U.S. health policy overview and framework

Health Policy

The health care setting for this paper on health care policy is the insurance industry ("insurers") that provides coverage for Americans who can afford to pay the ever-higher prices charged for policies. During his campaign for the presidency in 2007 and 2008, during the primaries and during the presidential election campaign against Senator John McCain, Barack Obama again and again mentioned the need for health care reform in the United States. He proceeded as an elected president to carry out his promise to institute reform through legislation.

The Affordable Care Act -- the Legislative Process in America

In 2009, the president began putting together a package that would eventually become legislation. He worked with mainly Democratic members of Congress -- albeit he offered to enlist the support of the GOP, but that relationship never jelled -- to hammer out the bill. Then members of Congress began to hold "Town Hall" meetings around the country to explain the proposals to the public. This portion of the legislation process was a disaster for many if not most of the elected officials that tried to conduct civil meetings.

Headlines told the story: "Town hall meeting on health care turns ugly" (CNN); "Audience shouts Down Sebelius, Specter at Health Care Town Hall in Philadelphia" (Fox News); "Town Hall Meeting Shouted Down…" (Yahoo). One after another town hall meeting became boisterous -- some even violent -- and outside some of the venues men with rifles stood menacingly by, as though they expected to find something to shoot at. The New York Times reported that the disturbances (at least some of them) were being orchestrated by the "tea party" and others "who oppose health care reform" (http://Opinionator.blogs.nytimes.com). Memos from "FreedomWorks" and other lobbying organizations tied to the tea party movement urged protestors to "rock-the-boat early in the Rep's presentation; Watch for an opportunity to yell out and challenge the Rep's statements…the goal is to rattle him, get him off his prepared script…" according to the New York Times reporting.

That having been reported, the actual legislative process and its limitations came into full view in Washington for any citizen who cared to observe. First, what did the Affordable Care Act offer to Americans? To wit: a) holding health insurance companies accountable by making it illegal for them to simply drop a child's coverage due to an existing health condition; b) forbid insurers from placing lifetime limits on coverage; c) prohibit insurers from denying coverage of vision care and eyeglasses for children; d) allow young people to stay on their parents' policies until they are 26 years old; among other provisions that are consumer-friendly.

When the legislation came up for a vote it passed the House 220-215. In the Senate, the vote passed easily as the Democrats held a strong majority. In both votes, just one Republican voted for the Affordable Act. The limitations of the American system are many, but money plays a vital role in any legislation. Millions of dollars went into lobbying against the bill (insurers, conservative special interest groups, etc.). Conservative media like Fox News, Rush Limbaugh, and others, authored smears about the legislation; for example, Sarah Palin and others insisted there was a "death panel" measure in the bill that would give doctors the right to say certain aged people need to be put to death, a patently false and absurd notion. The latest round of attacks are being launched by the Republican majority in the House, which voted to repeal the Affordable Care Act in February 2011, 245-189. But the Senate shot down the repeal, 51-47.