The moment Bruce Reed knew for sure that the health-care system was out of whack came in December 1991 when three men in dark suits paid him a visit. Reed, a little-known analyst working in a dimly lit Washington campaign office for dark-horse candidate Bill Clinton, listened politely as the three veteran lobbyists from a major pharmaceutical company pleaded with him to delete price controls from the health-care proposal that Clinton was soon to unveil. "If you guys can afford to send three high-priced lobbyists to buttonhole somebody like me," Reed told his visitors, "then you are charging too much for drugs."
Reed, a Princeton grad and Rhodes scholar from Idaho, was struggling to remake the ungainly and politically unworkable idea for health-care reform favored by most Democrats. Called "pay or play," the plan would have required employers to extend basic insurance to all their employees or contribute to a public trust that would provide the entitlement instead. Huddling with a brainy Rhode Island business consultant named Ira Magaziner, Reed spent several weeks souping up "pay or play" into a more ambitious- sounding plan that would use savings from cost controls and more efficient management to insure 37 million uninsured Americans.
In early January, Reed took the finished draft to Manchester, New Hampshire, where Clinton and his wife were campaigning. The three spent a Saturday night in the Clintons' cramped hotel room going over the plan. Dining on takeout Greek food, Clinton sat on a bed poring over Reed's draft while Hillary paced | the room suggesting changes. The session lasted several hours until the three were satisfied. The Clintons went to a late movie; Reed went to look for a printer. Two days later, Clinton released his "National Health Insurance Reform to Cut Costs and Cover Everybody." He claimed he could provide universal coverage without new taxes and without turning the medical industry inside out. It was pie in the sky, but that hardly mattered: Nebraska Senator Bob Kerrey had a plan and had been telling audiences that Clinton did not. The Arkansas Governor declared his plan to be "uniquely American" and promised to enact it in the first year of his administration. The tactic worked: campaign pollster Stan Greenberg noted later that once Clinton put his plan out, the issue went away.