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

Several from Arkansas had come to work in Bill’s administration, but ironically, they were among the people I missed the most those early weeks. We simply hadn’t had time to see them.

In early February, Bill and I invited Vince Foster, now Deputy White House Counsel; Bruce Lindsey, also in the Counsel’s office and still one of Bill’s closest advisers and traveling companions; and Webb Hubbell, Associate Attorney General, to a small, informal dinner in the second-floor dining room of the residence to celebrate our friend Mary Steenburgen’s fortieth birthday. Mary, a fellow Arkansan, had done well in Hollywood, winning an Academy Award for acting, but she had never lost touch with her roots. She, Bruce, Vince and Webb were among our closest friends, and I remember that meal as one of the last carefree times we had together. For a few hours, we screened out the worries of the day and talked about adjusting to Washington and timeless issues―kids, schools, movies, politics. I can still close my eyes and see Vince at that table, looking tired but happy, leaning back and listening with a smile on his face. At that moment, it was impossible to guess the strain he was under as a newcomer to Washington’s political world.

HEALTH CARE

On January 25, Bill invited me and two guests to lunch in the President’s small study near the Oval Office: Carol Rasco, the newly named White House domestic policy adviser who had served in Bill’s administration in Arkansas, and our old friend Ira Magaziner, a successful business consultant who had produced a groundbreaking study on health care costs.

Tall, angular and intense, Ira was prone to worry in the best of times, and on this day he seemed particularly anxious. In a few hours, Bill planned to unveil a health care task force and announce that it would produce reform legislation during his first one hundred days in office. Few on the White House staff knew that Bill had asked me to chair the task force or that Ira would manage the day-to-day operations as a senior adviser to the President for policy and planning. Ira had learned about his new job only ten days before the inauguration.

Bill wanted to approach health care reform from a new angle, and Ira, with his brilliant and creative mind, had a knack for coming up with inventive ways of looking at issues.

He also had private sector experience as the owner of a consulting business in Rhode Island that advised multinational companies on how to become more productive and profitable.

After the Navy stewards brought us our food from the White House Mess, Ira delivered troubling news: Some Capitol Hill veterans were warning him that our timetable for delivering a health care reform bill in one hundred days was unrealistic. We had been encouraged by the electoral success of Harris Wofford, the new Democratic Senator from Pennsylvania who had campaigned on a health care platform and often told crowds: “If criminals have the right to a lawyer, working Americans have the right to a doctor.” But Ira was getting a different message.

“They think we’re gonna get killed,” said Ira, who hadn’t touched his sandwich.

“We’ll need at least four to five years to put together a package that will pass Congress.”

“That’s what some of my friends are saying too,” I said. I had cared about this issue for a long time, well before Bill and I got into politics, and I believed that access to quality affordable health care was a right American citizens should be guaranteed. I knew that Ira felt the same way. That might explain why I didn’t run screaming from the room when Bill first broached the idea of my leading the task force and working with Ira on this signature initiative of his Administration. On this day, it was Bill’s boundless optimism and his determination that kept me in my chair.

“I’m hearing the same thing,” Bill said. “But we have to try. We just have to make it work.”

There were compelling reasons to push ahead. By the time Bill became President, thirty-seven million Americans, most of them working people and their children, were uninsured. They weren’t getting access to care until they were in a medical crisis. Even for common medical concerns they wound up in an emergency room, where care was most expensive, or they went broke trying to pay for medical emergencies on their own.

In the early 1990s, one hundred thousand Americans were losing coverage each month, and two million were without coverage temporarily as they changed jobs. Small businesses were unable to offer coverage for their employees because of the exploding cost of health care premiums. And the quality of medical care was suffering, too: In an effort to control costs, insurance companies often denied or delayed treatment prescribed by doctors in deference to their corporate bottom lines.

Rising health care costs were sapping the nation’s economy, undermining American competitiveness, eroding workers’ wages, increasing personal bankruptcies and inflating the national budget deficit. As a nation, we were spending more on health care―14 percent of our GDP―than any other industrialized country. In 1992, as much as $45 billion in health care costs was spent on administrative costs, rather than going to doctors, nurses, hospitals, nursing homes or other health care providers for direct care.

This terrible cycle of escalating costs and declining coverage was largely the result of a growing number of uninsured Americans. Patients without insurance seldom could afford to pay for their medical expenses out-of-pocket, so their costs were absorbed by the doctors and hospitals that treated them. Doctors and hospitals, in turn, raised their rates to cover the expense of caring for patients who weren’t covered or couldn’t pay, which is why $2 aspirin tablets and $2,400 crutches sometimes appear on hospital bills. Insurers, confronted with having to cover higher doctor and hospital rates, began trimming coverage and raising the price of premiums, deductibles and copayments for people with insurance.

As the price of premiums went up, fewer employers