Politics
AP
According to newly released documents from the Clinton presidency, former top Clinton aide Todd Stern sent a memo to other White House staffers ahead of the 1994 State of the Union. The memo warned of getting caught in a political trap over a promise that people would be able to keep health-insurance plan and doctor under the proposed health-care reform.
Stern perfectly outlined the problem then. It was the same problem that would plague Obama this fall (emphasis added):
"We have a line on p. 10 that. says "You'll pick the health plan and the doctor of your choice." This sounds great and I know that it's just what people want to hear.. But can we get away with it? Isn't the whole thrust of our health plan to steer people toward cheaper, HMO-style providers? It's one thing to say we'll preserve your option to pick the doctor of your choice (recognizing that this will cost more), it's quite another to appear to promise the nation that everyone will get to pick the doctor of his or her choice."
It's simple, and Stern recognized that the promise would be untenable: There were few theoretical ways to reform the U.S. health care system without making anybody change health plans. But that didn't stop Obama from making that promise at least 23 times between 2008 and 2010, when the Affordable Care Act finally became law.