The Politics of Health Reform

This essay focuses on the basic design of the Clinton administration’s health-care-reform policy. It examines how the president’s early decision in favor of employment-based private insurance rather than tax-based social insurance led to an unnecessarily complex program. While recognizing that the administration’s reforms would provide coverage to millions of Americans who now have no or inadequate insurance and would improve the way health care is financed in the United States, I argue that we would still fall short of the universal and progressive program our nation ought to have.

I will discuss three central questions: What should the goals of reform be? Are the Clinton administration proposals heading in the ...