ABLEnews Extra

                   Lost and "Foundling"

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WASHINGTON (AP)--An architect of President Clinton's 1,342-page health
plan blames "strategic miscalculation" by the White House as well as
backpedaling by Democrats and Republicans for last year's health
reform debacle.

Paul Starr, a Princeton University sociologist who helped author the
plan, writes, "The collapse of health care reform ... will go down as
one of the great lost political opportunities in American history."

His post-mortem, in The American Prospect, a liberal journal that
Starr edits, spreads the blame around.

The Republicans "enjoyed a double triumph, killing reform and then
watching jurors find the president guilty," he said. "It was the
political equivalent of the perfect crime."

But his article castigates the White House prescription for universal
coverage as too complex and ambitious, faults both the president and
Hillary Rodham Clinton for becoming too personally identified with the
enterprise, and questions the administration's decision not to defend
the particulars of its proposal.

"The administration had gone to the trouble of writing a bill and then
left it like a foundling on the doorstep of Congress," said Starr, who
has written a Pulitzer Prize-winning history of American medicine.

"Perhaps the fateful choice was the decision to design a proposal
inside the White House and put the Clinton name on it," Starr said.

By doing so, "Clinton gave the Republicans an incentive to defeat it
and humiliate him rather than compromise," said Starr. "The first
lady's role further muddied the issue."

The Clinton plan was panned by Republicans as a bureaucratic nightmare
and attacked by health industry groups for its premium controls.
Democrats distanced themselves from the proposal, big business refused
to endorse it and public sentiment eventually turned against it.

Starr argues that the administration's failure to mobilize strong
support was more damaging than the criticism and ad campaigns from
special interest groups.

The American Medical Association and other key groups were "actually
less hostile to reform than in any prior battle over health insurance
since the 1930s," he said.

"It is a story of compromises that never happened, of deals that were
never closed, of Republicans, moderate Democrats and key interest
groups that backpedaled from proposals they themselves had earlier
cosponsored or endorsed," he said.

"It is also a story of strategic miscalculation on the part of
the president and those of us who advised him," he wrote.

[as posted on HEALTHRE, January 6, 1995]

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