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Haynes Johnson, Author (with David Broder) of The System, which examined the failure to reform the health care system

Interviewed June 14, 1996

FL: Could you summarize for me the importance of Clinton's health care initiative.


The healthcare reform battle that Bill Clinton initiated in 1993 was the greatest, domestic reform attempt since Franklin Roosevelt in 1936 that created the modern New Deal, and modern American government. It was an attempt to bring about a century-long agenda, for the American people, to secure health security. Theodore Roosevelt talked about it, Woodrow Wilson talked about it. Harry Truman talked about it. Nixon had a more ambitious plan than even Bill Clinton. But by the '90s, when he came into the office, the President of the United States, Bill Clinton, a series of events had converged to make it, there was a bipartisan consensus, that something had to be done. Healthcare costs were bankrupting every governmental entity from the Congress, to the mayors, the state houses, right down to county commissioners. You couldn't restrain the cost of government unless you dealt with the exploding cost of healthcare. Where an aging nation, with new technologies that extends life, the costs are explosive. Also, the downsizing of America, with more and more and more people, millions of people losing their jobs, and losing their benefits, meant that people who were not concerned before, suddenly felt threatened and anxious. Therefore, comes this attempt across the board-- liberal, Democrat, conservative, Republican. Bob Dole led 23 Republican senators to call for universal healthcare when Clinton became President.

So it was a titanic struggle, that directly would affect the lives of every single American, and directly affect the entire American economy for generations to come. That's how big it was. It was a tragedy, because, not that the Clinton plan was failed or flawed, it was, terribly. But that something out of that background should have happened. There should've been some move, the political system is designed to deal with real needs that affect real people, their lives. It's made to sort of deal with war and peace, with ravages of the Depression, with things like the evils of slavery, or in this case, protecting and preserving and helping one's own life in this American society. And it failed across the board. Nothing happened. Everybody failed. The Republicans failed, Bill Clinton failed, his wife failed, the Democrats failed, the Congress failed, the press failed, and in the end the people were lost, left with 43 million without health insurance, 3 years later, when 37 million had it when it began. That's how big this was.

FL: In your book, you vividly and dramatically describe the President's speech outlining his vision for healthcare reform and how embedded in what happened, is the metaphor for the entire Clinton presidency. Describe what happened, and what it said.


The night that Bill Clinton finally came before the American people, to lay out his long-promised health reform plan, he had the entire country watching. It was a joint session of Congress. Everybody's in the room. A hundred million people are watching over satellite television. It's the most important speech of his life and of his presidency, it's going to define him. He goes up into this, it's live now, 9 o'clock at night. He goes up there, and he looks out over this incredible hothouse of a chamber, of a joint session of Congress, with the galleries packed with all the VIPs. And he sees in the lectern, he's about to speech, there are the texts of a speech that he gave 8 months before. And he looks and he said, God must be testing me, I shouldn't be giving this speech. And then he realized, he said, I've got to do it, if I don't know it now, I'm lost anyhow so I just reared back and did it. What happened was, they got the wrong speech, because of all the last minute, changes, the hectic, the desperate maneuverings, including his own, right up to the last minute, he was making changes in the limousine, going up to the Capitol. Making the changes in the speech so that by the time they got there, the poor military computer operator who was operating the computer, because it was so chaotic, had as a preservative, had put in another speech just to test it out. And then they got this new thing in, but he pushed the wrong button. Instead of purging the old speech, he saved it, and therefore it resided on top, 8 months ago. Clinton in that moment, and you, I, I've often thought what it would be like, he's totally what he felt, but I still can't imagine what you must be going through at this moment. He did give a great speech. The people down below were desperately concerned about this calamity, this disaster that had befallen, because they knew it wasn't in there and then all of a sudden they finally fixed it by, seven minutes of dead silence on that screen. They finally cut the screen off. So he was looking at a blank screen. That's another thing. He's speaking, and, the TelePrompTer goes off. So he's, he's really on his own. On his own before the whole world. And the whole world's watching, and as he does it, all of a sudden the people down below thinking a disaster, he had cheers. And there was the Congress, his enemies, his rivals, in both parties, say he's giving the greatest speech of his life. And then finally, seven minutes later it clicks in, and he's back on track. And it was such a high moment, that when he left there, people across the board assumed that this would be, he couldn't fail now, he was going to be vindicated with this problem.

But the way that that speech was designed, the chaos that pervaded it, the lack of discipline, the many drafts that went through it. The fact that it was 9 months late, by the way, in getting to final legislative form, all of that, in effect, doomed it. That was his highest point. From there on in, it was all downhill. Another 2 months would elapse, before the actual bill lands before the Congress. By then, almost a year of his presidency has been flitted away, and his enemies have mobilized and something called Whitewater is about [to] burst upon his presidency, and trust would begin to erode and viciously and quickly, and from that point on, the opportunity for this, really the best opportunity in the century, to make a genuine difference in people's lives was lost.

FL: Could you talk more about what happened-why it failed?


The failures of the Clinton administration on the health reform battle are many and obvious. And, you can almost tick them off very quickly. They took too long to evolve a process. They played into the hands of the enemies who had defeated health reform for decades. Socialized medicine, big government, the fear of big enterprises. That the government's going to intrude in your life. And they concocted a plan that was, seemed to be a secret, closed off behind closed doors. No briefings with the press allowed. Took months and months longer than expected. When it arrived it was filled with bureaucratic language, like, mandates and alliances that sounded bureaucratic, heavy, threatening. And also he was so diverted because he tried to take on too many other tasks, he had the budget, he had welfare reform, he had NAFTA, all of these things, all crowded into that first year. That's enough for any President in a lifetime, or 4 years, or 4 lifetimes, I think Franklin Roosevelt's case in 4 terms. And, so consequently, it just, there was one mistake after another of conception, delivery, of politics, of politics, policy, and failure to appreciate also the enormous role of the interest groups and how formidable they would be. They were not naive about that, but they also, I don't think, could realistically understand or express how formidable the opposition would be.

FL: To what extent is it Hillary's failure and what does it tell us about her?


I think of all the players in the healthcare drama, debacle, tragedy I would say, the one that suffered the most was Hillary Clinton. She took the worst beating. She went the highest and sunk the lowest. She sustained the battering against her reputation and character that is lasting to this day, and it tells you a great deal about her. She was brilliant, she was tireless, she was eloquent, she mastered her brief to use the legal term, on healthcare. She was not a healthcare policy expert. She was deeply involved, she cared passionately about it.

But, in the end, just simply being put in that position was a big mistake. She was not only given a role that no other First Lady has ever had--Eleanor Roosevelt included--by far, of directly crafting legislation that would affect the lives of every American. And the entire economy. No First Lady has ever had anything to do with the crafting of actual legislation, and this was the most enormous undertaking in 60 years. Secondly, the very fact that she was so powerful, and seen as so important to the President, co-President, the enemy said, and some people in the administration actually thought that too, meant that the people who were below her, felt very inhibited about being as candid with her because she was like the co-President. And it did inhibit, very much. Someone told us, Mr. Broder and myself that, look, the President did this just right, in appointing her to the position to lead the healthcare fight. That (unintel) across the board, she was first among equals, and that she would speak with the absolute authority of the President of the United States. The only problem was, the person who has that job shouldn't sleep with the President. Because the people below may be not so willing to be candid with that person. And I think there, it turned out to be true, people did feel inhibited. It tells you a lot about her strengths and her weaknesses. She was indefatigable, I think there was no doubt about the sincerity, no doubt about the falseness of many of the scurrilous charges made against her, but in the end, it was a great disaster.

FL: Could you talk some more about the policy making of this Administration regarding health care?


It was undisciplined, the policy making in the White House was chaotic, they made mistakes that I frankly would have never assumed that they would make. They made mistakes of a character of the Jimmy Carter administration which knew nothing about Washington, had contempt for its processes, and its people, but that was not Bill Clinton. He had studied Washington his whole life. He had worked here for 2 years for Bill Fulbright as an intern. He saw Washington at a time of great transformation and turmoil. During the civil rights period, the Vietnam War. He hungered to be here. Not as an outsider, but as an insider.

But they made one mistake after another, along the way, trying to do too much, and also maybe the fundamental mistake of all was hubris. He assumed because he was elected, and he had a Congress of his own party that he could enact a very activist governmental program. He couldn't. He only had 43% of the vote, he was a minority president at a time of great disillusionment about government, and politics, and the lesson shoulda been, to proceed more slowly and cautiously and carefully, much more step by step, instead of trying to do everything all at once. Consequently, very little succeeded. And healthcare most notably, was a total failure.

FL: Do you see the first two years of his presidency in some ways a reprise of the first two years as Governor....


Yes, there is a pattern in Clinton's life, and there's a pattern of brilliance, of eloquence, of incredible, sort of searching of issues and thinking, original. And nobody who's ever been with Bill Clinton that I know, is not impressed by the quality of his mind or the depth of his knowledge of issues. But he also tried to do too much, in governorship, and he lost, after 2 years. I mean, he lost his term in Arkansas, and he made the same kinds of mistakes here, or his administration did. And again, I think that part of it is because when you're so bright, and you've won against travail, and your own life is a triumph over adversity, your personal life is a triumph over adversity. It's quite remarkable that Bill Clinton, not only came to be President, but the fact that he came out of, really terrible difficult problems in his childhood. And he surmounted them. And I think that may give you the sense of invulnerability, or invincibility, and defeat, however, teaches terrible lessons. He is fond of quoting, as I am, Jack Kennedy's remarks after the Bay of Pigs. The day after Kennedy's Bay of Pigs failed, total failure, Kennedy gave this off-the-cuff remark, he said, victory has a hundred fathers and defeat is an orphan. Well, the orphans on the health reform battle were all over, are still all over Washington, and there are no victories from that pot. And you learn from it. I think Kennedy learned from his mistakes, and I think Bill Clinton learned from his. We'll finally see how the electorate decides.

The President is at his very best, is a remarkably analytical, introspective person. To a degree that is quite stunning. And over the course of 3 years of doing the book, we talked to everybody in the administration involved, we talked to the President, we talked to his wife, we talked to all the players. And, Clinton had a passion about healthcare. His mother was a nurse. His grandmother was a nurse. He had a feeling for it. He was not a health policy expert, per se, but he knew the subject as many people said, better than anybody else. George Mitchell said, many people say, Hillary Clinton was the best informed, he said, no, I would say, by far, of all the people involved, the President knew more about the issue, was more deeply involved in the sinews of it. Understood the processes by which you make changes.

And part of the problems that he encountered on this and other things, was he is cursed with having the kind of mind that sees the interconnectedness of things. That they're all related. You can't begin to tug at this thread without pulling the whole fabric apart. Well, that's wonderful in a policy sense. In a political sense, it means you gotta have the absolute perfect opportunity to make some changes. And if you have to have a country behind you, you almost have to have a crisis. Clinton at the end, was extremely, remarkably thoughtful and introspective.

We sat in the Oval Office. The summer of 1995, for a final conversation with the President. He's sitting in that high back yellow upholstered chair, back to the fireplace, the Stewart portrait of Washington, there are two yellow flanking sofas right here. Dave Broder, my colleague and co-author is over here, I'm over here, there's the Oval Office desk and so forth. And the President sits back in that chair and he talks in this very calm manner. On and on, almost like a soliloquy, of mistakes he had made. I tried to do too much too fast, I shoulda reached out to Bob Dole earlier, even if it wouldn'ta made a difference because Dole kept telling me privately we're gonna make a deal, we're gonna make a deal, but he didn't do it publicly. I should've told the country that, when I realized we couldn't get it done in a year as promised, that it was gonna take longer, maybe 2 or 3 years, I should've spoken to the country, I should've given a speech when it was over, explaining why I thought it had failed, where we went from here. I didn't appreciate the lightning rod of my wife in this, (unintel) Hillary in this process. That she would be not only so controversial but even inhibiting to members of my administration who wouldn't feel that they could be as candid with her as I thought they would be. I was surprised at that. And then he finally says, I set the Congress up for failure. And I set myself up for failure.

Now, I don't believe--my background in graduate school was American History--I don't believe any sitting President, has ever acknowledged so large a sense of responsibility of a major issue in which he felt responsible for its failures. I think he's too strong on himself by the way. I think the failures are across the board, his are among them. But he was doing this in an analytical way, which told me, and I look back at that moment in sort of awe because I think you can see a different President, emerging from that moment. The lessons, plural, he was drawing, from the debacle that he had suffered. After all, the Democrats had lost control of the Congress, no small measure on this issue, for the first time in 40 years he was then the weakest President, so people said, in the century? Irrelevant everybody said. The wise people of Washington, and the press and the political establishment, said he was doomed. And yet I think you could see the, the more cohesion, more discipline, more of a reaching out for bipartisanship, more willing to fight on the few things that he cares about, and make it clear. More focused, if he wins the presidency, is reelected, I think it'll be because he learned those lessons.

FL: It seems sort of a reprise of the devastating loss that he had as a governor....He wandered around tugging on people's sleeves, saying, what have I done, what have I done, and emerged back focused and, I guess my question is really about the man......


I think Bill Clinton's life is fascinating for a lot of reasons. Not only as an American fable, which it is, and an American metaphor, which it also is, of great heights and great depths. You battle back from adversity and you stumble again. You learn from, you fall into the cliff again. I think his whole pattern of his life he's been that.

A lotta bright people, who are energetic, and are supremely confident are, prone to make mistakes, even though they seem to learn from them. And, part of it is the risks implicit in the, and the octane of great adventures, and great, Jack Kennedy was that way, he had a sense of invulnerability, invincibility because of one's own impending death. I mean it does focus the mind. And this sort of, it affects you, so you grab life as you can. And you take risks, in his case, reckless ones.

Clinton seems to me, I don't want to be an amateur psychiatrist here, but he also takes great risks also. He extends himself farther. And, he is so supremely confident that he can do what's right, he's sure is gonna be right, and that has also been the failure of almost all strong leaders. If you go too far in assuming you've got the answers. Newt Gingrich had the same problem. The same sense of hubris that I overreached my mandate, the Congress was going to be mine, I'll remake America and the Congress in my image and so forth. It didn't work, that's not the way it works and I think Presidents and leaders are prone to that. Prince Hal was that way. If you look at his, in Shakespeare's Henry IV. I love Prince Hal as a metaphor for young leaders and, or Machiavelli that Clinton likes to quote Machiavelli also. About the difficulties of the reformer. How difficult it is to make change. How things just, the status, the enemies of reform are always multiple and many, and they cling to the status quo, where the change agents, where those who bring reform are very much alone and suffer enormous burdens and oppositions.

FL: Could you describe how the interest groups organized to defeat this plan.


Of all the episodes that I've learned, and my colleague Mr. Broder have learned out of this episode, this tragic story we tell, the most stunning and disturbing is the role of the interest groups. First of all, they have gone so far beyond the normal process of lobbying that what we now think of as lobbying in Washington is stone age. That is, you go before a Congressional Hearing room and you pluck at the sleeve of a senator, you're the lobbyist in your Gucci loafers and your Italian suit, thousand dollar suit, and you put out PAC money and you signal yes or no on a vote, that's not where it is now.

The interest groups now have the power to operate, surreptitiously, anonymously, forging enormous coalitions of power. Meeting in board rooms as they did during this battle, maybe 4 or 5 or 10 or 15 groups, pooling their resources, never wanting to be identified in public, and organize grassroots, so-called, campaigns out of Washington. So they manufacture opinion and they flood the airwaves of Washington, Congressional offices with e-mail, with faxes, with phone banks and alerts and they're seen to be as the authentic voice of the people, standing up to protest a terrible policy being hatched in Washington. They are not the authentic voice of the people. They are paid for. They are bought and manipulated. They are put into banks and they push a button and they flood the offices. And, the way they now have the power that both political parties used to have, and far more resources and they have the same people who now operate for them, for top dollar, as run, the presidential campaigns of both Democrat and Republicans, with vastly more money. They are unelected, unaccountable, they are like crypto-political parties. And they have enormously changed the equation in the way things are done in our political system.

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