Publisher's Letter

Abstract

From The Publisher Health AffairsVol. 13, No. 4 Publisher's LetterWilliam B. WalshPUBLISHED:Fall 1994Free Accesshttps://doi.org/10.1377/hlthaff.13.4.4AboutSectionsView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsDownload Exhibits TOPICSHealth reformAccess to careThe time has come to reflect on what has happened to health care reform. President Bill Clinton, like no other chief executive before him, made this issue a cornerstone of his election campaign and a key measure of his political leadership. The failure to enact his ambitious reform plan should come as no great surprise. After all, throughout this century presidents of both parties have tried and failed to persuade Congress to approve legislation that would change the way medical care is delivered and financed in the United States. While I disagree strongly with the president's reform prescription, he deserves credit for sparking a broad debate that will improve our system. But change will come incrementally and should be affordable to this richest nation on earth. 1 do not share the concern expressed by many that health care reform will slip off the nation's policy agenda. The health care system, at one-seventh of the economy, it is too large to be ignored. However, the lesson that has been learned is that one-party control of the presidency and Congress, in a nation with weak political parties, does not guarantee enactment of major change. Bipartisan participation and support are always necessary to command a working majority. What role did the average citizen play in this saga? After spending most of my career in a visible, quasi-public position, I know that the American people should never be underestimated. They are discerning and become cautious when they believe that government is overstepping its bounds. Entitlement programs that grow uncontrollably have become anathema to the average taxpayer. On the other hand, the benefits that derive from Medicare and Social Security, our largest entitlement programs, are now taken for granted, even though those who gain the most, on average, have contributed fewer dollars than they are now withdrawing. As a nation, we must be mindful that health care reform means providing insurance coverage to those citizens who lack access to it. Inevitably that means some redistribution of resources. I suspect that, in hindsight, Bill Clinton wishes he had moved more cautiously along this path, because his proposed major overhaul did not match Americans' appetite for incremental change. Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article Metrics History Published online 1 January 1994 InformationCopyright © by Project HOPE: The People-to-People Health Foundation, Inc.PDF download