US health care reform: The strategy that failed

Bill Clinton's ambition to go down in history as the President who completed the great missing piece of the liberal agenda, a national health insurance programme, has collapsed. Two main policy questions are posed by the failure of legislative reform. Was there a real opportunity this time which was lost by poor strategy and tactics or was the perception of opportunity a mirage? Was a redistributional policy of this complexity bound to be defeated by a combination of the institutional power of vested interests, the political weakness of the presidency and congressional gridlock?