The Road to Nowhere

The Genesis of President Clinton's Plan for Health Security

Jacob S. Hacker

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English

Princeton University Press
08 June 1999

Political science & theory; Political manifestos; Health systems & services

Series: Princeton Studies in American Politics

During the 1992 presidential campaign, health care reform became a hot issue, paving the way for one of the most important yet ill-fated social policy initiatives in American history: Bill Clinton's 1993 proposal for comprehensive coverage under ""managed competition."" Here Jacob Hacker not only investigates for the first time how managed competition became the president's reform framework, but also illuminates how issues and policies emerge. He follows Clinton's policy ideas from their initial formulation by policy experts through their endorsement by medical industry leaders and politicians to their inclusion--in a new and unexpected form--in the proposal itself. Throughout he explores key questions: Why did health reform become a national issue in the 1990s? Why did Clinton choose managed competition over more familiar options during the 1992 presidential campaign? What effect did this have on the fate of his proposal? Drawing on records of the President's task force, interviews with a wide range of key policy players, and many other sources, Hacker locates his analysis within the context of current political theories on agenda setting.

He concludes that Clinton chose managed competition partly because advocates inside and outside the campaign convinced him that it represented a unique middle road to health care reform.

This conviction, Hacker maintains, blinded the president and his allies to the political risks of the approach and hindered the development of an effective strategy for enacting it.

By: Jacob S. Hacker
Imprint: Princeton University Press
Country of Publication: United States
Edition: New edition
Volume: 69
Dimensions: Height: 235mm, Width: 152mm, Spine: 19mm
Weight: 369g
ISBN: 9780691005287
ISBN 10: 0691005281
Series: Princeton Studies in American Politics
Pages: 256
Publication Date: 08 June 1999
Audience: Professional and scholarly , College/higher education , Undergraduate , Primary
Format: Paperback
Publisher's Status: Active

Jacob S. Hacker is a Guest Scholar in Governmental Studies at the Brookings Institution, a doctoral candidate in political science at Yale University, and a Robert M. Leylan Fellow in Social Sciences at Yale University.

Reviews for The Road to Nowhere: The Genesis of President Clinton's Plan for Health Security

Mr. Hacker brings commendable clarity to a subject that has usually encouraged jargon and convolution. -- David Greenberg The New York Times Book Review Hacker's assessment is measured and balanced... This book will be read by two audiences: those who are interested in health policy per se and those who are interested in the policymaking process. It is equally instructive for both. -- Mary E. Guy American Political Science Review As an intellectual history, his narrative is unrivaled... Hacker's book raises many provocative questions ... and it is for that reason that it is immensely valuable. -- Flint J. Wainess Journal of Health Politics, Policy and Law [Hacker] is particularly adept at showing how top policymakers used the media to sell ideas, not just to the public, but to each other... A fascinating portrait. -- Julian E. Zelizer Reviews in American History

Joint winner of Louis Brownlow Book Award of the National Academy of Public Administration 1997 (United States)
Winner of National Academy of Public Administration Louis Brownlow Award 1997
Winner of National Academy of Public Administration Louis Brownlow Award 1997.