Ira Magaziner - The Clinton Years

The Clinton Years

Magaziner is best known for leading, along with Hillary Clinton, the failed Task Force to Reform Health Care in the early Clinton administration, which aimed to implement a managed competition regime for the health insurance industry, and to establish community rated insurance pools to cut costs for small businesses and the uninsured. The plan was widely-criticized for being too complex. Pharmaceutical companies and health insurance companies waged a broad-based ad-campaign against the plan, which included the famous "Harry and Louise" ads. Despite the attacks by Republicans and industry associations, Magaziner did little to respond. People within the administration criticized Magaziner's blunt and domineering approach, attacking critics who disagreed instead of trying to build consensus. The Democratic congressional staff began calling him "Hillary's Rasputin".

Brad DeLong, Deputy Treasury Secretary for the Clinton administration at the time, argues that Magaziner's failures stemmed from having a background in management consulting instead of policy: "A management consultant's principal goal is to win a debate in front of his employer ... by making intellectual arguments, controlling the flow of information..., walling-off potential adversaries from the process ... You develop a policy by forming a large coalition ... Then you have a large group of people who are enthusiastic about the proposal: they will go out and make your arguments for you."

Despite its political failings, the substance of the Clinton Health Plan has echoes in current reform plans for the US Health System. For instance, almost all of the 2008 Democratic candidates' plans call for employer mandates, cooperative insurance pools, and managed competition between health plans with a minimum benefits package. Of his Health Plan, President Clinton often says that it was politics that undermined Magaziner's efforts, not policy. It should be noted, however, that these are all Democratic endorsements. Most conservatives still believe less drastic measures are a better approach to increasing coverage while maintaining quality.

Magaziner was court ordered to pay $285,864 to the Association of American Physicians and Surgeons, in 1997 by a federal judge for lying about whether the Task Force to Reform Health Care hired non-governmental employees, and therefore would be required to release documents from their strategic deliberations upon public request. Under a 1972 Federal law required a task force not be private if it includes non-Government people. The fine, however, was later overturned on appeal on August 25, 1999.

Following the controversy, Magaziner stayed in the administration and worked to develop an E-Commerce policy initiative with OSTP staff and industry advisors. That initiative evolved to include a facilitative role in the formation the Internet Corporation for Assigned Names and Numbers (ICANN), to assume Internet administrative activities previously maintained by the US DARPA. Magaziner's White House office also oversaw the development of policies to increase American exports, and drafted legislation for American involvement in international health, including the development of "compulsory licensing" for developing countries facing health crises.