Health Care BS

The Health Affairs blog has posted a number of papers that attempt to explain the failure of the original Clinton attempt at health care reform. Although each takes its own route through the history of the initiative, they all manage to arrive at the same conclusion: the problem was the public. Daniel Yankelovich, for example, advises that the “leadership class” failed to properly explain the plan to the hoi polloi. Thus:

There was no way for average Americans to understand what it meant for them … This makes moot the question of whether the reforms were the right ones.

Blendon, Brodie, and Benson advise that the American electorate was just too selfish:

From the outset Americans showed more concern for solving their own health care problems than for solving those facing the nation as a whole.

Theda Skocpol agrees that an excess of self-interest was the problem:

The Clinton plan promised too much cost-cutting … and not enough pay-offs to … middle-class citizens pleasantly ensconced in the existing U.S. health care system.

Zelman is not quite this obnoxious, but he clearly thinks the problem was the public’s inability to accept change:

We called for an amount of change that couldn’t help but make many people insecure and that was susceptible to charges of too much change.

Ironically, the failure of Hillarycare was largely due to this patronizing attitude toward the public. The plans creators and backers made it clear that they knew best and that the benighted electorate was to be quiet and fall in line. This was the message that Mrs. Clinton’s task force sent when it decided to deliberate in secret, and it was reinforced by Bill Clinton when he threatened to veto anything but universal health care. Naturally, the public resented that sort of condescension and handed Hillary her hat.