Betsy McCaughey - Influential Critic of Clinton Healthcare Bill

Influential Critic of Clinton Healthcare Bill

On September 22, 1993, U.S. President Bill Clinton delivered a nationally televised speech about his healthcare reform plan to a joint session of Congress. From September 28–30, 1993, First Lady Hillary Clinton, the architect of the universal health care plan, testified about its details before five U.S. congressional committees. The cost of providing insurance for the estimated 37 million people who were then uninsured was to be covered in part, by new taxes on tobacco. On the last day of Hillary Clinton's testimony, The Wall Street Journal published an op-ed by McCaughey, who wrote that the 239-page draft legislation differed markedly from the White House's public statements and would have "devastating consequences". Citing words and phrases from the draft, she argued that the 77 percent of Americans then covered by insurance would see a downgrade in their policies—most would not be able to keep their own physicians and would be forced into price-controlled Health maintenance organizations (HMOs), which would provide only the most basic of care. According to McCaughey, the HMO plans would not pay for visits to specialists or for second opinions, and most physicians would be driven out of private practice.

In late November, 1993, the Clinton health care plan of 1993 bill was introduced in the U.S. Congress as a 1,342-page document, (in large print and double-spaced), and was also distributed to the press and made available to the public. The Wall Street Journal then published an op-ed by McCaughey in which said she had pored over the entire bill and concluded that it had price controls that would cause rationing, and that in her opinion, the bill was dangerous.

McCaughey expanded her op-eds into a five-page article titled "No Exit", that appeared as the cover story in The New Republic (TNR) and was published a few days before President Clinton's 1994 State of the Union address. An internal memo by tobacco company Philip Morris, dated March 1994, indicated that representatives of Philip Morris had collaborated with McCaughey when she was writing "No Exit", stating: "Worked off-the-record with Manhattan and writer Betsy McCaughey as part of the input to the three-part exposé in The New Republic on what the Clinton plan means to you. The first part detailed specifics of the plan." (When the memo was discussed in a 2009 story in the Rolling Stone, McCaughey declined to comment.)

McCaughey's "No Exit" article was quickly used by conservative officials and commentators seeking to discredit the Clinton plan. Senator Bob Dole, in the Republican Party response to the President's State of the Union, used some of McCaughey's arguments of fewer choices, lower quality and more government control. Bill Kristol's Project for the Republican Future quickly launched television advertisements featuring quotes from McCaughey's two Wall Street Journal op-ed columns and herTNR article. Newsweek columnist George Will used McCaughey's writings as a basis for predicting the Clinton health plan would kill patients and make it illegal for patients to pay doctors directly for care—with 15-year jail terms for patients who tried to do so.

The Clinton White House press office issued a response to McCaughey's "No Exit" article, arguing that it contained "numerous factual inaccuracies and misleading statements." McCaughey responded that her claims were accurate and factual because they came "straight from the text of the bill". Supporters of the Clinton plan questioned McCaughey's claims, including her statements that "the law will prevent you from going outside the system to buy basic health coverage you think is better," and that "doctor can be paid only by the plan, not by you", by pointing to the text of the legislation such as Section 1003 that said: "Nothing in this Act shall be construed as prohibiting ... An individual from purchasing any health care services." — House Bill 3600. February 4, 1994.

According to The Washington Post, the "No Exit" article, the White House response, and the ensuing television and radio interviews with McCaughey made her a star, and, "Her toothy good looks, body-conscious suits, Vassar BA and Columbia PhD reduced right-wingers to mush". The bill stalled and died in Congress in 1994, and the next year Clinton was reduced to asking Congress for a series of small, incremental reforms to the healthcare system. The "No Exit" article won the National Magazine Award for excellence in the public interest. Andrew Sullivan, then the editor of The New Republic later acknowledged he was aware of flaws in McCaughey's article, but said he ran it "as a provocation to debate." In 2006 a new editor recanted the story.