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THE FAILURE TO MEET “THE CHALLENGE OF OUR TIME”: THE DEMISE OF BILL CLINTON’S PLAN FOR UNIVERSAL HEALTH CARE by CHRISTOPHER MAYS Submitted in partial fulfillment of the requirements For the degree of Master of Arts Thesis Advisor: Dr. Kimberly Emmons Department of English CASE WESTERN RESERVE UNIVERSITY May, 2008 CASE WESTERN RESERVE UNIVERSITY SCHOOL OF GRADUATE STUDIES We hereby approve the thesis/dissertation of _____________________________________________________ candidate for the ______________________degree *. (signed)_______________________________________________ (chair of the committee) ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ (date) _______________________ *We also certify that written approval has been obtained for any proprietary material contained therein. Table of Contents Abstract............................................................................................................................ 2 Introduction...................................................................................................................... 3 Chapter One: People? Or Profit?: The Reversal of Bill Clinton’s Proposal for Universal Health Care.................................................................................... 27 Chapter Two: The “Dramatic” Appropriation of the President’s Message: Same Words, Different Story.............................................................................. 57 Conclusion....................................................................................................................... 82 Works Cited..................................................................................................................... 95 The Failure to Meet “The Challenge of Our Time”: The Demise of Bill Clinton’s Plan For Universal Health Care Abstract by CHRISTOPHER MAYS This thesis employs the theories of Kenneth Burke in an analysis of Bill Clinton’s failed 1993-1994 attempt to institute universal health care in the United States. My study examines Clinton’s initial televised address introducing his plan and the various media responses to it as an example of the ways a rhetor can motivate public opinion and public policy on a national stage. I argue that Clinton’s attempt to control the public response to his plan through the use of a humanitarian terministic screen ultimately failed because he simultaneously introduced a competing economic terministic screen. This allowed his opponents to appropriate his argument selectively and, ultimately, to prevent the public from comprehending the importance of the humanitarian arguments. Thus, this project demonstrates the power of public discourse to shape policy decisions and social realities. 2 Introduction Can a single rhetorical moment shape public policy? On September 22, 1993, President Bill Clinton gave a televised speech to the nation that at the time seemed destined to do just that. Clinton’s address, which was “one of the most comprehensive domestic policy proposals ever made by an American president” (West, Heith and Goodwin 41), was essentially an attempt to persuade the American public to radically overhaul the existing system of health insurance by instituting guaranteed universal health care, and, as such, was a tremendously ambitious use of deliberative rhetoric to reshape social reality. Under Clinton’s proposed plan, almost every facet of the health care system would change, and this meant that almost every feature of every industry connected in some way to the system’s operation would be transformed; in short, everyone in the country would be affected by the implementation of the proposed system of health care, and thus all Americans had a reason to pay close attention to Clinton’s address. As public support of his plan was crucial to its chances for enactment, for Clinton, his speech was a vital opportunity to generate the initial widespread enthusiasm for the plan that he hoped would create the conditions for its eventual success. Of course, Clinton’s attempt to transform the system did not go unanswered. As the fate of Clinton’s bill had powerful and lasting ramifications for all areas of American society, his proposal was intensely scrutinized, and, in the months to follow, highly contested. Correspondingly, the massive public debate sparked by his initial address generated more media coverage on health care than in any other single period since the turn of the century (Laham xiii). As well, throughout the course of this melee, a flood of 3 special interest groups, political factions, and grassroots movements all took nuanced positions vis-à-vis Clinton’s plan, and as well all did their best to exert their own influence over its fate. Initially, Clinton’s proposal was effectively able to harness preexisting support for a drastic makeover of the health care system. One week before Clinton made his speech, polls showed that 42% of Americans thought that “the American health care system has so much wrong with it that we need to completely rebuild it,” and, two days after his televised address 59% of the public was in favor of Clinton’s plan in particular (Jacobs and Shapiro 416-418). According to one poll, in fact, only 18% of the public was actually opposed to his plan (Stout B1). Despite this significant popular enthusiasm, however, in a matter of months support for Clinton’s plan had virtually evaporated. A Wall Street Journal/NBC News poll conducted in March of 1994 – only six months after Clinton had unveiled his proposal – showed that 45% of Americans were specifically opposed to “the Clinton plan.” Clearly, though Clinton’s September address had been effective, in the months to follow, his campaign to crystallize public support for the plan – and, in effect, to establish permanently the rhetorical foundation that had produced his initial success – had failed. In this study, then, I intend to critically examine both Clinton’s initial speech and the tenor of the public debate that followed in order to better illuminate the reasons for Clinton’s immediate success, and as well for his eventual failure. Essentially, in his address, Clinton attempted to control the way the public conceived of universal health care itself by refocusing public discourse about health care through a specific set of issues. In other words, within this study, I will analyze Clinton’s initial speech as an 4 attempt to influence the public’s view of health care specifically by determining the way they spoke – and thus thought – about the issue of universal health care. If Clinton were to be successful, then, he would have had to effectively convince the public to see the issue from his perspective, within which universal health care was a necessary and natural step in the progression of American social policy. In addition, though, Clinton’s rhetoric would have needed to establish his viewpoint in the public sphere in such a way that would be immune to the rhetorical counter-strategies of his opponents, who, in their myriad responses to his speech, would undoubtedly attempt to refocus the public’s view of health care in a way favorable to their own aims. Though Clinton’s effort was ultimately unsuccessful, his initial success is evidence that his speech did have a significant effect on the public’s view of his plan – and as well on their view of universal health care in general. As I posit, the single rhetorical “moment” that was encompassed by Clinton’s address on September 22 undoubtedly did have the potential to shape public policy, and though he ultimately failed to do so, his lack of success was not due to the underlying impotence of this particular rhetorical situation, but rather was a result of the rhetorical failings present within the speech itself, as well as the effective rhetorical counter-strategies employed by Clinton’s opponents. My analysis of the progression of Clinton’s health care proposal thus can shed light not only on the way that rhetoric in specific situations affects public policy, but also on the reasons for the continuing lack of any major change to the health care system, even as popular support for reform, as well as the number of uninsured Americans, continues to grow. 5 Within this study, the work of Kenneth Burke will serve as the primary theoretical ground of analysis. Several aspects of Burke’s theories not only are centered around the determinative power of language that is at the core of my thesis, but also are effective organizing principles by which the complex rhetorical structure of Clinton’s discourse – which was a key factor in its initial success as well as in its eventual failure – can be examined both in extensively magnified detail, dissecting even its smallest elements, and from a broad overarching perspective, taking into account the sweeping themes employed throughout the address. In addition, of course, Burke’s theories can be applied to the variety of responses to Clinton’s speech, which not only took up the themes Clinton himself laid out, but also revealed a distinct rhetorical agenda, the imposition of which played a significant role in the shape and, thus, the outcome of the debate. With this in mind, then, a general introduction to Burke’s work is in order. Kenneth Burke, Language and Society When a bit of talking takes place, just what is doing the talking? Just where are the words coming from?

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