PHILADELPHIA ― A video at the Democratic National Convention on Tuesday night highlighted Hillary Clinton’s work on health care issues, with particular focus on her efforts to make sure children have health insurance and to reduce the price of prescription drugs.
It was a truthful recitation of Clinton’s accomplishments. But it was not a complete one, because it left out one key initiative: the Affordable Care Act.
She owns a big piece of that, too, from her own attempt to craft and help pass a universal health care plan back in 1993 and 1994 when her husband was president and she was the first lady.
Democrats had been trying seriously to achieve universal coverage for more than half a century, going back to the early 1940s, when Rep. John Dingell Sr. led a congressional effort and then former President Harry Truman made a national health plan a key promise of his campaign.
Lyndon Johnson won a huge victory in 1965, when he won passage of laws creating Medicare and Medicaid, but millions of non-elderly Americans still had no coverage ― and efforts to reach them with legislation seemed to be going nowhere.
Then Bill Clinton became president, with an idea for breaking through where Democrats had failed before. He proposed to achieve the traditional liberal goal of universal coverage, but to do so by using a method conservatives might find acceptable ― specifically, by providing people with private insurance rather than some form of government-run program. When Clinton became president, he handed over responsibility for crafting and then selling the plan to Hillary ― an unprecedented delegation of authority to a first lady.
The proposal never became law and Clinton, who had won gushing praise for her mastery of health policy, ended up taking a lot of the blame. From then on, she focused her efforts on health care initiatives less likely to arouse opposition. Among other things, she played a key role in crafting and promoting the Children’s Health Insurance Program ― a bona fide big deal that has helped millions of children.
But the failed Clintoncare effort also left a legacy. The veterans of that effort went back to work, studying where they had gone wrong and how they could get it right the next time. Over the next few years, they did the unglamorous but necessary work that goes into passing a major law ― hashing out the minute details of policy and building alliances of interest groups.
By the time of the 2008 election, Democrats more or less agreed on what a new health care system should look like ― a version of Clintoncare, basically, but with less disruption of existing private insurance arrangements. And that turned into Obamacare.
Plenty of people aren’t happy about that. There are progressives who would prefer a single-payer system ― in other words, the kind of government program Hillary Clinton first rejected in 1993. There are (many more) conservatives who would prefer no universal coverage system at all.
But the number of uninsured Americans has declined by something like 20 million since the Affordable Care Act became law, millions more have security they once lacked, efforts to make medical care efficient appear to be producing positive results, and health care costs are not exploding as predicted.
They have Obama to thank for that, yes, but they have Clinton to thank too.