That week I named the deputy secretary of defense, Bill Perry, to succeed Les Aspin, who had resigned as secretary not long after the day of Black Hawk Down. We had conducted an exhaustive search, and all the while the best candidate had been right under our noses. Perry had led several defense-related organizations, been a professor of mathematics and engineering, and done a superb job at the Pentagon, promoting Stealth technology, procurement reform, and realistic budgeting. He was a soft-spoken, modest man whose demeanor disguised a surprising toughness. He would turn out to be one of my best appointments, probably the finest secretary of defense since General George Marshall. On the twenty-fifth, I gave my State of the Union address. It’s the only time in a year when a President gets the chance to speak to the American people, unfiltered, for a whole hour, and I wanted to make the most of it. After a tribute to the late House Speaker Tip O’Neill, who had died the day before Mother, I summarized the long list of congressional achievements in 1993, saying that the economy was producing jobs; that millions of Americans had saved money by refinancing their homes at lower rates; that only 1.2 percent of the American people had had their income taxes increased; that the deficit would be 40 percent lower than previously predicted; and that we would reduce the federal payrolls by more than 250,000 instead of the 100,000 I had previously promised.
The rest of the speech was an outline of my 1994 agenda, beginning with education. I asked Congress to pass my Goals 2000 initiative to help public schools reach the national education goals the governors and the Bush administration had given the country, through reforms like school choice, charter schools, and connecting all our schools to the Internet by 2000; and to measure schools’ progress toward reaching the goals the old-fashioned way, by whether our students were learning what they needed to know.
I also asked for more investments in new job-creating technologies and defense conversion projects; urged passage of the crime bill and a ban on assault weapons; and promoted three environmental laws: a Safe Drinking Water Act, a revitalized Clean Water Act, and a reformed Superfund program. The Superfund was a public/private partnership to clean up polluted sites that had been abandoned and had become ugly, unusable health hazards. It was important to me and to Al Gore, and by the time we left office we had cleaned up three times as many Superfund sites as the Reagan and Bush administrations combined.
I then asked Congress to pass both welfare reform and health-care reform in 1994. One million people were on the welfare rolls because it was the only way they could get health care for their children. When people left welfare for low-wage jobs without benefits, they were in the incredible position of paying taxes to support the Medicaid program, which provided health care for families that had stayed on welfare. At some time during each year, nearly sixty million Americans found themselves without health insurance. More than eighty million Americans had “pre-existing conditions,” health problems that meant they were paying more for insurance, if they could get it, and often couldn’t change jobs without losing it. Three out of four Americans had policies with “lifetime limits” on how much of their healthcare costs would be covered, meaning they could lose their insurance just when they needed it most. The system hurt small businesses, too; their premiums were 35 percent higher than those paid by large businesses and government. To control costs, more and more Americans were being forced into health maintenance organizations, which restricted patients in their choice of a doctor, and doctors in their choice of care, and forced health-care professionals to spend more and more time on paperwork and less on their patients. All these problems were rooted in one fundamental fact: we had a crazy-quilt pattern of coverage in which insurance companies called the shots.
I told the Congress I knew it was hard to change the system. Roosevelt, Truman, Nixon, and Carter had all tried and failed. The effort virtually destroyed Truman’s presidency, driving his approval ratings below 30 percent and helping the Republicans gain control of the Congress. This happened because, for all our problems, most Americans had some kind of coverage, liked their doctors and hospitals, and knew we had a good system of health-care delivery. All those things were still true. Those who profited from the way health care was financed were spending huge sums to convince the Congress and the people that fixing what was wrong with the health-care system would destroy what it did right. I thought my argument was effective except for one thing: at the end of the health-care portion of the speech, I held up a pen and said I would use it to veto any bill that didn’t guarantee health insurance to all Americans. I did it because a couple of my advisors had said that people wouldn’t think I had the strength of my convictions unless I demonstrated that I wouldn’t compromise. It was an unnecessary red flag to my opponents in Congress. Politics is about compromise, and people expect Presidents to win, not posture for them. Health-care reform was the hardest of all hills to climb. I couldn’t do it alone, without compromise. As it turned out, my error didn’t matter, because Bob Dole would decide to kill any health-care reform.