Haynes Johnson, Author
(with David Broder) of The System, which examined the failure to
reform the health care system
Interviewed June 14, 1996
FL: Could you summarize for me the importance of Clinton's health care
initiative.
JOHNSON:
The healthcare reform battle that Bill Clinton initiated in 1993 was the
greatest, domestic reform attempt since Franklin Roosevelt in 1936 that created
the modern New Deal, and modern American government. It was an attempt to
bring about a century-long agenda, for the American people, to secure health
security. Theodore Roosevelt talked about it, Woodrow Wilson talked about it.
Harry Truman talked about it. Nixon had a more ambitious plan than even Bill
Clinton. But by the '90s, when he came into the office, the President of the
United States, Bill Clinton, a series of events had converged to make it, there
was a bipartisan consensus, that something had to be done. Healthcare costs
were bankrupting every governmental entity from the Congress, to the mayors,
the state houses, right down to county commissioners. You couldn't restrain
the cost of government unless you dealt with the exploding cost of healthcare.
Where an aging nation, with new technologies that extends life, the costs are
explosive. Also, the downsizing of America, with more and more and more
people, millions of people losing their jobs, and losing their benefits, meant
that people who were not concerned before, suddenly felt threatened and
anxious. Therefore, comes this attempt across the board-- liberal, Democrat,
conservative, Republican. Bob Dole led 23 Republican senators to call for
universal healthcare when Clinton became President.
So it was a titanic struggle, that directly would affect the lives of every
single American, and directly affect the entire American economy for
generations to come. That's how big it was. It was a tragedy, because, not
that the Clinton plan was failed or flawed, it was, terribly. But that
something out of that background should have happened. There should've been
some move, the political system is designed to deal with real needs that affect
real people, their lives. It's made to sort of deal with war and peace, with
ravages of the Depression, with things like the evils of slavery, or in this
case, protecting and preserving and helping one's own life in this American
society. And it failed across the board. Nothing happened. Everybody failed.
The Republicans failed, Bill Clinton failed, his wife failed, the Democrats
failed, the Congress failed, the press failed, and in the end the people were
lost, left with 43 million without health insurance, 3 years later, when 37
million had it when it began. That's how big this was.
FL: In your book, you vividly and dramatically describe the President's speech
outlining his vision for healthcare reform and how embedded in what happened,
is the metaphor for the entire Clinton presidency. Describe what happened,
and what it said.
JOHNSON:
The night that Bill Clinton finally came before the American people, to lay out
his long-promised health reform plan, he had the entire country watching. It
was a joint session of Congress. Everybody's in the room. A hundred million
people are watching over satellite television. It's the most important speech
of his life and of his presidency, it's going to define him. He goes up into
this, it's live now, 9 o'clock at night. He goes up there, and he looks out
over this incredible hothouse of a chamber, of a joint session of Congress,
with the galleries packed with all the VIPs. And he sees in the lectern, he's
about to speech, there are the texts of a speech that he gave 8 months
before. And he looks and he said, God must be testing me, I shouldn't be
giving this speech. And then he realized, he said, I've got to do it, if I
don't know it now, I'm lost anyhow so I just reared back and did it. What
happened was, they got the wrong speech, because of all the last minute,
changes, the hectic, the desperate maneuverings, including his own, right up to
the last minute, he was making changes in the limousine, going up to the
Capitol. Making the changes in the speech so that by the time they got there,
the poor military computer operator who was operating the computer, because it
was so chaotic, had as a preservative, had put in another speech just to test
it out. And then they got this new thing in, but he pushed the wrong button.
Instead of purging the old speech, he saved it, and therefore it resided on
top, 8 months ago. Clinton in that moment, and you, I, I've often thought what
it would be like, he's totally what he felt, but I still can't imagine what you
must be going through at this moment. He did give a great speech. The people
down below were desperately concerned about this calamity, this disaster that
had befallen, because they knew it wasn't in there and then all of a sudden
they finally fixed it by, seven minutes of dead silence on that screen. They
finally cut the screen off. So he was looking at a blank screen. That's
another thing. He's speaking, and, the TelePrompTer goes off. So he's, he's
really on his own. On his own before the whole world. And the whole world's
watching, and as he does it, all of a sudden the people down below thinking a
disaster, he had cheers. And there was the Congress, his enemies, his rivals,
in both parties, say he's giving the greatest speech of his life. And then
finally, seven minutes later it clicks in, and he's back on track. And it was
such a high moment, that when he left there, people across the board assumed
that this would be, he couldn't fail now, he was going to be vindicated with
this problem.
But the way that that speech was designed, the chaos that pervaded it, the lack
of discipline, the many drafts that went through it. The fact that it was 9
months late, by the way, in getting to final legislative form, all of that, in
effect, doomed it. That was his highest point. From there on in, it was all
downhill. Another 2 months would elapse, before the actual bill lands before
the Congress. By then, almost a year of his presidency has been flitted away,
and his enemies have mobilized and something called Whitewater is about [to] burst
upon his presidency, and trust would begin to erode and viciously and quickly,
and from that point on, the opportunity for this, really the best opportunity
in the century, to make a genuine difference in people's lives was lost.
FL: Could you talk more about what happened-why it failed?
JOHNSON:
The failures of the Clinton administration on the health reform battle are many
and obvious. And, you can almost tick them off very quickly. They took too
long to evolve a process. They played into the hands of the enemies who had
defeated health reform for decades. Socialized medicine, big government, the
fear of big enterprises. That the government's going to intrude in your life.
And they concocted a plan that was, seemed to be a secret, closed off behind
closed doors. No briefings with the press allowed. Took months and months
longer than expected. When it arrived it was filled with bureaucratic
language, like, mandates and alliances that sounded bureaucratic, heavy,
threatening. And also he was so diverted because he tried to take on too many
other tasks, he had the budget, he had welfare reform, he had NAFTA, all of
these things, all crowded into that first year. That's enough for any
President in a lifetime, or 4 years, or 4 lifetimes, I think Franklin
Roosevelt's case in 4 terms. And, so consequently, it just, there was one
mistake after another of conception, delivery, of politics, of politics,
policy, and failure to appreciate also the enormous role of the interest groups
and how formidable they would be. They were not naive about that, but they
also, I don't think, could realistically understand or express how formidable
the opposition would be.
FL: To what extent is it Hillary's failure and what does it tell us about
her?
JOHNSON:
I think of all the players in the healthcare drama, debacle, tragedy I would
say, the one that suffered the most was Hillary Clinton. She took the worst
beating. She went the highest and sunk the lowest. She sustained the
battering against her reputation and character that is lasting to this day, and
it tells you a great deal about her. She was brilliant, she was tireless, she
was eloquent, she mastered her brief to use the legal term, on healthcare. She
was not a healthcare policy expert. She was deeply involved, she cared
passionately about it.
But, in the end, just simply being put in that position was a big mistake.
She was not only given a role that no other First Lady has ever had--Eleanor
Roosevelt included--by far, of directly crafting legislation that would affect
the lives of every American. And the entire economy. No First Lady has ever
had anything to do with the crafting of actual legislation, and this was the
most enormous undertaking in 60 years. Secondly, the very fact that she was so
powerful, and seen as so important to the President, co-President, the enemy
said, and some people in the administration actually thought that too, meant
that the people who were below her, felt very inhibited about being as candid
with her because she was like the co-President. And it did inhibit, very much.
Someone told us, Mr. Broder and myself that, look, the President did this just
right, in appointing her to the position to lead the healthcare fight. That
(unintel) across the board, she was first among equals, and that she would
speak with the absolute authority of the President of the United States. The
only problem was, the person who has that job shouldn't sleep with the
President. Because the people below may be not so willing to be candid with
that person. And I think there, it turned out to be true, people did feel
inhibited. It tells you a lot about her strengths and her weaknesses. She was
indefatigable, I think there was no doubt about the sincerity, no doubt about
the falseness of many of the scurrilous charges made against her, but in the
end, it was a great disaster.
FL: Could you talk some more about the policy making of this Administration
regarding health care?
JOHNSON:
It was undisciplined, the policy making in the White House was chaotic, they
made mistakes that I frankly would have never assumed that they would make.
They made mistakes of a character of the Jimmy Carter administration which knew
nothing about Washington, had contempt for its processes, and its people, but
that was not Bill Clinton. He had studied Washington his whole life. He had
worked here for 2 years for Bill Fulbright as an intern. He saw Washington at
a time of great transformation and turmoil. During the civil rights period,
the Vietnam War. He hungered to be here. Not as an outsider, but as an
insider.
But they made one mistake after another, along the way, trying to do too much,
and also maybe the fundamental mistake of all was hubris. He assumed because
he was elected, and he had a Congress of his own party that he could enact a
very activist governmental program. He couldn't. He only had 43% of the vote,
he was a minority president at a time of great disillusionment about
government, and politics, and the lesson shoulda been, to proceed more slowly
and cautiously and carefully, much more step by step, instead of trying to do
everything all at once. Consequently, very little succeeded. And healthcare
most notably, was a total failure.
FL: Do you see the first two years of his presidency in some ways a reprise of
the first two years as Governor....
JOHNSON:
Yes, there is a pattern in Clinton's life, and there's a pattern of
brilliance, of eloquence, of incredible, sort of searching of issues and
thinking, original. And nobody who's ever been with Bill Clinton that I know,
is not impressed by the quality of his mind or the depth of his knowledge of
issues. But he also tried to do too much, in governorship, and he lost, after
2 years. I mean, he lost his term in Arkansas, and he made the same kinds of
mistakes here, or his administration did. And again, I think that part of it
is because when you're so bright, and you've won against travail, and your own
life is a triumph over adversity, your personal life is a triumph over
adversity. It's quite remarkable that Bill Clinton, not only came to be
President, but the fact that he came out of, really terrible difficult problems
in his childhood. And he surmounted them. And I think that may give you the
sense of invulnerability, or invincibility, and defeat, however, teaches
terrible lessons. He is fond of quoting, as I am, Jack Kennedy's remarks after
the Bay of Pigs. The day after Kennedy's Bay of Pigs failed, total failure,
Kennedy gave this off-the-cuff remark, he said, victory has a hundred fathers
and defeat is an orphan. Well, the orphans on the health reform battle were all
over, are still all over Washington, and there are no victories from that pot.
And you learn from it. I think Kennedy learned from his mistakes, and I think
Bill Clinton learned from his. We'll finally see how the electorate decides.
The President is at his very best, is a remarkably analytical, introspective
person. To a degree that is quite stunning. And over the course of 3 years of
doing the book, we talked to everybody in the administration involved, we
talked to the President, we talked to his wife, we talked to all the players.
And, Clinton had a passion about healthcare. His mother was a nurse. His
grandmother was a nurse. He had a feeling for it. He was not a health policy
expert, per se, but he knew the subject as many people said, better than
anybody else. George Mitchell said, many people say, Hillary Clinton was the
best informed, he said, no, I would say, by far, of all the people involved,
the President knew more about the issue, was more deeply involved in the sinews
of it. Understood the processes by which you make changes.
And part of the problems that he encountered on this and other things, was he
is cursed with having the kind of mind that sees the interconnectedness of
things. That they're all related. You can't begin to tug at this thread
without pulling the whole fabric apart. Well, that's wonderful in a policy
sense. In a political sense, it means you gotta have the absolute perfect
opportunity to make some changes. And if you have to have a country behind
you, you almost have to have a crisis. Clinton at the end, was extremely,
remarkably thoughtful and introspective.
We sat in the Oval Office. The summer of 1995, for a final conversation with
the President. He's sitting in that high back yellow upholstered chair, back
to the fireplace, the Stewart portrait of Washington, there are two yellow
flanking sofas right here. Dave Broder, my colleague and co-author is over
here, I'm over here, there's the Oval Office desk and so forth. And the
President sits back in that chair and he talks in this very calm manner. On
and on, almost like a soliloquy, of mistakes he had made. I tried to do too
much too fast, I shoulda reached out to Bob Dole earlier, even if it wouldn'ta
made a difference because Dole kept telling me privately we're gonna make a
deal, we're gonna make a deal, but he didn't do it publicly. I should've told
the country that, when I realized we couldn't get it done in a year as
promised, that it was gonna take longer, maybe 2 or 3 years, I should've spoken
to the country, I should've given a speech when it was over, explaining why I
thought it had failed, where we went from here. I didn't appreciate the
lightning rod of my wife in this, (unintel) Hillary in this process. That she
would be not only so controversial but even inhibiting to members of my
administration who wouldn't feel that they could be as candid with her as I
thought they would be. I was surprised at that. And then he finally says, I
set the Congress up for failure. And I set myself up for failure.
Now, I don't believe--my background in graduate school was American History--I
don't believe any sitting President, has ever acknowledged so large a sense of
responsibility of a major issue in which he felt responsible for its failures.
I think he's too strong on himself by the way. I think the failures are across
the board, his are among them. But he was doing this in an analytical way,
which told me, and I look back at that moment in sort of awe because I think
you can see a different President, emerging from that moment. The lessons,
plural, he was drawing, from the debacle that he had suffered. After all, the
Democrats had lost control of the Congress, no small measure on this issue, for
the first time in 40 years he was then the weakest President, so people said,
in the century? Irrelevant everybody said. The wise people of Washington, and
the press and the political establishment, said he was doomed. And yet I think
you could see the, the more cohesion, more discipline, more of a reaching out
for bipartisanship, more willing to fight on the few things that he cares
about, and make it clear. More focused, if he wins the presidency, is
reelected, I think it'll be because he learned those lessons.
FL: It seems sort of a reprise of the devastating loss that he had as a
governor....He wandered around tugging on people's sleeves, saying, what have I
done, what have I done, and emerged back focused and, I guess my question is
really about the man......
JOHNSON:
I think Bill Clinton's life is fascinating for a lot of reasons. Not only as
an American fable, which it is, and an American metaphor, which it also is, of
great heights and great depths. You battle back from adversity and you stumble
again. You learn from, you fall into the cliff again. I think his whole
pattern of his life he's been that.
A lotta bright people, who are energetic, and are supremely confident are,
prone to make mistakes, even though they seem to learn from them. And, part of
it is the risks implicit in the, and the octane of great adventures, and great,
Jack Kennedy was that way, he had a sense of invulnerability, invincibility
because of one's own impending death. I mean it does focus the mind. And this
sort of, it affects you, so you grab life as you can. And you take risks, in
his case, reckless ones.
Clinton seems to me, I don't want to be an amateur psychiatrist here, but he
also takes great risks also. He extends himself farther. And, he is so
supremely confident that he can do what's right, he's sure is gonna be right,
and that has also been the failure of almost all strong leaders. If you go too
far in assuming you've got the answers. Newt Gingrich had the same problem.
The same sense of hubris that I overreached my mandate, the Congress was going
to be mine, I'll remake America and the Congress in my image and so forth. It
didn't work, that's not the way it works and I think Presidents and leaders are
prone to that. Prince Hal was that way. If you look at his, in Shakespeare's
Henry IV. I love Prince Hal as a metaphor for young leaders and, or
Machiavelli that Clinton likes to quote Machiavelli also. About the
difficulties of the reformer. How difficult it is to make change. How things
just, the status, the enemies of reform are always multiple and many, and they
cling to the status quo, where the change agents, where those who bring reform
are very much alone and suffer enormous burdens and oppositions.
FL: Could you describe how the interest groups organized to defeat this
plan.
JOHNSON:
Of all the episodes that I've learned, and my colleague Mr. Broder have
learned out of this episode, this tragic story we tell, the most stunning and
disturbing is the role of the interest groups. First of all, they have gone so
far beyond the normal process of lobbying that what we now think of as lobbying
in Washington is stone age. That is, you go before a Congressional Hearing
room and you pluck at the sleeve of a senator, you're the lobbyist in your
Gucci loafers and your Italian suit, thousand dollar suit, and you put out PAC
money and you signal yes or no on a vote, that's not where it is now.
The interest groups now have the power to operate, surreptitiously,
anonymously, forging enormous coalitions of power. Meeting in board rooms as
they did during this battle, maybe 4 or 5 or 10 or 15 groups, pooling their
resources, never wanting to be identified in public, and organize grassroots,
so-called, campaigns out of Washington. So they manufacture opinion and they
flood the airwaves of Washington, Congressional offices with e-mail, with
faxes, with phone banks and alerts and they're seen to be as the authentic
voice of the people, standing up to protest a terrible policy being hatched in
Washington. They are not the authentic voice of the people. They are paid
for. They are bought and manipulated. They are put into banks and they push a
button and they flood the offices. And, the way they now have the power that
both political parties used to have, and far more resources and they have the
same people who now operate for them, for top dollar, as run, the presidential
campaigns of both Democrat and Republicans, with vastly more money. They are
unelected, unaccountable, they are like crypto-political parties. And they
have enormously changed the equation in the way things are done in our
political system.
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