This will be a short diary to address the myth that Hillary Clinton flipped from a ferocious advocate of single-payer healthcare to an opponent.

Bill Clinton ran on a platform that included healthcare reform and Hillary Clinton headed the task force that would give birth to the Health Security Act (AKA “Hillarycare”) of 1993. As part of her effort to get this passed, Hillary Clinton was indeed a fierce advocate of universal healthcare and used failures in the existing healthcare system to build sympathy for universal healthcare and villainize opponents.

The Health Security Act was not, however, a single-payer system. It proposed a mandate and government regulation to reduce the costs of pharmaceuticals and ensure universal coverage, but was a system of “managed competition” to promote innovation in the system while protecting the rights of patients. The act failed due to resistance on multiple sides including advocates of single-payer who were dissatisfied with the proposed solution.

In 2006 the Dutch enacted a similar managed-competition plan which has seen great success in achieving universal coverage and high quality of care. The Swiss also adopted a similar system in the mid 1990s. These systems are all private, with a risk-sharing system and government regulation to ensure a certain standard of coverage, care, and to set targets for costs. The Clintons pointed to these systems as evidence that Hillarycare or some variant thereof would have been a good solution to opponents on both sides of the aisle.

So in a strict sense, Hillary Clinton never was a proponent of single-payer. Though she has said many times that she believes that separating employment and insurance is one of the ultimate objectives of healthcare reform and that single-payer would be one solution to this problem, her official stance on healthcare reform has been relatively consistent.