The System: The American Way of Politics at the Breaking Point

by David S. Broder

Taking as an example the Clinton health care reform initiative, the authors show how a policy that aimed to please everyone ended by satisfying no one due to pressure groups, political gamesmanship and the inertia of the American 'system'.

Genres: Politics, History, Health Care, Nonfiction, The United States Of America

710 pages, Kindle Edition

First published January 1, 1996

Reviews

[Greg · Rating 5 out of 5]

In what I consider to be one of the best books ever written on American politics and public policy, Johnson and Broder describe the intricate and sad story of why the U.S. didn't get universal health care in 1994. For those who care to actually understand why history matters, this provides a great insight into the myth of Hillary Clinton and how she helped squander the promise of real progress.

In retrospect, among the particularly galling lessons of this account is that the Affordable Care Act (or Obamacare) is pretty much the same policy that Senator John Chafee (R-RI) tried to get the Clinton commission to accept as a compromise. The U.S. could have had this in 1994! But Hillary Clinton rejected it in large part because she could not take credit for it. It didn't fit the mold that her secretive process and commission wanted to implement. Looking back, I am convinced that if Chafee's compromise had been accepted and passed into law, it would have evolved into a single payer system over time.

The other tragedy was the story of Bob Dole. He was ready to support a national health care plan based on Chafee's proposal and he could have provided the votes to make it happen. But two things got in the way. First was the Gingrich-led and inspired Contract with America that ushered in the Republican congressional majority in 1994. The second was his decision to run for president in 1996. It forced him to appease the House majority and move dramatically to the right and oppose anything that had the name Clinton on it. That meant abandoning health care reform in order to confirm his conservative bona fides.

But as I observe the presidential primaries of 2016, I think it is important to understand how far the Republican Party has moved from its traditional, pragmatic roots and how the myth of Hillary Clinton obscures the pivotal role she played in scuttling health reform compromise in 1994. Average Americans have paid the price ever since. We could have had so much more than we have now. And had Dole remained a strong, sane presence in the Senate instead of striving for the presidency, we might have avoided the birth of right-wing extremism that has infected public discourse and governing. Instead we got costs spiraling out of control that are now almost impossible to reign in even with a radical overhaul of the entire system.

The more the lesson of the brilliant reporting of Johnson and Broder sinks in, the more this story takes on the aura of a Greek tragedy that leaves no winners, only losers. And it helps those who pay attention to understand why the rest of the Western world looks upon the U.S. with confused curiosity and not as the beacon of freedom that deluded, jingoistic Americans fool themselves into believing.

[Julie · Rating 2 out of 5]

Oh my god, this has got to be one of THE most boring books I've ever read. It's just bad writing. The subject is interesting. Example of good writing but a topic that bored me: "Showdown at Gucci Gulch." I was bored out of my mind by Regan's tax reform by the end, but... at least I MADE it to the end, given the writing was so bad! I don't recommend The System unless you are enthralled with the ins and outs of the Clinton Healthcare Plan. Then you might not care about the poor writing.

[Scott · Rating 5 out of 5]

I read this book as part of a health care (HC)class. It is well written by reporters, it is reasonably unbiased (important in politics) and approachable. Ultimately, I will echo what my teacher said that it is probably the best explanation of how complicated our HC system is in the US and why it is so hard to change the status quo. It does this by telling the story of President Clinton and explaining why he was unable to pass HC reform.

I relished reading about the players in "The System" and in learning about those that are still in the game in Congress and government. In many ways it reinforced my respect for of those people and with others it made me like them less. This was surprisingly not party specific.

Since I work on HC policy, this was also something that was thought provoking. I underlined many passages while also jotting down ideas in the margins. Now I need to go back to review them!

To be honest, Congress in the 90s seemed easier to work with than it is today. Regardless, it was good to see the similarities that they faced that are just like those we are trying to address today. I just wonder what the next tipping point will be that will force change in our current climate.

[Dex]

Under a time crunch doing research about presidential theories of success using Clinton’s health care reform failure as a case study. I did actually read this cover to cover in a little over 24 hours, definitely used some skimming ability but only skipped a few pages during the interviews from LA and Minnesota since they weren’t that helpful.

Great access from Johnson and Broder leads to great detail. Great detail makes a great book. I’m probably biased because I’m researching this exact topic, but I thought this was an engaging read that describes a new form of American politics in an engaging way. Interesting that they call it The System given that they are demarcating a dramatic change in it starting with Gingrich.

[David Kaufman · Rating 5 out of 5]

ok, this is kind of a hard core health policy book. but it's also probably the best description of how politics and policy really work in the real world. it's the story of the clinton health plan and how/why it bombed. reading this now, it's amazing that to think that hillary is the the presidential frontrunner. there's a pretty good argument (and it's one these guys make) that she was almost singlehandedly responsible for republican control of congress from 1994-2006. also, it's crazy how far to the right the country has moved since we were about 10. in the early 90s republicans were proposing things that were so far to the left, no democrat would dare say them today for fear of being branded a socialist.

[Grindy Stone · Rating 4 out of 5]

One of the old saws with presidential politics is that, if a president wants to make his or her mark, the best way to pull it off is with foreign policy, as there are too many special interests represented by too many politicians to accomplish anything domestically. If anyone doubts that truism, he would do well to read this book, which does a great job of explaining why health care in the US could use some reform as well as with how it tells the story of the Clinton Administration's efforts to overhaul the system. The congressional portion of this book is where it becomes a slog, but the details are here for those interested in the process.

[Matt · Rating 4 out of 5]

A very solid, reported examination of the Clinton administration's 1993-1994 effort to enact comprehensive health care reform. I wish I had read it last spring though, so much of the current health care fight parallels that fight.

One annoying tick I noticed in the book was that Broder and Johnson referred Clinton as the first Democratic president since LBJ to do one thing another. There was only one Dem president between LBJ and Clinton! Clinton wasn't breaking some kind of historical trend by simply doing something that Jimmy Carter didn't do.

[Jessica · Rating 4 out of 5]

The book I read to try to prepare myself for what it really might be like to work on Capitol Hill. It was a good introduction to the outsized personalities, committees of jurisdiction and interest groups with influence in all their glory, all tossing their weight around. I mean, it's early 1990's wrangling over health care policy, what could be better???

[Ethan · Rating 4 out of 5]

Although a foreboding tome, this is an incredibly readable account of the Clinton health plan and its inevitable demise in 1993. Reads like a novel. If you like "West Wing" you'll probably like this dramatic rendering how politics (doesn't) work.

[Russ · Rating 4 out of 5]

Covers the back room politics of the Clintons' failed '93 health reform. Liked it both from the political game coverage (especially the unreal tactics of special interests) as well as learning about health reform. Recommended.

[Jack · Rating 5 out of 5]

I love this book. Anyone who wants an in-depth analysis of the Clintons' pursuit of universal health care in 1993-1994 needs to read it. Just re-read it from cover to cover and can't wait for someone to write the memoirs of the Obama effort.

[RYD · Rating 4 out of 5]

A really great account of Bill and Hillary Clinton's attempt in his first term to pass universal health care. What really stood out...though the authors bemoaned the lack of bipartisanship, it is clear from the recent health care votes that it has only gotten worse.

[Karen · Rating 5 out of 5]

Definitely a worthwhile read for those interested in health care reform and the political process. Ultimately a frustrating, yet incredibly informative book.

[Matt Simmons · Rating 4 out of 5]

This might make the list of the top 10 books about politics that I can't live without.

[Elizabeth · Rating 3 out of 5]

Lessons learned? Let's hope the Obama administration takes away this lesson: don't neglect Congress when you're writing the policy. Let there be no war room for the new health care plan.

[Polly Callahan]

pick up with chapter 7