Boomerang [Hardcover]

 

 

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National Health Care?--The compassion of the IRS!--The efficiency of the post office!--All at Pentagon prices! Theda Skocpol's Boomerang--Clinton's Health Security Effort and the Turn against Government in U.S. Politics opens with this collection of irreverent aphorisms sighted on the bumper sticker of an old American pick-up truck in the summer of 1994. Later that year, however, a political pundit hailed the Democratic party for "believ[ing] in great government enterprises to solve great problems." A real health reform effort was ignited. American optimism was high. Mere months later, the wind behind the sail of Clinton's proposed reform vanished and the effort lay in defeat--a casualty that seemingly leant credence to the Chevrolet's shameless propaganda. Skocpol's incisive work wends the reader through the course that was "the rise and resounding demise of the Health Security effort."

Boomerang is not an explanation of health care reform. Rather, it is an exercise in politics--an eye-opening account of a massive political undertaking from a vantage close enough to be well inside the Beltway, but far away enough to spare the reader sleepy academic dogma. Skocpol begins our journey with a proclamation: "The presentation and decisive defeat of the Clinton plan in 1993-94 was a pivotal moment in the history of the U.S. governmental and political system." Ostensibly, the American political landscape is now irrevocably changed. That said, we enter the first of six chapters. The author initiates us with the embers of health reform talk from the early twentieth century. She then springs to the beginning of the current decade to explain how a Pennsylvania state senate hopeful put reform back into the American consciousness with a simple television campaign advertisement. Following the candidate's victory, several schemes for national reform were promulgated. Eagerly, 1992 Democratic presidential hopefuls picked up on the reform rhetoric. In time, the Democratic candidate emerged toting "an alternative middle-of-the-road approach to comprehensive reform"--and William J. Clinton was elected.

Skocpol relates the fascinating story of the President's quick assembling of a health reform Task Force of experts charged with constructing the would-be plan for reform. The document, some 1,300 pages, arrived several months later into Clinton's tenure than planned and was very eagerly received by Washington insiders who quickly obtained leaked copies. After White House tweaking of the plan, which included such features as mandatory regional purchasing alliances (one of several features that was largely unrecognized and/or poorly understood by the citizenry), public approval was considerable.

Skocpol's third chapter, "Democrats in Disarray," recounts what "went wrong...for the Clinton Health Security proposal." The author blames in part the virtual "dissapear[ance]" of Health Security from the President's agenda. Ostensibly, Clinton's agenda was supplanted by NAFTA, foreign affairs, and congressional problems at home. Skocpol then observes the remarkable power of political action committees and the effects such key organizations had on the once-burgeoning reform effort. Even PAC's whose support was expected seemed to offer lukewarm embraces. What is more, Congress could not agree about "exactly what kind of health reform they wanted."

Chapter Four, "Marketing an Ambivalent Message," reflects Skocpol's attitude that the conveyance of the details of the reform effort to the general public "proved thin and unconvincing." The goals and themes of reform were presented, but the details were not. Such was the prescription of the consultants charged with the marketing of the proposal. In the author's assessment, such "vague and evasive explanations" of the workings of health reform left Americans vulnerable to the rhetoric of the manifold naysayers. Attenuated public support for reform resulted from this scenario.

Boomerang's lengthiest chapter, "Mobilization Against Government" is the author's thrust toward her thesis. In this chapter, Skocpol paints the boomerang course of the reform effort--the hawkish biting back of those who would oppose the Clinton effort. She recounts the mobilization of stakeholders ("groups with an occupational or financial stake in the $800 billion-per-year business of health care...") against the proposal. Of particular import were the efforts of the Health Insurance Association of America. This anti-Clintonian association undertook to lobby at the grassroots level and utilized television advertising with the infamous "Harry and Louise" doubt-casting commercials. Moreover, key congressional members began to attack the Clinton plan in the media. Such aspersions seemed to propagate exponentially and were eventually aimed at the First Lady. This uncontrollable disparagement coupled with the public's general fear of "managed care" rendered the citizenry even more averse to the reform effort.

"Ambitiously launched but poorly explained by its own sponsors, Health Security gave antigovernment conservatives exactly the target they were looking for--a proposed federal initiative that could be portrayed as threatening to the American middle class."

Skocpol's conclusion, "Legacies and Lessons," portrays the impetus for the downfall of the Clinton reform effort as "Reagan's Revenge"--a rampant distrust of government borne of President Reagan's evisceration of federal programs. "[T]he Clinton Health Security proposal--in its ultimate irony--gave new life to the outcries about [the problems with big government]." Moreover, Skocpol alleges that even more moderate approaches toward health reform would likely have suffered the same defeat because Clinton "was trying to deal with the aftereffects of previous conservative attacks on government."

Did Skocpol support her thesis? Is the political landscape irrevocably changed? Time will tell. However, the author's resolute charge that the demise of the Clinton proposal was a "pivotal moment in the history of the U.S. governmental and political system" can be construed as overstatement. Perhaps, more plausibly, only future thoughts of monumental social reform and over-arching federal programs will resound from the aftershock of the toppled Clinton proposal.

Skocpol's Boomerang is a well written, compelling account of the events that surrounded Clinton's health reform effort. Replete with pertinent, illustrative political cartoons, the work is a comfortable read with great appeal for those who crave the war stories of the American political machine.

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