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    Even though the Health Security Act, commonly known as the Clinton plan did not pass, the whole debate that happened during 1993 put managed care on the front page for the first time. This debate set the framework for dialogue that is going on today in Washington.

    The Health Security Act attempted to create a system that would over time change the way most Americans receive health care. In this system, a group alliance of some sort would govern the type of health care people would or would not receive. Health care would be controlled by Primary Care Physician who must be approved by the alliance. This Primary Care Physician would be told what he/she can and cannot do by the alliance and by the new rules and regulations to be created. A lot of power would be given to various governing boards, governmental bureaucrats, Secretary of Health Human Services, and the National Health Board. Potentially, the National Health Board would become like a czar of U.S. healthcare. This plan, which is more than 1,000 pages long, basically defines the new health care system in the broadest of terms. It cannot be determined how the system would really work until future volumes of rules and regulations were created and made public.

    It has been said that this Health Security Act failed because America was not ready to be told which doctors they can and cannot use. Doctors feared they would lose control over the decision making process involved in rendering medical care. It was claimed that quality for health care was missing in that compensation for doctors would be tied to a quota system that rewards doctors for prescribing minimal amounts of treatments and financially penalizes doctors if the amount of treatment provided is above the quota set by bureaucrats. It seemed that the health care system as proposed by Clinton would be governed by boards of people outside of the healthcare and medical industry so that the best remedy to deal with health insurance issues would probably be to contact one’s local congressman to override some bureaucrat’s health care decision. It was said that the bureaucrat’s paperwork would not contain costs but with the added procedures, approvals required under the system, costs could actually increase. Another concern was that this plan would create favored classes of individuals for better coverage as compared to most others.

    The Health Security Act succeeded in getting everybody’s attention including the attention of the employer groups who were not using that much managed care. This plan was a big advertisement to get the employer groups to think about using managed care.

    A study was done to examine the health care policy implications of the 1994 Congressional elections. This study looked at election day surveys to determine (1) what role did the health care issue play in voter’s choice of candidates and (2) what do voters want the new Congress to do about health care policy. It found that the candidates stands on issues were not the most important factors in determining the outcome. The candidate’s experience, character, ethics and political party were most important and that the voters top priorities for the new Congress was health care. The study found that voters wanted candidates who would support modest and incremental reform and be less supportive of major health system reform. The reasoning was because voters did not think the government would do a major health system reform right. The voters did not want a single payer system.