Although every Congress and administration since the Gerald Ford era tinkered with healthcare to some degree and with various levels of success, President Clinton made the most comprehensive-and many would say most convoluted-attempt at reform.
The effort by Clinton, spearheaded by his wife, now Sen. Hillary Rodham Clinton (D-N.Y.), began with a belated bang in September 1993 and ended with a whimper a year later. It suffered a death of a thousand cuts, but its demise defined the politics of the 1990s.
The failure of the 1,000 page reform proposal cost Democrats the majority in Congress shortly afterward, and turned Clinton from a visionary-although ineffective-master policy strategist into a highly effective political counterpuncher as he dueled Republicans on Medicare, Medicaid and other healthcare issues.
But if the effort failed in accomplishing the goal of universal coverage, it succeeded in pointing up the failures of the healthcare system: job-lock, working uninsured, cost. And that led to some incremental advances in healthcare coverage in the 1990s, such as health-insurance portability and the State Children's Health Insurance Program.