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Bill Clinton's 1993-94 health care reform initiative was one of the most active and sustained presidential campaigns ever undertaken in support of a single social issue, and certainly the boldest attempt to establish national health insurance in the United States. An analysis of the Clinton campaign, therefore, reveals much about the politics of divided government in the late 20th century, the apparent end of the New Deal-Great Society approach to governance and the enduring democratic coalition which supported it, and, of course, the high stakes politics of health care reform. This study attempts to advance our understanding of why national health insurance has proven to be such a potent idea while seemingly impossible to accomplish. The work focuses on the political factors which derailed the Clintons' health care reform initiative, providing a case study of a most significant modern-day political and policy battle.