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Clinton's 1993 Health Care Speech Had Little Impact

As the country awaits President Barack Obama's speech on health care reform Wednesday night, it might be helpful to take a look at the impact of a similar speech then-President Bill Clinton made about health care reform in September 1993. To what extent did that speech affect -- or not affect -- the debate over health care?

Sixteen years ago, views of the U.S. health care system were very negative -- much as they are now. Nine in ten Americans felt the U.S. health care system needed fundamental changes or to be completely rebuilt. At the time, many thought the system was headed for a financial crisis.

But there was confusion: in September of 1993, most Americans didn't have a clear view of how President Clinton's health care reform plans would affect them. A CBS News/New York Times Poll conducted just before President Clinton's speech found that only 13 percent of Americans had a good understanding of what the Clinton health care plan would mean to them, and 84 percent felt it was too early to tell.

Forty percent felt that the reforms the president was proposing were fair to people like themselves, but almost as many, 36 percent, felt they were not fair. In addition, the public was divided, 41 percent to 41 percent, as to whether the Clinton plan would bring about the changes the health care system needed. And Mr. Clinton's job approval rating was 43 percent, with nearly as many, 42 percent, disapproving.

Late in September, the president gave a speech on health care reform.

A CBS News Poll conducted in early October showed the speech as having a limited impact. The percentage who felt they had a clear understanding of what the Clinton health care reform plan would mean rose just a bit, from 13 percent to 23 percent. And while there was a modest increase in the percentage of Americans who thought Mr. Clinton's reforms were fair to them -- from 40 percent before the speech to 45 percent -- the percentage that thought the plan would make health care better dropped slightly, from 46 percent to 43 percent.

By mid-October, Americans were reacting to the health care plan just as they did before Mr. Clinton's September 22 address to the nation. Much of the improvement in perception that occurred after the speech had disappeared; Americans were evenly divided on whether the plan would be fair to them, and were also divided on Mr. Clinton's handling of health care reform. By mid-October, only 18 percent said they had a good understanding of the plan.


Mr. Clinton's approval rating rose in the initial weeks after the speech, but that didn't last either. In that early October poll, his overall job approval rating rose to 48 percent, but by mid-October, a CBS News Poll found it had fallen back to where it was before the speech – 43 percent. Views of Mr. Clinton's handling of health care experienced a similar short-lived uptick after the speech, with a subsequent return to pre-speech levels.

Back to the health care debate in 2009. Much of the public still views health care as needing fundamental change or to be completely rebuilt, and Americans express concerns about the quality of care and the cost of reform.

(AP Photo/Gerald Herbert)
And as in 1993, Americans in 2009 aren't clear what the reform proposals being discussed would mean for them. A CBS News Poll conducted at the end of August found two thirds of Americans saying they don't understand the proposals being discussed by members of Congress, and by two to one, Americans did not think Mr. Obama had clearly explained his plans for health care reform.

The public's approval of how Mr. Obama is handling health care fell six points between July and August, and now more Americans disapprove (47 percent) than approve (40 percent).

It remain to be seen whether Mr. Obama's experience with health care -- and a speech designed to communicate his plans for reform -- is different, or the same as, Mr. Clinton's.

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Sarah Dutton is the CBS News director of surveys. Poll Positions is weekly Hotsheet feature on polling trends from the CBS News Survey and Polling Unit. Click here for more posts from the series.