Talk of Power, Power of Talk: The 1994 Health Care Reform Debate and Beyond

By Michael W. Shelton | Go to book overview

Chapter 9
The Deliberation

"[T]he Clinton plan was deader than Elvis."

-- SenatorPhil Gramm

By now, everyone knows that Senator Gramm was right. The Clinton plan was dead. The Mitchell bill was dead. In fact, unlike the pop icon Gramm invoked, it is unlikely that you will see any version of comprehensive national health care reform popping into a Dairy Queen in your neighborhood any time soon. There is a general consensus that the issue of comprehensive health care reform was once again derailed and displaced from the national agenda in 1994. Various interpretations of the defeat of the proposals by President Clinton and Senator Mitchell have been posited by political pundits and observers of the political process in Washington. Rovner ( 1995b) has argued that structural features of policy making in Congress played a central role in the 1994 defeat of comprehensive health care reform. Schick ( 1995) contends that health care reform failed primarily because of a misreading of the public mood by proponents of reform. And, Starr ( 1994) has argued that a mix of political forces tended to work in favor of the Republican opposition and cost the advocates of comprehensive reform their best chance for action in decades. In fact, Starr proclaimed "The collapse of health care reform in the first two years of the Clinton administration will go down as one of the great lost political opportunities in American history. It is a story of compromises that never happened, of deals that were never closed, of Republicans, moderate Democrats, and key interest groups that backpedaled from proposals they themselves had earlier co-sponsored or endorsed" (p. 21). Despite Starr's allusion to narrative, all of these explanations failed to address the centrality of discourse and the power that was played out through talk. This chapter will continue to address the actual discourse of the 1994 health care reform debate by focusing upon the deliberation that shapes the debate itself.

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Talk of Power, Power of Talk: The 1994 Health Care Reform Debate and Beyond
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Illustrations ix
  • Series Foreword xi
  • Acknowledgments xv
  • Chapter 1 Introduction: A Framework and Overview 1
  • Part I The Context 9
  • Chapter 2 The U.S. Health Care System 11
  • Chapter 3 The History of Health Care Reform 21
  • Chapter 4 Health Care Reform in the 1990s 29
  • Part II The Text 39
  • Chapter 5 The Senate Battleground 41
  • Chapter 6 The Congressional Record 53
  • Chapter 7 Textual Features 61
  • Part III The Discourse 71
  • Chapter 8 Discourse Patterns 73
  • Chapter 9 The Deliberation 95
  • Chapter 10 The Triumph of the Big Government Argument 107
  • Part IV The Implications 123
  • Chapter 11 An Ethical Assessment 125
  • Chapter 12 Scholarly Horizons 139
  • Chapter 13 Contemporary Currents 151
  • References 167
  • Index 177
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