President Clinton's And Obama's Health Care Policies
President Obama's Healthcare policies
The Affordable Care Act (ACA) has drawn some comparisons to elements of past efforts, including Mitt Romney's health care plan in Massachusetts and the Clinton plan from the 1990s. This paper will mainly examine the context of the Clinton Plan vs. The ACA. After winning office, President Clinton followed up on a campaign promise to provide health care to the 37 million uninsured Americans. This plan had motivation citing a strong sense of social justice, especially in light of America's tremendous wealth. There was majority public approval for the plan at the time. However, a single payer plan idea faced opposition and Clinton needed to create an alternative (Pfiffner, 1994).
The Clinton government recognized that a major overhaul was not going to find favor, so he sought to implement a plan that would expand coverage rather than dramatically restructure the system. The political environment favored Clinton, in that he had a lot of support, even from some Republicans, for such overhauls. The economic environment was improving as well under his stewardship. The Clinton plan, however, did not pass. Republicans as too large and too complex characterized the reforms. These arguments apparently created enough doubt among enough voters the plan began to lose public support, and there was debate about whether it represented a fundamental change. Details of the plan were problematic -- Clinton had a mandate to fix health care but not for his particular plan. Without any Republican support, and with public support waning, the Clinton plan eventually scrapped (Pfiffner, 1994).
Obama had also campaigned on expanding health care coverage as one of his major reforms. Like Clinton, he sought to seize his election momentum to execute the plan. Unlike Clinton, Obama did it quickly. Clinton's plans were not ready, and as a result, by the time legislation worked on it, public opinion began to turn. For Obama, moving quickly was one of the key success factors. The reforms in the Affordable Care Act are extensive, though not a total overhaul of the system, which still relies on private insurance and private providers. Despite having an overwhelming mandate from the American people and a supermajority in the Senate, Obama still had to work hard to pass the Affordable Care Act. The social environment was healthy for the Act, but the political and economic environment were significant challenges (Mary, 2010).
The political environment was rather toxic. Republican opposition to anything Obama proposed in any aspect of government has been strong, and not based on anything other than hurt feelings. Instead of presenting cogent arguments against the ACA, the political environment turned into a circus sideshow of death panels and other absurdities, in an attempt to sway public opinion. There was a surge of public opposition to the plan, as enough Americans feared that there were going to be government hands on their Medicare.
The economic environment was also a challenge. The economy had tanked, and the U.S. was in a full-blown recession. There was a sense among some politicians and members of the public that this was not a good time to embark on a risky (extensive) program of change in the health care system. The ACA had no impact on the economy, but there was a lot of concern expressed by a number of stakeholders that it could further disrupt the economy. It took considerable legislative effort and horse-trading, and some creative work in the Senate to get the ACA passed, through the reconciliation process that circumvented some of the opposition.
There is doubt about the effectiveness of either policy. Certainly Clinton's work on health care reform was ineffective because he was not able to get anything substantive passed. The implementation of the ACA has taken effect, so only now are we able to see whether it is going to be effective or not. The media are full of stories about some of the implementation efforts, but it is too early for a macro-level view that weighs all of the different tradeoffs that took part.
The main players identified in the health care policymaking process include the official players, unofficial players, and the interest groups. The official player includes the legislature and executive who are involved in the policy creation process. The unofficial include those who are indirectly involved in the policymaking process but are important. They include the public, while the interest groups include the various organizations, for example, the human rights group. The public policy making process involves the branches of the government and the public. The government branches...
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