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Why did Clinton Health Security Act of 1993 failed despite the opportunity to reform?

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  1. Introduction.
  2. The Health Security Act (HSA) delivered by Clinton.
  3. Why President Clinton's proposal was not legislated.
    1. Rapidly rising costs which began to affect both public and private sectors.
    2. Problems for the employers.
    3. What placed health care reform on the political agenda.
  4. Clinton and his administration.
    1. Clinton and his administration.
    2. Attracting the middle class.
    3. The employer mandate.
    4. Mobilizing interest groups.
    5. The legislative strategy.
  5. Why did HSA fail despite the favourable context.
    1. US political institutions - structurally biased against comprehensive reform.
    2. Absence of complete control on his agenda.
    3. Preoccupation with other issues.
    4. The loss of intrest from big employers.
    5. Clinton's overestimation of the Democrats and their capacity to get unified around the bill.
  6. The Republican mobilization effort.
  7. Conclusion.
  8. Bibliography.

Reforming the US health care system was one of the top priorities of the presidential battle in 1992 and William Jefferson Clinton managed to appear as the most competent candidate to deliver a comprehensive plan to solve this problem. Since the late 1970's, the country was facing problems because of its health care system. Many Americans had no health insurance, and the first cause of individual bankruptcy was due to high medical expanses. American companies also faced competitive disadvantages because of high health care costs: from 1965 to 1989, business spending on health benefit climbed from 2.2 % to 8.3% of wages and salaries and from 8.4 % to 56% of pre-tax corporate profits. But those problems only came up at the national level after Wofford's 1991 victory in the senatorial election in Pennsylvania. Indeed, the latter used the health care issue to win those elections and as a result, paved the way for the national leader to utilise this topic in order to get elected. The Health Security Act (HSA) delivered by Clinton and his administration in 1993 pretended to be universal and of high quality. But, above all, it was a strategic tool which ultimate aim was to legitimate the Democrats within the US political sphere for decades to come.

[...] That's why Clinton and his taskforce designed a plan which aimed to concern every American, and by doing so, reminded people about the old age insurance of 1935 Social Security Act. The principle of this new reform consisted in sharing medical costs between employers, employees and state government. This was the employer mandate system. Employers had to pay for health insurance for employees and their families, employees had to pay a small part of the same fees, and eventually, national and state governments had to pay for non-employed. [...]

[...] is to analyse the different reasons why President Clinton's proposal for national health insurance was not legislated despite the opportunity for reform as well as Clinton's strategy for achieving it. When Clinton became President in 1992, there was a real opportunity to act: health reform, although it has been on the agenda for a long time, was yet a burning issue which never had such a broader popular resonance than at that time. The road toward health reform has been long and Clinton was not the first President to tackle the issue. [...]

[...] Missing Millions: Organized Labor, Business, and the Defeat of Clinton's Health Security Journal of Health Politics, Policy and Law (1999) 489-530. Klein, Jennifer. ?Review of Cathie Jo Martin, Stuck in Neutral,? Journal of Health Politics, Policy and Law. (2002) 27 677-82. Martin, Cathie Jo. Stuck in Neutral, Princeton: Princeton University Press Peterson, Mark A. Politics of Health Care Policy: Over reaching in an Age of Polarization,? in Margaret Weir, ed., The Social Divide, New York: Brookings Institution Press 181-229. Skocpol, Theda. [...]

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