think that was the wrong call. Giving up without one last public fight demoralized Democrats and let the opposition rewrite history.

After twenty months, we conceded defeat. We knew we had alienated a wide assortment of health care industry experts and professionals, as well as some of our own legislative allies. Ultimately, we could never convince the vast majority of Americans who have health insurance that they wouldn’t have to give up benefits and medical choices to help the minority of Americans without coverage. Nor could we persuade them that reform would protect them from losing insurance and would make their medical care more affordable in the future.

Bill and I were disappointed and discouraged. I knew I had contributed to our failure, both because of my own missteps and because I underestimated the resistance I would meet as a First Lady with a policy mission. I also felt bad for Ira, who had taken a lot of criticism that was unfair and unwarranted. Bill appreciated his hard work and asked him to head up the Administration’s Working Group on Electronic Commerce. Ira did a great job establishing the government’s approach for encouraging electronic commerce. He was soon praised in the business community for his insight and became known as the “Internet Czar.” But our most critical mistake was trying to do too much, too fast.

That said, I still believe we were right to try. Our work in 1993 and 1994 paved the way for what several economists dubbed the “Hillary Factor,” the purposeful restraint on price increases by medical providers and pharmaceutical companies during the 1990s. It also helped to create the ideas and political will that led to important smaller reforms in the years following. Thanks to the leadership of Senator Kennedy and Senator Nancy Kassebaum, a Kansas Republican, the nation now has a law guaranteeing that workers will not lose their insurance when they change jobs. I worked behind the scenes with Senator Kennedy to help create the Children’s Health Insurance Program (CHIP), which by 2003 provided coverage to more than 5 million children of working parents too well off for Medicaid but unable to afford private insurance. CHIP represented the largest expansion of public health insurance coverage since the passage of Medicaid in 1965, and it helped reduce the number of Americans without health insurance for the first time in twelve years.

Bill signed a series of bills that I had worked for, including laws ensuring that women be allowed to stay in the hospital for more than twentyfour hours after childbirth, promoting mammography and prostate screening, increasing research into diabetes and improving childhood vaccination rates so that go percent of all two-year-olds were immunized against the most serious childhood illnesses for the first time ever. Bill also took on the tobacco lobby and began seriously addressing HIV/AIDS here at home and around the world. He used his presidential prerogative to extend patients’ rights to more than eighty-five million Americans and their dependents enrolled in federal health plans and to those covered by Medicare, Medicaid and the Veterans Health System. None of these actions represented a seismic shift on the order of the Health Security Act. But collectively, these reforms of health care policy improved conditions for tens of millions of Americans.

On balance I think we made the right decision to try to reform the whole system. By 2002, with the economy in trouble again and the financial savings of managed care in the nineties having leveled out, health insurance costs were again rising much faster than inflation, the number of people without insurance was going up and seniors on Medicare still didn’t have prescription drug coverage. The people who financed the Harry and Louise ads may be better off, but the American people aren’t. Someday we will fix the system. When we do, it will be the result of more than fifty years of efforts by Harry Truman, Richard Nixon, Jimmy Carter and Bill and me. Yes, I’m still glad we tried.

Bill’s name wouldn’t appear on a ballot in the 1994 midterm congressional election, but we both knew that his Presidency would be part of the electoral calculus-and that the health care setback would likely affect the outcome. There were other factors, including one of the few predictable trends in U.S. politics: Conventional wisdom says that the party in control of the White House usually loses congressional seats in the midterm elections.

This may reflect a deep-rooted desire among voters to maintain a balance of power in Washington―never let the President have so much authority that he believes he can act like a King. One way to keep him in line is to reduce