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Journal of Health Politics, Policy and Law 2002 27(4):605-638; DOI:10.1215/03616878-27-4-605
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Duke University Press

Foul Weather Friends: Big Business and Health Care Reform in the 1990s in Historical Perspective

Peter Swenson and Scott Greer
Northwestern University

Abstract.

Existing accounts of the Clinton health reform efforts of the early 1990s neglect to examine how the change in big business reform interests during the short period between the late 1980s and 1994 might have altered the trajectory of compulsory health insurance legislation in Congress. This article explores evidence that big employers lost their early interest in reform because they believed their private remedies for bringing down health cost inflation were finally beginning to work. This had a discouraging effect on reform efforts. Historical analysis shows how hard times during the Great Depression also aligned big business interests with those of reformers seeking compulsory social insurance. Unlike the present case, however, the economic climate did not quickly improve, and the social insurance reform of the New Deal succeeded. The article speculates, therefore, that had employer health expenditures not flattened out, continuing and even growing big business support might have neutralized small business and other opposition that contributed heavily to the failure of reform. Thus in light of the Clinton administration's demonstrated willingness to compromise with business on details of its plan, some kind of major reform might have succeeded.


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M. Gottschalk
Back to the Future? Health Benefits, Organized Labor, and Universal Health Care
Journal of Health Politics Policy and Law, January 1, 2007; 32(6): 923 - 970.
[Abstract] [PDF]




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