Mandating Social Change: The Business Struggle Over National Health Reform

This article explores the conditions under which business managers endorse human resource investment policy drawing from the recent national health reform episode. In order to generate corporate support, a business community must develop corporate policy capacity, or the ability to grasp complicated social issues and to act in support of this social agenda. Corporate support is also influenced by the business–related strategies of government leaders who can encourage businesses to organize around legislative issues. The bid for national health reform met neither condition. Corporate policy capacity was inadequate to sustaining business support for health reform at the point of translating general corporate anxiety into specific legislation. Because U.S. business groups are weak, fragmented, and compete for members, they tend to cater to strong, vocal minorities and are often unable to act on majority positions. In health reform although a majority of business groups’ members wanted reform, minority objections prevailed. In addition, where the Clinton administration’s business mobilization efforts were complicated by its campaign for mass support, the Republicans organized a formidable corporate lobby against the bill.