Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

Impact of tobacco industry and other corporations in the defeat of the 1994 Clinton health care plan

Author: Michael Givel

Published in: BMC Public Health | Issue 1/2017

Login to get access

Abstract

Background

The primary reason cited by many scholars for the defeat of the Clinton Administration’s 1994 health care reform bill has long been identified as Health Insurance Association of America and National Federation of Independent Businesses opposition to the bill. Given this predominant consensus combined with sizeable proposed funding for the bill by a large tobacco product tax, this manuscript examined what the tobacco industry’s role was in whole or part in defeating the Clinton health care bill.

Methods

This research occurred through crosschecking internal tobacco industry documents and Clinton White House documents.

Results

Prior to the passage of the bill, the tobacco industry accepted a compromise of 45 cents per pack increase phased in over five years. Due to this compromise, the industry or third party allies had no role in the ultimate defeat in the bill.

Conclusions

The primary reason for the bill’s ultimate defeat was general business (but not tobacco industry and third party ally) opposition, the bill running out of time, and conflicting bills. Secondary reasons for the bill’s defeat included issues with: employer mandates, high taxes on insurance plans, impacts on medical research and education, Congressional attention to other issues, election year politics, and possible future excise tax possibilities.
Footnotes
1
In the article: 1. Tesler L, Malone R. “Our Reach is Wide by Any Corproate Standard”: How the Tobacco Industry Helped Defeat the Clinton Health Plan and Why It Matters Now. American Journal of Public Health. 2010;100 (7):1174–88., there is a detailed overview of this manufactured grassroots lobbying effort. This eventually led to the 45 cents increase over five years compromise agreed to by the tobacco industry in August 1994.
 
Literature
1.
Quadagno J. One Nation, uninsured. Oxford: Oxford University Press; 2006 October 9.
2.
Quadagno J. Why the United States has no health insurance: stakeholder mobilization against the Welfare state, 1945-1996. J Health Soc Behav. 2004;45:25–44.PubMed
3.
Starr P. Remedy and reaction: the peculiar American struggle over health care reform. New Haven: Yale University Press; 2013.
4.
Cutler D, Gruber J. Health Policy in the Clinton Era: Once Bitten, Twice Shy. Cambridge, Massachusetts: 2001 September. NBER Working Paper No. 8455.
5.
6.
Henry J. Kaiser Foundation. Focus On Health Reform. Menlo Park, California: 2009 Contract No.: 7871.
7.
Congressional Quarterly. Congress and the Nation: A Review of Government and Politics. 1993–1996.
8.
Barr D, Lee P, Benjamin AE. Health care and health care policy in a changing world. In: Lee P, Estes C, editors. The Nation's health. 7th ed. Dudbury, Massachusetts: Jones and Bartlett; 2003.
9.
Weissert C. Weissert W. Governing Health: Baltimore Johns Hopkins University Press; 2006.
10.
Patel K, Rushefsky M. Health care politics and policy in America. 3rd ed. New York M.E. Sharpe: Armonk; 2006.
11.
Daemmrich A. U.S. Healthcare Reform and the Pharmaceutical Industry. Cambridge, Massachusetts: Harvard Business School, 2011 September 14,. Working Paper 12-015.
12.
Tesler L, Malone R. "Our reach is wide by any corporate standard": how the tobacco industry helped defeat the Clinton health plan and why it matters now. Am J Public Health. 2010;100(7):1174–88.
13.
Domestic Policy Council, Jennings C. HSA Clinton Digital Library. October 1994:1994.
14.
15.
Brown & Williamson. Memo Regarding the Proposed $1.25 a Pack FET Increase. University of California, San Francisco, Legacy Tobacco Documents Library <http://​legacy.​library.​ucsf.​edu/​> Brown & Williamson; Bates No. 202027094/7097; 1994.
16.
Ciresi M, Lee K. Decades of deceit: document discovery in the Minnesota tobacco litigation. William Mitchell Law Review. 1999;25:477–566.
17.
18.
19.
20.
21.
22.
23.
Philip Morris. Newsletter. 1994(Bates No. 2041129162/9165).
24.
25.
26.
27.
28.
29.
30.
31.
Philip Morris. Cigarette Tax Hike Would Hurt Hispanic Businesses, Cost Jobs. University of California, San Francisco, Legacy Tobacco Documents Library <http://​legacy.​library.​ucsf.​edu/​> Philip Morris; Bates No. 2078845727/5729; 1994.
32.
33.
34.
Philip Morris. Kraft General Food; Miller; PM, Philip Morris; WA Report. University of California, San Francisco, Legacy Tobacco Documents Library <http://​legacy.​library.​ucsf.​edu/​> Philip Morris; Bates No. 2041129162/9165; 1994.
35.
36.
37.
R J Reynolds. External Environment, FDA Cigarette Regulation Update as of 8/22/94. R J Reynolds; Bates No.: 519782954/2960; 1994.
38.
R J Reynolds. Federal Excise Tax. R J Reynolds; Bates No.: 512693503/3504; 1994.
39.
40.
41.
42.
Houston T. Tobacco Use: An American Crisis. Washington, D.C.: 1993 January 9–12. Report No.
43.
Philip Morris. Updated Version (5/12/94) of the Speech Delivered 1/25/94 by Ellen Merlo at PM USA Vendor Conf. The Update was Requested by Pam Inman for John Magnum. University of California, San Francisco, Legacy Tobacco Documents Library <http://​legacy.​library.​ucsf.​edu/​> Philip Morris; Bates No 2047945859/5881; 1994.
44.
Johnson H, Broder D. The System: The American Way of Politics at the Breaking Point Back Bay Books; 1997.
45.
Domestic Policy Council, Jennings C. HSA-Section by Section Analysis [1]. Clinton Digital Library.
46.
Domestic Policy Council, Jennings C. Analysis [10]. Clinton Digital Library.
47.
Domestic Policy Council, Jennings C. Analysis [21]. Clinton Digital Library.
48.
Domestic Policy Council, Jennings C. Analysis [13]. Clinton Digital Library.
49.
Domestic Policy Council, Jennings C. Undated HSA Files [3]. Clinton Digital Library.
50.
Domestic Policy Council, Jennings C. Meeting With Senator Ford [Part 3]. Clinton Digital Library; 1993.
51.
Domestic Policy Council, Jennings C. HSA [1]. Clinton Digital Library; 1993.
52.
Domestic Policy Council, Jennings C. December 1993 HSA [2]. Clinton Digital Library; 1993.
53.
Domestic Policy Council, Jennings C. Analysis of the Health Security Act 1993–94 [4]. Clinton Digital Library; 1993–1994.
54.
Domestic Policy Council, Jennings C. Analysis of the Health Security Act 1993–94 [6]. Clinton Digital Library; 1993–1994.
55.
Domestic Policy Council, Jennings C. Analysis of the Health Security Act 1993–94 [12]. Clinton Digital Library; 1993–1994.
56.
Domestic Policy Council, Jennings C. June 1994 HSA [1]. Clinton Digital Library,; 1994.
57.
Domestic Policy Council, Jennings C. HRC Memos - HSA Files [5]. Clinton Digital Library; 1994.
58.
Domestic Policy Council, Jennings C. Analysis [3]. Clinton Digital Library; 1994.
59.
Domestic Policy Council, Jennings C. Analysis [17]. Clinton Digital Library; 1994.
60.
Domestic Policy Council, Jennings C. Health Securities Act, “Analysis [23]. Clinton Digital Library; 1994.
61.
Domestic Policy Council, Jennings C. HRC Memos - HSA Files [7]. Clinton Digital Library; 1994.
62.
Domestic Policy Council, Jennings C. Analysis of the Health Security Act 1993–94 [12]. Clinton Digital Library; 1994.
63.
Domestic Policy Council, Jennings C. Analysis [19]. Clinton Digital Library; 1994.
64.
Domestic Policy Council, Jennings C. Analysis [14]. Clinton Digital Library; 1994.
65.
Domestic Policy Council, Jennings C. Analysis [22]. Clinton Digital Library; 1994.
66.
Domestic Policy Council, Jennings C. August 1994 HSA [1]. Clinton Digital Library; 1994.
67.
Domestic Policy Council, Jennings C. September 1994 HSA [1]. Clinton Digital Library; 1994.
68.
Domestic Policy Council, Jennings C. December 1993 HSA [3]. Clinton Digital Library; 1993.
69.
Domestic Policy Council CJ. HRC Memos - HSA files [8]. Clinton Digital Library; 1994.
70.
Domestic Policy Council CJ. Analysis of the health Security act 1993–94 [11]. Clinton Digital Library; 1994.
71.
Domestic Policy Council CJ. Analysis [6]. Clinton Digital Library; 1994.
72.
Metadata
Title
Impact of tobacco industry and other corporations in the defeat of the 1994 Clinton health care plan
Author
Michael Givel
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4501-7

Other articles of this Issue 1/2017

BMC Public Health 1/2017 Go to the issue

Research article

Estimating the variation in need for community-based social care by body mass index in England and associated cost: population-based cross-sectional study

Research article

Socioeconomic status and dietary patterns in children from around the world: different associations by levels of country human development?

Research article

An evaluation of outdoor school environments to promote physical activity in Delhi, India

Research article

Determinants of tuberculosis transmission and treatment abandonment in Fortaleza, Brazil

Study protocol

Queensland Alcohol-related violence and Night Time Economy Monitoring project (QUANTEM): a study protocol

Study protocol

Measuring the effectiveness of in-hospital and on-base Prevent Alcohol and Risk-related Trauma in Youth (P.A.R.T.Y.) programs on reducing alcohol related harms in naval trainees: P.A.R.T.Y. Defence study protocol