A Woman in Charge (48 page)
On February 19, vivid evidence of the problem showed up in a
Chicago Sun-Times
column by Bill Zwecker: “Seems First Lady Hillary Rodham Clinton has a temper to match her hubby's.” Zwecker reported, without attribution, that Hillary had smashed a lamp during a fierce argument with Bill in the family quarters. “Just in case you care,” he added, “Bill and Hillary sleep in separate bedrooms”âwhich, in fact, was not the case. Other mainstream media outlets picked up the story, some embellishing it: Hillary, it was said, had thrown a vase or a Bible at her husband. In one version, a Secret Service agent supposedly had to break up the dispute, telling Hillary, “We've got to protect him, including from you.”
That Hillary had a temper and that she had directed it toward Bill (and vice versa) was hardly news to people who had been close to the Clintons in Arkansas. They had scrapped and screamed at each other since their courtship. None of their friends or aides is known to have given credence to the
Sun-Times
story. Still, it raced through the capital as no other bit of Clintonian gossip had since their arrival.
Hillary was livid about the story and about the Secret Service. When the Service failed to issue a formal denial, she became even angrier. (Later, Zwecker said that one of two sources for his column had been someone involved in “White House security.”) When
Newsweek
picked up the item, she declared the magazine
escrit non grata
and said she would never allow its correspondents to interview her.
She was also harsh in her response to Foster. If she had ever previously had a really cross word with him, no one had ever heard about it, including Webb Hubbell. The relationship between Hillary and Vince had always reflected a solicitous mutual caring, and a deep understanding of the vulnerabilities beneath the surface of each. In this instance, she seemed to draw no distinction between Watkins and Foster, reprimanding them at the same time. Both were subordinates who had failed to take action when she had expressed her urgent concerns. The two of them were “too naive and too nice, being from Arkansas,” Hillary said, making a strange connection.
Watkins seemed to take her rebuke in stride, but Vince was clearly devastated. Thereafter, he referred to Hillary as “the client.”
Vince had come to Washington a week before the inauguration, excited at the prospect, filled with high hopes. He was not a political animal, and never had been. His allegiance was personalâto the president, but even more so to Hillary. His wife, Lisa, had told him, when he was asked to join the administration, “I'm afraid if you don't do it you'll always be sorry.” But now he was beginning to have doubts, according to many of his fellow Arkansans who also made the trip.
While Bernie Nussbaum had temporarily moved into the $300-a-night Jefferson Hotel, Vince felt he couldn't afford such extravagance. He had a family back home to support. The price of living in Washington was generally shocking to him. Real estate, food, going to the moviesâhe could see that he would not be able to live nearly as well as he had in Little Rock, no matter how exalted his position. He moved into the Northwest Washington house of his sister, Sheila, who was married to a former congressman from Arkansas, Beryl Anthony.
Lisa had been expecting to enjoy living in the capitalâher husband was deputy counsel to the president; there would be state dinners at the White House, congressmen and senators to rub shoulders with, the Kennedy Center honors. But Vince had insisted that she and their children stay behind until their youngest son had finished the high school year in Little Rock. She was not pleased with his decision. She and their children came to Washington for the inauguration, but Vince had no time for them. As soon as the ceremony at the Capitol was over, he had hurried to the White House because of the trouble with the Zoë Baird nomination. Lisa and the children were left behind on the Capitol grounds, in a strange city with little idea of how they would get back to Sheila's house. She was so angry that she refused to go to the inaugural ball that evening. In fact, she said later, “I was angry at Vince about 90 percent of the time. I wasn't angry at him for going [to Washington]. I was just angry at him for ignoring us and leaving us behind, and making me have to deal with everything, all the decisions, and he was getting all the so-called glory.”
Immediately Vince was thrown into the maelstrom of the administration's difficult first days, almost everything in which Hillary was involved. Though he was deputy counsel to the president in title, he was, in fact, her counselor, all the more so as she became preoccupied with her health care mandate, and left more and more details of other matters to him. “This is gold,” he told Webb Hubbell, referring to his White House pass. “I could never go back.” In the White House, Vince and Hillary “were the team he had always imagined they would be,” Hubbell said. The glow did not last long.
Foster appeared to internalize the blame for the item in the
Sun-Times,
as if he had failed to protect her and the president. She was right, he told Nussbaum. He had not been forceful enough. Nussbaum thought Foster's initial instinctsâthat dismissing members of the presidential Secret Service detail would leak to the press and cause a backlashâwere probably correct, but by now, Vince and Watkins had no doubt that action was in order, if for no other reason than to calm the first lady.
Foster and Watkins met with the Secret Service official in charge of the presidential detail, John McGaw, and expressed the displeasure of Hillary and the president over both the
Sun-Times
story and the attitude of agents in the residence.
McGaw defended his men and womenâthe fact that the agents were taciturn didn't mean they were hostile, he said. They were going by the book. He expressed certainty the leak had not come from them.
His days heading the presidential security office were soon over. Through the intercession of Foster and Watkins, he was “promoted” to director of the Bureau of Alcohol, Tobacco, and Firearms. As Hillary had demanded, many of the resident Secret Service agents were now given jobs outside the White House, and replaced by others who had not served directly with the Bushes or Reagans. The number of agents assigned to the residence was reduced, as was the size of the detail hovering around the Oval Office. Upstairs, the agents now stayed out of the living areaâand Hillary's way.
11
Health Care
I didn't fully realize the magnitude of what we were undertaking.
âLiving History
T
HE
C
LINTONS CAME
to Washington to accomplish great things. The greatest of their goals was to establish a system of universal health care in which every American would be insured against catastrophic illness and guaranteed adequate, paid lifelong medical care. Such an undertaking would be the biggest public works project in the nation's history, and was perhaps the most necessary since the advent of Social Security. “If I don't get health care done, I'll wish I didn't run for president,” Bill told his aides in February.
Both the Clintons were, by nature, optimists, but also realists. They understood the inevitability of political combat. But they had not expected to come to Washington and immediately find themselves under constant attack and suspicion, or forced to change their course abruptly because their predecessors had sailed recklessly into a fiscal storm and couldn't find, or did not try to find, their way out in an election year. But those were the realities.
As in Arkansas with her education portfolio, by the time Hillary had begun consulting with experts, she already knew where she wanted to go. Hillary wanted to combine government controls and the will of the competitive marketplace, taking the best elements of both to restrain health care costs. The government (rather than private insurance companies) would dictate a set of basic medical benefits that would be available to all patients, and require private insurers to offer all of these benefits in their policies. A competitive bidding process in each state would determine the price of insurance policies, so that state officials could bargain with insurance companies for the lowest premium rates for their citizens. Most American companies would be required to pay for 80 percent of their employees' health insurance; the government would partially subsidize the cost to smaller businesses, and buy insurance for the unemployed poor.
Hillary's plan was an impressive demonstration of her intellect, dedication, and ability to grasp the entirety of a huge policy debate. But it was tangled from the start with political missteps that could have been avoided. Her demonstrable sense of entitlement, the idea that the goal was so worthy that extraordinary procedures could be justified to achieve it, hence her insistence from the start on secrecy that appeared almost conspiratorial, made her task far more contentious than necessary, and almost immediately jeopardized her cause.
From the beginning, Hillary and Ira Magaziner were confronted by an inherent conflict with the budgetary realities the president was trying to deal with. But they insisted that the health care model they were proposing would be more efficient and less costly than the existing Medicare and Medicaid systems it would replace. By their calculations, they could bring about substantial savings that would cover the costs of insuring the millions of Americans currently uninsured, and eventually reduce the federal deficit further to help the president. It was almost a magic bullet, they felt.
Unfortunately, most of Bill Clinton's economic advisers thought Hillary and Magaziner's numbers were wishful thinking.
To develop the specifics of her proposal, Hillary established what was formally known as the President's Task Force on National Health Care Reform, comprising five hundred consultant-experts in various aspects of medical and health care policy. The consultants were drawn from congressional staffs, federal agencies, academia, corporations, and professionals in the medical community. Under Hillary's watch, Magaziner divided the task force participants into thirty-four “working groups,” designated by specialty. They were expected to debate the issues in their purview, present a set of recommendations, and then defend their conclusions. Group assignments ranged from how to serve the particular medical needs of Native Americans to deciding whether prescription drugs and mental health counseling should be included in the basic benefits the government would guarantee.
As conceived, the duties of the task force seemed overly complexânot to mention impossible to complete within the hundred-day deadline set by the president. Magaziner distributed a rigorousâsome said outlandishâschedule that called for each of the thirty-four working groups to develop recommendations on seven different topics, and present their suggestions to a huge formal assembly at seven different meetings. He explained to doubters, “People work best when they work for deadlines. It forces discipline.” Many of the task force members were working six-and seven-day weeks, often for eighteen hours a day.
The scene inside the Executive Office Building, where the five hundred consultants met, always seemed on the brink of chaos. Task force members were crammed into makeshift meeting rooms that lacked sufficient desks and chairs or adequate light.
The conclusory presentation meetings of the individual groups were held in the Indian Treaty Room, an ornate, inadequate space that had once been the Navy Department Library and Reception Room. About two hundred people would attend, usually including either Magaziner or Hillary; Shalala or an analyst from her Department of Health and Human Services; and representatives of various cabinet departments. The last to arriveâexcepting senior officialsâhad to sit outside in the hall. The sessions often went late into the night, without reaching conclusions about the matters under discussion, as Hillary, Magaziner, and others tried to pay attention.
Hillary spent hundreds of hours in such meetings, taking notes on every issue, and trying to absorb the numbing detail. Whether she was in the White House or traveling on airplanes, she always seemed to be studying. But for all of that, she was floundering.
The White House, meanwhile, refused inquiries from the press and interested organizations to identify her five hundred consultants, or provide any details of what they were working on. This made practical sense. There was no precedent for presidential administrations drafting legislation in public and, even in secret, the process was disorderly. Advance release of partially developed ideas might encourage premature debate, divert energy from formulating final recommendations, and hamper the work generally.
But health care reform was one of the most charged public policy issues of the day. Republicans, ideological opponents of government controls, and important segments of the health care industry that stood to lose money in a revamped system complained immediately that they had been cut out of the process. For the most part, they had.
The first week in February, William F. Clinger Jr., the ranking Republican member on the House Government Operations Committee, charged that the process was illegal, and demanded that the General Accounting Office investigate whether Hillary was authorized to conduct such proceedings in private. He cited the 1972 Federal Advisory Committee Act, which mandated public meetings unless all task force members were federal employees. Clinger danced around direct criticism of the first lady, but his target was unmistakable. His accusation of illegal and abnormal secrecy was devastating. It resonated both with Hillary's potential opponentsâlegislators and bureaucrats committed to existing standards and structures of the health care system, lobbyists with narrow agendas, and Republican partisansâand also with those who could have been her natural allies: journalists who covered the medical field, associations of professionals in medicine and health care, Democratic politicians, and the president's principal economic and domestic program advisers, including Bentsen, Rubin, Panetta, and Shalala.
Clinger's charges made Hillary appear to be something of a paranoid. It was now made to seem that she and Magaziner were running their operation with a military-like secrecy unprecedented for a peacetime domestic program. (That was pretty much true.) They had devised a security system in which it was forbidden to photocopy drafts of documents under discussion or even to bring writing instruments into many meetings. Room monitors were assigned to keep track of who reviewed certain papers. All meetings were closed not only to the press, but to all outsiders. “They would take documents away from us and look for leaks. They didn't trust us. You'd think you were in the FBI,” said former Minnesota health commissioner Mary Jo O'Brien, who served as a task force member. “The funny thing was, these were not new ideas. I expected it would be stuff that could be patented, but there was nothing new, just discussions of policy. It was handled very poorly. It became a military operation.”
Many blamed Magaziner for the secrecy requirements, but it was Hillary who wanted them, as Magaziner confirmed later.
Hillary wasn't open to any substantive compromise with her vision of health care reform. She ignored the possibility that instituting a system of gradually phased-in improvements to the existing health care system, leading eventually to her larger goals, might be helpful both to the Clintons' political allies, up for reelection in 1994, and to her husband's own political future. As Stephanopoulos said, “Compromise didn't come naturally to Hillary.”
Hillary also tended to view anyone who criticized her plan, even constructively, as an enemy. Michael Bromberg, head of a lobbying organization for private hospitals, had tried to explain to Hillary that compromise was the biggest lesson he'd learned from working with Congress. “Any bill that passes Congress will be a credit to you,” Bromberg told her. “But if you say, âThis must be in there,'” and the provision fails on Capitol Hill, “then it will be perceived as a loss.” Hillary replied, “Bill and I didn't come to Washington to play the game as usual.” Hillary drew a line in the sand: she said that she and the president would make the midterm congressional elections in 1994 a vote about her health care plan, and would use the public's support for her approach to attack those who opposed her. “We know how to run a populist campaign,” she said, reviving the warrior woman theme of Camp David.
Her husband's top deputies were beginning to worry that she was both politically tone-deaf and strategically inept, especially within the toxic Washington environment. Hillary had convinced her own aides and a few important members of the president's domestic policy staff that the administration could pass health care legislation without any Republican votes. A senior White House official later explained, “Among Clintonites, it was widely thought that the Republicans had engaged in so much malign neglect over the years that the public would rally to Democratic nostrums.” Lawrence O'Donnell, the principal aide to Senator Moynihan, concluded that “Hillary believedâ¦this is so clearly a moral good that no one can stand up and say, âI'm going to stop it.'”
Hillary was more than three months into the job before she started soliciting suggestions from Republicans and conservative Democrats. She visited dozens of congressmen in their offices, asked about their families, complimented their work, and dutifully followed up with a thank-you note. But many lawmakers believed her attempts were mainly for show. In fact, Republicans were totally frozen out of the process. As Senator Dave Durenberger, a Republican from Minnesota, said, “We may have been consulted, but we weren't involved.”
By then, Hillary had established her health care war room, staffed by young aides who, around the clock, monitored threats and attacks against her still secret plan. Her message was unambiguous: she did not want negotiations that would end in compromise. She was looking for unconditional surrender. Health care had now become part of the Permanent Campaign, too.
“There's just nothing stupider in government than, You're with me or against me,” said O'Donnell, reflecting the Washington experience Hillary lacked at that point. “Campaigning is: You beat the other guy, you leave him for dead in New Hampshire, that's the endâyou don't care what happens to him. But you never, ever, ever beat Dole. He's there the next day in the Senate. And he's there for the next vote, which you desperately need.”
Shalala and the president's other senior economic experts expressed modest objections to Hillary and Magaziner's tactics. But a dangerous dynamic was developing: the president's aides and advisers felt increasingly uncomfortable confronting the first lady. Even Stephanopoulos and Greenberg did not make known to Hillary their deep reservations about her plan. McLarty remained silent, too, though he believed Hillary was moving in the wrong direction. Bentsen and Rubin became so diplomatic and circumlocutous in their criticism that at times Hillary and Magaziner didn't comprehend the extent of their concern. Laura Tyson, chairwoman of the Council of Economic Advisers, Shalala, and Deputy OMB Director Alice Rivlin were less inhibited. But they were no more successful in persuading Hillary to change what they perceived as flaws in the plan or her methodology.
Magaziner said that such concernsâparticularly the sensitivity to offending conservative Democrats and Republicansâwould be addressed as the legislation moved through Congress. His strategy was to get liberals on board first to ensure their support later in the process. Inevitably, he said, the bill would have to be modified during congressional negotiations but, he hoped, to the least extent possible. Shalala warned that reaching out to one group first, instead of building initial support across the political spectrum, would unite opponents against the administration's plans. Hillary ignored the warning.
Many of Bill Clinton's top aides felt that Hillary was impatient when listening to their criticisms or condescending, as if even Bentsen and Rubin could not be trusted. Magaziner exacerbated problems with his dismissive manner. “The president has already decided that,” he would say, or, “It hasn't been decided yet.” Hillary frequently interrupted the president's advisers. “You're right.” “You're wrong.” “No, that's not right,” she would say. Meanwhile, Magaziner infuriated the president's aides when they learned he was meeting privately with the Clintons in the White House residence and urging them to make important decisions without consulting either the task force or the economic team. Hillary's stature with Bentsen and even her old friend Shalala was deteriorating.