I spoke to people who temporarily lost their coverage because they switched jobs―which was happening to an average of two million workers each month. I met men and women who discovered they couldn’t get insurance if they had “a preexisting condition”

  like cancer or diabetes that was already diagnosed and part of their medical history.

  Some elderly Americans living on fixed incomes told me they were forced to choose between paying the rent or buying prescription drugs. My father’s hospitalization taught me that even with the best care and support, losing someone you love is indescribably painful.

  I couldn’t bear thinking how much harder it would be if the loss were avoidable.

  I also met Americans who made my heart soar with hope. One day when I went to speak to health care reformers on Capitol Hill, I noticed a little boy in the front row sitting in a wheelchair. He had the most beautiful smile on his sweet face, and I couldn’t keep my eyes off him. Just before I spoke, I went over to him. When I bent down to say hello, he threw his arms around my neck. I picked him up and discovered that he wore a full body brace that must have weighed forty pounds. I addressed the audience, holding him in my arms. That was my introduction to Ryan Moore, a seven-year-old from South Sioux City, Nebraska, who had been born with a rare form of dwarfism. His family constantly battled with their insurance company to pay for the multiple surgeries and treatments he needed. Ryan’s condition stunted his body’s growth, but it didn’t interfere with his positive attitude. He so endeared himself to me and my staff that Melanne hung a giant photo of him on the wall in the Hillaryland offices. Stories like Ryan’s kept our eyes on the prize throughout our struggle to bring health care coverage to all Americans, and his courage and hope continue to inspire me today. Ryan is now in high school and dreams of becoming a sportscaster.

  By early September, Bill was also focused on preparations for the upcoming visit of Israeli Prime Minister Yitzhak Rabin and Palestinian leader Yasir Arafat and the signing of a new Middle East peace accord. The historic meeting that took place on the White House South Lawn on September 13, 1993, was the result of months of negotiations in Oslo, Norway, and the agreement was known as the Oslo Accords. It was important to establish our government’s support for the agreement because the United States is the only country that could push both sides to actually implement the agreement’s terms and be trusted by Israel to protect its security. The people of the Middle East and the world would also see Prime Minister Rabin and Chairman Arafat personally commit to what their representatives had negotiated.

  I had first met Yitzhak and Leah Rabin earlier that spring when they paid a courtesy call at the White House. The Prime Minister, a man of medium height, did nothing to demand attention, but his quiet dignity and intensity drew me―and so many others―to him. He created an aura of strength; this was a man who made me feel safe. Leah, a striking, dark-haired woman with piercing blue eyes, exuded energy and intelligence. She was also well read, observant and knowledgeable about the arts. Now, on this second visit with me at the White House, she noticed where I had rehung some paintings from the White House art collection. Leah was outspoken, sharing her opinions about personalities and events with blunt remarks that quickly endeared her to me. Both Rabins were realistic about the challenges that lay ahead for Israel. They believed they had no choice but to try to achieve a secure future for their nation through negotiations with their sworn enemies.

  Their attitude called to mind the old saying “Hope for the best, plan for the worst.”

  That was also Bill’s and my assessment.

  On that auspicious day, Bill persuaded Yitzhak to shake hands with Arafat as a tangible sign of their commitment to the peace plan. Rabin agreed, as long as there would be no kissing, a common Arab custom. Before the ceremony, Bill and Yitzhak engaged in a hilarious rehearsal of the handshake, with Bill pretending to be Arafat as they practiced a complicated maneuver that would prevent the Palestinian leader from drawing too close.

  The handshake and the agreement, which seemed to offer such hope, were seen by some Israelis and Arabs as a rebuke to their political interests and religious beliefs, which later led to violence and Rabin’s tragic assassination. But on that perfect afternoon―

  under bright warm sunlight that seemed to bestow God’s blessing―I hoped only for the best and determined to help in any way I could to support Israel’s courageous decision to take this risk for a lasting and secure peace.

  Even as he worked on these varied and pressing issues, Bill scheduled a televised primetime address to Congress on September 22 to outline the health care plan. Following that, I was slated to testify be fore the five congressional committees that would consider health care legislation, which we hoped would be introduced in early October.

  It was an ambitious September schedule, and we couldn’t afford more roadblocks. Although the bill itself was not finished, Bill, Ira and I wanted to acquaint Democratic members with it before Bill’s big speech so that they would understand the reasoning behind our decisions. But the raw numbers in the bill needed to be calculated and confirmed by budget experts, and that took several weeks longer than anticipated. Instead of circulating an unfinished document, we set up a “reading room” where Democratic staffers could look at the proposal with the understanding that the figures were likely to change.

  The content of the document was leaked to news organizations, and the ensuing stories left many in Congress thinking that this draft was the final bill. Already wary of health care reform, Senator Moynihan decried the whole enterprise, saying it was based on “fantasy”

  numbers.

  Proponents and opponents of reform had begun organizing their own campaigns to influence the outcome. Groups representing consumers, families, workers, the elderly, children’s hospitals and pediatricians were, for the most part, lining up in favor of reform.

  But business groups, particularly small business, pharmaceuticals and the insurance giants had long viewed reform as a threat. Doctors, too, objected to specific elements of the plan.

  It didn’t take long to see how well organized and well financed the opposition was. In early September, the Health Insurance Association of America, a powerful interest group representing the nation’s insurance companies, launched television advertisements designed to discredit reform. The ads featured a couple at a kitchen table, reviewing their medical bills, worrying aloud that the government was going to force them to sign up for a new health care plan they didn’t want. “Things are changing and not all for the better.

  The government may force us to pick from a few health care plans designed by government bureaucrats,” the announcer intoned. It was false and misleading advertising, but it was a clever scare tactic that had the desired effect.

  On September 20, two days before Bill was to unveil his health care plan to Congress and the nation, he asked me to look at the speech draft he had just received from the speechwriting team. Over the years, Bill and I have always relied on each other as sounding boards. We also recruit each other as editors whenever we are working on a big speech or any important writing. It was a Sunday afternoon, and I settled into an oversize chair in one of my favorite rooms on the top floor of the White House―the Solarium―

  where we often retreated to relax, play cards, watch television and feel like a regular family. Quickly thumbing through the pages of the speech, I could see that it wasn’t ready―and Bill was supposed to deliver it in just over forty-eight hours. Panic set in. I picked up the phone and asked the White House operator to call Maggie. Always calm in a storm, she glanced at the speech and quickly called a meeting of top health care advisers and speechwriters for that evening. Over bowls of nachos and guacamole, Bill and I and about a dozen staffers sat in the Solarium and tossed around themes for the speech. I suggested that health care reform was pan of the American journey, an apt metaphor because in Bill’s view, this was our generation’s chance to answer a call on behalf of future generations. We settled on the journey theme, and with a combined sense of urgency and relief, we handed a rough draft back to the speechwriters. With constant editing and rewriting from Bill, they wrestled the text into shape for Tuesday night’s appearance.

  Presidents deliver special addresses to Congress from a podium in the ornate chamber of the House of Representatives. It’s a ritual-filled evening. As the President enters the hall, the sergeant-at-arms announces in a somber tone: “The President of the United States.” The audience rises, and the President greets members of both parties who, by tradition, sit on opposite sides of the aisle. He then climbs to the lectern and faces the audience.

  The Vice President and the Speaker of the House sit directly behind him.

  The First Lady, along with White House guests and other dignitaries, sits in a special area of the balcony, and it was a favorite Washington parlor game to guess who would be seated with her. On my right that evening was one of the nation’s leading pediatricians and one of my favorite people, Dr. T Berry Brazelton, with whom I had worked on behalf of children’s issues for about ten years. More surprising was the guest on my left, Dr. C.

  Everett Koop. Dr. Koop, a pediatric surgeon by training, had been President Reagan’s Surgeon General, in charge of overseeing the nation’s Public Health Service. Bearded and bespectacled, he was a Republican and an adamant foe of abortion who had endured a vitriolic confirmation battle. Bill and I had come to admire Dr. Koop for the courageous stands he took as Surgeon General, warning Americans about the dangers of tobacco use and the spread of AIDS and crusading for immunizations, condom use, environmental health and better nutrition. Having witnessed the failings of the system as both a clinician and a policy maker, Koop had become a vocal advocate for health care reform and was an invaluable adviser and ally.

  After motioning the audience to sit down, Bill began the speech. To his immense credit, not even I realized that something was wrong. We learned later that an aide had placed the wrong speech in the TelePrompTer―the economic address Bill had given months before. Bill is legendary for extemporizing and ad-libbing, but this speech was too long and too important to do entirely off-the-cuff. For a nerveracking seven minutes, as his staffers rushed to correct the mistake, he delivered his remarks from memory.

  It was a great speech, with just the right mix of passion, wisdom and substance. I was so proud of him that night. It was a courageous path for a new President. Franklin D.

  Roosevelt had boldly found a way to give older Americans economic security through the Social Security program; Bill wanted, through health care reform, to vastly improve the quality of life for tens of millions of Americans. He held up a red, white and blue “health security card” that he hoped would be issued to every American, vowing to deliver a plan that would guarantee every citizen health insurance coverage and access to affordable, quality medical care.

  “Tonight we come together to write a new chapter in the American story,” Bill told the nation. “… At long last, after decades of false starts, we must make this our most urgent priority: giving every American health security, health care that can never be taken away, health care that is always there.”

  When he finished the fifty-two-minute speech, the audience gave him a standing ovation.

  Although a few Republican lawmakers immediately took issue with some details of the plan, many in both parties said they admired Bill’s willingness to tackle an issue that had vexed so many of his predecessors. As one journalist put it, the reform effort was like “scaling the Mount Everest of social policy.” We had started the trek. I felt excited yet apprehensive, well aware that a rousing speech was one thing while designing and passing legislation was another. But I was grateful for Bill’s commitment and eloquence, and I believed we would reach a compromise because our nation’s long-term economic and social wellbeing depended on it.

  After the speech we loaded up the motorcade and headed back to the White House.

  We had planned a post-speech party on the State Floor, but we decided to go first to the Old Executive Office Building, where the health care staff worked in crowded, makeshift cubicles in room 160. Bill and I thanked them for spending days and nights working for reform. I stood on a chair and declared to laughter and applause that with the impending birth of the health care bill, the room would now be renamed “the Delivery Room.”

  We had every reason to be optimistic about the reform plan as reviews of Bill’s speech and the outlines of the plan were generally positive. The public overwhelmingly supported action on health care reform. News reports praised the plan and our efforts at reaching bipartisan consensus with headlines that read, HEALTH CARE REFORM; WHAT WENT RIGHT?

  Although the bill wouldn’t be “delivered” for another month, I was eager to proceed with my testimony before the committees reviewing reform. Six days after Bill’s speech, on September 28, I had my opportunity. My appearance before the House Ways and Means Committee marked the first time a First Lady was the lead witness on a major administration legislative initiative. Other First Ladies had also testified before Congress, including Eleanor Roosevelt and Rosalynn Carter, who appeared before a Senate subcommittee in 1979 to argue for increased funding of programs that aid mental health patients and support treatment facilities.

  The hearing room was packed when I arrived, and I was unusually nervous. Every seat was taken, and there wasn’t an inch of empty space left along the side and back walls. Several dozen photographers were sitting or lying on the floor in front of the witness table, clicking furiously as I took my seat. All of the networks had sent camera crews to record the event.

  I had worked hard preparing my testimony. In one of our prep sessions, Mandy Grunwald, the savvy media consultant who had worked with James Carville on our 1992 campaign and continued working for the Democratic National Committee, asked me what I really wanted to convey.

  I knew I couldn’t afford to make any factual mistakes, but I also didn’t want the human stories of anxiety and suffering to get lost in the arcana of public policy. I wanted my words to convey the real-life dimension of the health care problem. I decided to start with the personal: why I cared so deeply about improving health care. At 10 A.M., Chairman Dan Rostenkowski, that gruff and gritty old-school pol from Chicago, gaveled the House Ways and Means Committee to order and introduced me.

  “During the past months, as I have worked to educate myself about the problems facing our nation and facing American citizens about health care, I have learned a great deal,” I said. “The official reason I am here today is because I have had that responsibility. But more importantly for me, I’m here as a mother, a wife, a daughter, a sister, a woman. I’m here as an American citizen concerned about the health of her family and the health of her nation.”

  For the next two hours I answered questions from committee members. Later that day I testified before the House Energy and Commerce Committee, chaired by one of the longest-serving House members and a longtime champion of health care reform, Democratic Congressman John Dingell of Michigan. Over the next two days, I appeared before one other House committee and two Senate committees. The experience was fascinating, challenging and exhausting. I was happy to have had the chance to speak publicly about our plan and pleased that the reviews were generally positive. Members of Congress applauded the testimony and, according to news reports, were impressed that I knew the intricacies of the health care system. This gave me hope. Maybe my testimony had helped people understand why reform was so vital to American citizens and their families, as well as to the nation’s economy. I was also just plain relieved that I had gotten it behind me and hadn’t embarrassed myself or my husband, who was on the line for choosing me to represent him on such a big undertaking.

  While many members genuinely appreciated the finer points of the health care debate, I realized that some of the laudatory responses to my testimony were just the latest example of “the talking dog syndrome,” which I had learned about as First Lady of Arkansas.

  There’s a similar thought attributed to Dr. Samuel Johnson by Boswell: “Sir, a woman preaching is like a dog’s walking on its hind legs. It is not done well; but you are surprised to find it done at all.”

  Much of the praise centered on the fact that I hadn’t used notes or consulted my aides and that I generally knew my stuff. In short, even many complimentary committee members who appreciated my appearing were not necessarily sold on the substance of the plan.

  I also learned that my popularity beyond the Beltway, my positive reception on the Hill and the apparent willingness of Congress to consider health care reform set off alarms among Republicans. If Bill Clinton passed a bill that provided every American with health insurance, he would be a shoo-in for a second term as President. That was an outcome Republican Party planners were determined to prevent. Our own political experts sensed a scorched-earth strategy emerging on the Right. Steve Ricchetti, the chief White House liaison with the Senate, was concerned. “They are going to come after you,”

  he told me one afternoon in my office. “You’re too strong in this process. They have to take a pound of flesh out of you, one way or another.”

  I assured Steve that I had taken heat before, and at least I’d be taking it now for something I believed in.

  After my testimony, it was time for what the White House called the health care “rollout”―

  a series of speeches and events in which the President generates attention and support for the policy. Bill was scheduled to do the rollout for much of the first half of October, starting with a trip to California on October 3, where he would hold town meetings to discuss reform and win as many converts as possible. But any presidential agenda is subject to outside events. Bill was en route to California on October 3 when his aides received an urgent call from the White House Situation Room. Two Black Hawk helicopters had been shot down in Somalia. Details were vague, but it was clear that American soldiers had been killed and that there might be ongoing violence. Troops had originally been sent to the famine-ravaged country by President Bush on a humanitarian aid mission, but it had evolved into a more aggressive peacekeeping effort.