Health reform, a popular issue that Bill Clinton and the Democrats skillfully featured in the 1992 campaign, became the spearpoint of the most concerted attack on government in recent American history. One year after it had been introduced to acclaim from almost all quarters, Clinton's compromise plan lay in political wreckage.

In this incisive account, a prize-winning Harvard social scientist draws on contemporary documents, media coverage, and confidential White House strategy memos to offer deep insights into the changing terrain of U.S. politics and public policy. President Clinton and his closest advisers thought they had found an ideal "middle way" between excessive government regulation end the play of free market forces in their plan to extend health care coverage to all Americans, not foreseeing that they were creating an ideal target for their political enemies. By 1994 the conservatives needed a cause to attract middle-class voters and unite widespread groups in opposition to the federal government and an already weakened Democratic party. The Health Security bill, as Theda Skocpol discloses, inadvertently became a perfect foil for antigovernment mobilization. Its enemies found it easy to distort while its supporters failed to marshal their forces at a critical time.