THE US PRESIDENCY

The US Presidency

The U.S. Presidency

Introduction

Healthcare reform has been a contentious political issue since the 1940s. Whereas most industrialized countries have single-payer systems, where the government administers and finances healthcare, the U.S. system has been built on employer-paid healthcare insurance sold by private companies. Under single-payer plans, such as used in Canada, everyone is provided benefits and no one has to pay deductibles or co-payments. Single-payer plans reduce overhead expenses because the government pays the medical costs directly to the provider, eliminating the middle-person, which in the United States are Health Insurance companies. (Kernell 2006, 12-20)

Efforts to establish a single-payer system in the United States have been unsuccessful, as opponents warn of socialized medicine and the loss of free choice. Meanwhile, healthcare costs rise every year, putting financial strains on employers and their employees. More than 47 million people in the United States did not have health insurance in 2009. By the 2008 presidential election, healthcare reform was a hot political topic. The election of Barack Obama as president meant that healthcare legislation would be on the congressional agenda in 2009. As the year unfolded, five committees in the House and Senate worked on reform plans. By the end of 2009, it appeared likely that a major reform will would be passed in early 2010.

This paper discusses the public policy of healthcare namely the “Patient Protection and Affordability Act”. This policy was chosen because the president has attempted to lead some degree of change in this.

Discussion

President Obama put healthcare at the top of his agenda when he entered the White House. Though he sought a plan with universal coverage, cost controls, and tougher regulations of health insurance practices, he did not propose a specific plan but left it to Congress to determine the details. Seeking to avoid the Clinton debacle, Obama gambled that Congress could write a comprehensive plan with bipartisan support. As the year progressed and competing ideas surfaced, it became clear that virtually all Republicans would oppose legislation written by the Democratic majorities in the House and Senate. However, moderate and conservative Democrats also raised concerns about the scope and cost of the proposals that were in five committees. (Boyle 2003, 89)

By March 2009 the committee chairs had reached consensus on what the legislation should contain. Like Massachusetts, the plan would require universal coverage and carry penalties for those who do not comply. ...