|
|
May 24, 1996
HAYNES JOHNSON ON THE STATE OF OUR SYSTEM
When former Senate Majority Leader George Mitchell [D-ME] "pulled the plug" on the Clinton Administration's efforts to reform the health care system, many pundits declared it a victory for Republicans and a stunning defeat for Congressional Democrats and President Clinton. Yet, Haynes Johnson, historian and commentator, believes the way the health care debate took place and the reasons it died are telling indications of the state of our governing system. In the book, "The System," Johnson and Washington Post commentator David Broder detail the behind-the-scenes negotiating with members of Congress and special interest groups.
After the dust had settled and the Republicans had seized control of the Congress, President Clinton reflected on the failings of his administration. He admitted to the two authors that the debate had inadvertently "set [the Democratic] Congress up for a fall." Others agreed saying that the health care debate had been one of the principle issues that had led to the stunning defeat of the Democrats in Congress in 1994. Johnson argues that although the issue had been a potent one politically, the truly disturbing fact was in the face of overwhelming need, no reform of the health system passed.
Johnson and Broder say that many in the debate fought off the political pressures to work for reform, "At the same time, the [health care] story shows how private interest can triumph over the public interest, how a powerful minority can manipulate opinion to defeat a reform desired by a majority, how hope for needed change can result in more cynicism about the workings of The System."
Click here for a conversation with Broder and Johnson about The System.
Is "The System" broken? What does the failed attempts at health care reform in 1993-1994 say about the way this country is governed? Can government take on challenging and difficult issues or have the special interests entrenched themselves too much in the status quo? Was the health care debate the defeat of "big government" or the failure of Congress and the President to address a real need? Haynes Johnson answers your questions below.
A question from Steve Serlin, MD, of Phoenix, AZ:
The failure of health care reform reflects the immense power of small wealthy interests and how politicians support such interest groups over the needs and desires of the majority of Americans. I'm a physician and often have been ashamed of the positions supported by other physicians that are contrary to the health needs of many Americans, but the role of physicians against health care reform pales to the misguided and almost sinister positions taken by many of our politicians.
Why aren't our "leaders" more humane, more empathetic to the medical needs of so many Americans? Why has SB 1028 been so difficult to pass?
Haynes Johnson responds:
I agree completely with your point about the power of small wealthy interests combined with politicians who place their personal and economic interests over the needs and desires of the majority of Americans. As I hope you'll see when you read The System, that is one of the central tenets of our book. As we also point out, there's blame enough in this failure to encompass the entire political spectrum. But Dave Broder and I are not pessimists about the American experiment. We continue to believe that an informed public, an aroused electorate, and a tougher national press to provide accurate information on the great issues like health care reform can produce a positive outcome. I hope you'll find The System of use in exploring these and other questions.
A question from Melody Safran of Augusta, ME:
Much of the health care debate centered around the people affected by it. It quickly became an issue of those who operated within it and produced and profited within it. At what point was the main issue of American access to adequate health care dismissed?
Haynes Johnson responds:
I don't believe the "main issue of American access to adequate health care was dismissed," as you suggest, but you are certainly right that those who operated from within and profited from the health system drove the debate and the ultimate outcome. The story we tell -- a tragedy, in our view -- is of how an undeniable need affecting the lives of every American and the entire American economy, for which the broad public and political consensus existed when the battle began, was thwarted and defeated by a series of political miscalculations, partisan politics, and overwhelming ability of special interests to manipulate public opinion so that the American people who were strongly supportive of health reform initially moved farther and farther away from it out of fear and misinformation.
A question from Steve Serlin, MD, of Phoenix, AZ:
Kristin Miller of Los Angeles, CA asks
Was Hillary Clinton as key to the failure of healthcare reform as we have been led to believe? Certainly her popularity as first lady was already in question before she was chosen to head up the push for reform. So from a public relations stand point her appointment was questionable. But I have also heard that her leadership style was aloof and exclusionary, which hurt attempts to work with the Democrats in Congress. Is this true? How much of the blame does she deserve? Also, if Clinton is re-elected with a Democratic Congress, having learned from their mistakes, will the issue re-emerge on a similar level, or is the disaster still too fresh in the minds of Americans?
Haynes Johnson responds:
The First Lady is a central player in our story and we devote intensive scrutiny to her role and her efforts in the reform battle. She did become a key to the failure, and despite brilliant, tireless and eloquent advocacy of the cause, her appointment as head of the task force charged with drafting legislation to affect every citizen's life was a major mistake. The lessons of this debacle are many and we try to point them out in detail. Certainly President Clinton, as I hope you'll see when reading our book, has clearly learned many of the central ones and is profiting from them politically in his re-election effort. But neither Clinton nor Dole nor a Democratic Congress, if reinstated next fall, will undertake anything resembling the sweep and scope of the comprehensive universal health coverage plan initiated in the first two years of Clinton's presidency.
A question from Bart Preecs of Richland, WA:
James Fallows says (in Breaking the News) that the failure of the mainstream media to adequately cover the 1993-94 healthcare debate is so embarrassing it can only be compared to the failure of the military in Vietnam.
Do you agree?
Do you see any sign that press or media people are taking seriously the need to rethink their principles or practices?
Haynes Johnson responds:
I'm a great admirer of James Fallows, and Dave Broder and I agree with many of his criticisms of the press. we are equally harsh on the press performance during the health reform battle, but, as you'll see, we do not agree with Fallows' assertion that it was the press that doomed the Clinton reform, nor that it represented the press's equivalent of the military failure in Vietnam. That ignores the disastrous political planning, conception, and battling for the Clinton plan by its authors and the complete failure of the Democrats, who then controlled both houses of Congress and had a President on the other end of Pennsylvania Avenue, to implement their power to bring a bill to a successful conclusion. They failed even to bring a single bill to a vote, thereby setting them up for their loss of Congress in 1994. As for the press learning its lesson, I hope so, and we make what we believe are constructive criticisms along that line.
A question from Rick Sigrist of LaRue, Ohio:
Can Medicare be cured in the next 4 years by Congress? Will huge, higher tax increases be needed to keep the system from becoming bankrupt? Will the Democrats be able to suggest changes to a system needing reform without alienating voters? Finally, what do you believe is going to happen to Medicare?
Haynes Johnson responds:
Yes, Medicare can be reformed, if not cured, in the next four years, and the pressure to deal with it realistically and constructively is growing exponentially even as we "speak" here. It will not be easy, of course, because of the enormous conflicting interests involved, but in short, huge, higher tax increases are not required to keep solvent. Reductions in benefits and extension of the time people begin receiving benefits will probably be necessary, however. In the end, Medicare will survive.
A question from Lance Garber of Los Angeles, CA:
Is the "System" so broken that, notwithstanding the Senate's recent 100-0 vote, Kennedy-Kassebaum might not even be signed into law this year? Also, do you think it is right or fair that the public does not even know the identities of the handful of Senators who both put a "hold" on Kennedy-Kassebaum and then voted for it? Personally, I think the single biggest part of the problem with the "System" is the Senate rules.
Haynes Johnson responds:
The total bipartisanship displayed in the 100-0 Kassebaum-Kennedy bill is the strongest evidence that the System is learning some of the painful lessons of the health reform disaster David Broder and I chronicle in our book: it has to be bipartisan to pass; it has to be simplified to principles upon which everyone can agree; it has to be understood to be a first, incremental step along the road to greater national health security for all Americans. It still faces formidable opposition in the Gingrich House, but clearly the prospects for passage are far better than the they were only weeks ago. I agree with you that it is shameful for the identities of the Senators who put the "hold" on the bill not to be identified publicly. This is another example of the failure of two elements of The System we describe -- the politicians and the press -- to adequately serve the people on an issue of undoubted need.
 |
        |
|
| Support the kind of journalism done by the NewsHour...Become a member of your local PBS station. | ||
| ||
| PBS Online Privacy Policy Copyright ©1996- MacNeil/Lehrer Productions. All Rights Reserved. | ||
| ||
