Holy cow, what a sucker I am.
And I'm not alone. All the other reporters, lobbyists, healthcare and insurance executives, congressional staff, White House Healthcare Reform Task Force members, and everyone else who lived and died with every twist and turn in the 1993-1994 healthcare reform debate also were pigeons.
That's the lasting impression I have from reading the fascinating new book about the short rise and long fall of the Clinton administration's healthcare reform proposal called The System, by Washington Post reporters Haynes Johnson and David Broder.
The book makes it painfully clear that all those hours I and dozens of other reporters and lobbyists spent chasing White House officials and congressional staff down hallways and through hotel lobbies trying to get them to cough up even the smallest detail of their healthcare reform plan were a complete waste of time.
It is obvious from The System that the bill's demise was preordained. The collapse was guaranteed from the minute the White House chose first lady Hillary Rodham Clinton and White House domestic policy adviser Ira Magaziner to head up the reform effort.
For anyone who was involved in or interested in the healthcare reform movement that overtook the country after Bill Clinton took office in 1993, the book offers a wealth of insights that make the end so plainly evident that I couldn't help but feel duped for not having seen it at the time.
Of course, numerous candid assessments by the principals are included in the book that were not available during the heat of the battle. Oh, if we had only known what lawmakers were thinking at the time.
President Clinton admits it was a mistake to try to pass the healthcare reform package as one huge bill, rather than using the budget process or phasing in the changes over a number of years. "I set the Congress up for failure," Clinton said in hindsight.
Other policymakers are equally open. House Speaker Newt Gingrich (R-Ga.) discloses that he was plotting to defeat a major healthcare initiative from the left several years before Clinton had even announced his presidential candidacy.
Several offers were made to pull the "Harry and Louise" ads that helped defeat the Clinton plan, reveals Willis Gradison, the head of the Health Insurance Association of America, in the book. Gradison said he made the offer as a goodwill gesture to open a bargaining avenue. But Clinton administration officials made it clear they needed an enemy to bash, and the insurance companies were the target.
Most revealingly, nearly every Democratic congressional leader and even a number of White House officials say they thought the plan had at best a 50-50 chance of passage from the start.
Perhaps because the entire healthcare reform culture suffered such an inglorious and painfully slow demise, Broder and Johnson expanded The System to look at whether the death of healthcare reform is symptomatic of a larger problem in the political system.
The authors' central question: "If legislation can't be passed on something everyone agrees needs fixing, such as the healthcare system, is the political system broken beyond repair?"
The authors conclude that the failure of ClintonCare is indicative of a wider problem, but they offer little to substantiate their link. The system may indeed be flawed, but the death of the 1,400-page White House reform plan doesn't prove it.
In reality, it was an overly complicated, overly ambitious plan that scared most Americans. Add to that the political ineptitude of the White House, which The System documents in extraordinary detail, and you have a program that should have, and did, die in Congress without so much as a single floor vote in either chamber.
In many ways it's too bad the authors couldn't have included the current debate over small-group health insurance reform in their book because it might do more to prove their thesis than the death of the Clinton administration reform plan.
The modest health insurance reform plan sponsored by Sens. Nancy Kassebaum (R-Kan.) and Edward Kennedy (D-Mass.) passed the Senate by a unanimous 100-0 vote. A companion bill passed the House by a vote of 267-151.
Both bills seek to insure the portability of health insurance by requiring insurers to cover workers who change jobs or lose their job. Both bills have essentially the same structure. Yet even though the basic plans have strong bipartisan support, passage is by no means assured.
The main culprits were controversial amendments added to the plans at the behest of special-interest groups. These included medical savings accounts, medical malpractice reforms and mandated federal benefits for mental health.
Those add-ons, regardless of whether they are good or bad policy, and presidential politics between Clinton and Senate Majority Leader Robert Dole (R-Kan.) are endangering a bill that would otherwise be a slam-dunk.
If the Kassebaum-Kennedy bill fails it will be a far more stinging indictment of the system than the death of the Clinton reform plan.
Speaking of Kassebaum-Kennedy, the action on the periphery of the Senate floor, out of sight of the C-SPAN cameras, during the most crucial series of votes was the most interesting in many years.
The key vote was on whether to strip a provision that would give tax incentives to spur the use of medical savings accounts from an amendment sponsored by Dole.
The vote was expected to be so close that Vice President Al Gore was summoned to break a potential tie.
As the votes were being tallied, Dole, who had invested a lot of political capital in MSAs, and other GOP leaders worked over the few Republicans who voted with Kassebaum to kill the provision.
They were successful in getting Sen. William Cohen (R-Maine) to change his vote. Sen. Slade Gorton (R-Wash.) sat defiantly as Dole aides harangued him. A couple of other GOP nonconformists voted against Dole, then left the chamber quickly.
As tensions rose, moderate Sen. Jim Jeffords (R-Vt.) sat alone in the back of the chamber counting votes to see if the MSA provision would be stripped. Democrats said they were sure that Dole would find the votes he needed to keep MSAs in the bill.
"I kept thinking he would pull something out, but he never did," said one aide. A Democratic Senator said you could "hear the bones breaking" as the GOP leaders lobbied their maverick colleagues.
In the end, Dole lost and the MSA measure was deleted by a vote of 52-46 with five Republicans voting with the Senate's 47 Democrats.
All in all, it was great theater of the kind not normally seen in the decorous Senate.*n