Focus: Washington: US health reform: how to achieve the achievable

BMJ 1994; 309 doi: (Published 02 July 1994) Cite this as: BMJ 1994;309:10
  1. J Roberts

    This summer Americans are witnessing a historic debate in congress that brings out the difficulties of compromise and the reality of principle versus pragmatism. Not since 1964, when black Americans gained true voting rights, has the country witnessed the magnitude of politicking now going on in Washington over health care reform — and specifically over the meaning of universal coverage.

    In 1964 President Johnson had a martyred President Kennedy and his own congressional career as assets. In 1994 President Clinton has a majority in both houses of congress and can already claim more success in pushing forward health care reform than Johnson or any other president. He has so far withstood the massive efforts of various interest groups to stop his reform plan, repeated rebuffs for cooperation by the Republican minority, and discord among his …

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