Hurdles to Public Healthcare

by bmckernan

A recent NY Times poll found that the overwhelming majority of respondents (72%) support a government administered public healthcare program. In addition, the poll found wide support for the government initiative amongst both Democrats and Republicans. As the NY Times article on the poll’s results rightfully points out, this is not the first time in recent American history when the majority of the public has been in favor for a universal healthcare program, as President Clinton was originally elected into office in 1992 after campaigning heavily for such measures. However, despite the initial support for a universal plan at the beginning of his tenure in office, ultimately President Clinton was unsuccessful in passing the appropriate legislation. While certainly President Obama’s administration will be grappling with many different concerns compared to President Clinton’s administration, it may be helpful to re-examine what many scholars consider to be the mistakes of President Clinton’s original attempts to pass a universal plan.

Fortunately, the prominent sociologist Theda Skocpol has already written an insightful and persuasive book on just this topic. Entitled Boomerang, Skocpol provides both an in-depth account of the construction of Clinton’s plan as well as identifies what she considers to be the major factors that ultimately led to the plan’s failure. According to Skocpol, one of Clinton’s key pitfalls was his shift in attention to NAFTA after taking office, an issue which disenfranchised many potential supporters on the left and persuaded them to side with the right as a matter of retaliation. While President Obama is not at this moment dealing with any similar free trade agreements, he is certainly attempting to cover a wide political ground, dealing with such foreign policy issues as the war in Iraq and Afghanistan, the potential nuclear crisis in North Korea, and of course the recent events in Iran, issues all of which he has received critiques from both sides of the political spectrum.

Beyond that, President Obama’s behavior in the current torture debate has also raised some concern amongst part of the left, and of course one cannot forget the economy. Similar to Skocpol’s writings on President Clinton’s plan, all these issues currently facing President Obama run the risk of alienating many of the interest groups whose support would most likely be necessary to pass his universal healthcare plan.

Related to this, Skocpol’s work also highlights at least two additional hurdles facing President Obama’s plan. First, Skocpol claims that the Congressional Budgetary Office and the budgetary process in general strongly inhibited President Clinton’s plan from passing. Certainly, given America’s current economic stability and the heated debate that emerged during the last round of budgetary talks, one could expect an even more precarious budgetary process for President Obama’s initiative.

Additionally, Skocpol concludes that one of the primary reasons for the failure of President Clinton’s plan was the administration’s inability to provide the public with clear and concise understanding of the plan. According to Skocpol, rather than grapple with adding a public plan on to America’s current private healthcare industry, President Clinton’s initiative may have been better received if the administration had chosen to back one of the more comprehensible alternatives, such as employer-mandated or play-or-pay healthcare programs.

While certainly much has changed both in politics and American life in general since Clinton’s failed attempt at universal healthcare back in 1992, Skocpol’s work provides interested readers with strong insight into the political and bureaucratic hurdles that such a major initiative as universal healthcare reform must grapple with beyond simply receiving the necessary support from the American public. Democrats may want to pay particular attention to Skocpol’s insights, since according to her work, Clinton’s failure to create a universal healthcare plan led to the Republican sweep of Congress in 1994.

Jenny Irons “Political Elites and the Culture of Social Movements”