The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

On Drivers Licenses, National Health Care Reform and Clinton Inevitablility

Posted by Alan on December 2, 2007

It would be ironic if whether Senator Hillary Clinton leads the upcoming national health care reform debate is decided on the issue of driver licenses for illegal immigrants, but that may be what’s happening.

Here’s the (il)logic: Senator Hillary Clinton’s campaign is based, in large part, on convincing voters and contributors that her election is inevitable. (This is a page out of Governor George W. Bush’s playback back in 1999 and it worked for him). Yet in a debate last month, Senator Clinton stumbled on a question involving providing driver licenses to those in the country illegally. Her convoluted answer seemed to both support and oppose the measure — maybe.

This stumble, in turn, reminded voters, at least in Iowa, of Senator Clinton’s image as a First Lady who had trouble speaking frankly and forthrightly. Clearly some voters found this troubling. As a result, Senator Barack Obama moved up in Iowa polls. (For a list of poll results in Iowa and elsewhere, check out

Losing ground in polls is not good for an inevitability strategy. Losing the first vote in the nomination process is even worse. Senator Clinton needs to win in Iowa. To regain momentum Senator Clinton’s campaign went on the offensive against Senator Obama and one of the major lines of her attack involves health care reform. (Admit it, you were wondering if I was ever going to get back to the topic of this blog). But the tact she took seems to have been counter-productive. She claims that Senator Obama’s proposal is inadequate because it doesn’t achieve universal coverage in the way she believes it should be achieved — through a mandate that all individuals obtain coverage. (The New York Times‘ coverage of the November 15th debate in Nevada captures the tone of the two Clinton-Obama tussle on health care reform).

Yet Senator Clinton’s attacks seem to have damaged her own campaign more than Senator Obama’s, perhaps by reminding voters of her “my way or the highway” approach to reform in the 1990’s. Bringing to mind her reputation for inflexibility, not to mention her greatest political and policy failure, is not a recipe for electoral success. Senator Clinton now trails Senator Obama in most Iowa polls.

This may not mean much as polls roughly 30 days prior to the Iowa caucuses sometimes fail to indicate much of anything. Four years ago, former Governor Howard Dean and former Representative Richard Gephardt were riding high in those polls; Senators John Kerry and John Edwards were in single digits. Yet it was the two Senators who wound up finishing one-two on election day.

That the Clinton campaign has let a poor answer to a debate question lead them into a fight over health care reform generates a long list of ironies. What’s interesting is that the debate between Senators Clinton and Obama is more about tenor than goals. Senator Clinton focuses on universal coverage through an individual mandate and making coverage affordable through subsidies. Senator Obama focuses on bringing down the cost of health care and health insurance, bolstered by employer mandates. (It’s interesting to note this chicken-and-egg debate over mandates and affordability is similar to what’s happening in California, as described in an earlier post).  

Whether President Hillary Clinton is as inevitable as President George W. Bush was eight years ago is yet to be determined. If it’s not to be, however, one reason will be because of the drivers license answer — and what it drove her to do on health care. And that must be driving her campaign nuts.


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