어떻게 정치제도가 개혁을 방해하는가: 1993-94년 미국 클린턴대통령의 건강보험개혁 실패사례

Abstract

In the early 1990s, health care reform in the United States seemed inevitable. There were wide public support and consensus on the reform, the president’s devotion to the reform issue, and Congress dominated by the president’s own party. Political atmosphere was favorable to the reform than ever. However, the health care reform plan initiated and passionately pursued by President Clinton in 1993and 1994 failed miserably. The question is why. This paper attempts to shed light on the question by focusing on institutional constraints in policymaking process. It argues that the fragmentation and the lack of leadership in policymaking process considerably delayed legislation, killed the momentum of reform, and played a decisive role in dooming Clinton’s health care reform in 1994.