Obama’s Health Care Bill: Reform in America’s Health Care
President Barrack Obama, after the historic occasion and fete of being sworn in as America’s 45th President and 1st Black-American President, embarked on a number of key missions in his first term of office. Among them included the difficult work of cleaning up the post-global financial crisis and its aftermath. Critical to the above was the need to reform, and thereafter boost America’s social welfare system. Health care, in terms of either Medicare or Medicaid, required thorough reform measures, some of which proved to be too sensitive as shall be discussed below. This paper will discuss Obama care outlining the Democrat and Republican arguments about the healthcare reform bill including the support, opposition and controversies of the bill brought forward.
The Obama administration’s reactions to the global economic melt-down entailed difficult yet decisive measures resulting in varied reactions from all sections of America’s society. From governing Democrats to the opposing Republican arena, Independents, environmentalists, social groups, organizations and others movements, the task indeed was a tough one. Market-forces, initially blamable for the economic crisis, were also responsible for the amalgamation of many facilities, health centers and agencies, for better business management and returns (Zwillich, 2008).
The above was critical to America’s health care and had been transformed into profit-making business entities that could no longer serve the ordinary American citizens, especially those without insurance/ social covers. This led to a scenario where many un-insured citizens were denied basic healthcare. It also caused an increase in government social spending. On the other hand, money was scarce and in order to avoid the ‘fiscal cliff’, measures had to be taken. Spending cuts, in addition to necessary higher taxes, were envisaged as among the prerequisite avenues for America’s recovery.
Thus, the above issues called a reduction of reimbursement rates to both Medicaid and Medicare, as part of overall reform in the federal health care system. After a great debate, critique and opposition in March 2010, Congress was finally able to pass the Patient Protection and Affordable Care Act into law signed by President Obama (Friedman, 2012). Its passage was seen as a most significant step in the overall reform of America’s health care system. It was likened to other fundamental bills such as ‘the Civil Rights Bill’, the Social Security Act (1935) and the creation of Medicaid and Medicare (1965) (Zwillich, 2008).
Unfortunately, controversy still dogs the bill with variants of perspectives from amongst politicians, policy analysts, health care economists and political pundits. This is damaging since the parties with the most stakes in the overall health care system including doctors, nurses, pharmacists, medical researchers, patients were not considered, and their perspectives and ideals not resolved. With better understanding, informed decisions are best made without the influence of either political pundits or the profit-seeking health care industry (Ornstein, 2011).
Health care legislation has had both its share of weaknesses and strengths as perceived from different stakeholders, such as doctors, patients, and health centre/ facility administrators. It should be indicated that health care reform, not only entailed a single measure, but also a variant of succeeding measures. These were exemplified in Medicare and Medicaid, the private insurance industry, Quality of care, the tackling of impending healthcare workforce shortage and the organization of disease prevention and wellness programs. Others included the care for those underserved (health care’s safety net), the elimination of fraud, high administrative fees and waste from overutilization, Tort reform, medical practice and on comparative- effectiveness of research, as necessary treatment comparison ventures (Feldman, 2012).
There have been calls for people to ‘cut-out’ the political rhetoric and instead address the fundamental issue; that is, how best to preserve America’s ability at providing the best possible health care for its patients, and thus fulfil its societal mission and duty of care provision for its citizenry, independent of their own financial abilities. There is need to focus on existent strengths or weakness, instead of focusing on whether an action is wrong or right, if America’s future is to become brighter and better (Feldman, 2011).
The aforementioned Patient Protection and Affordable Care Act (2010) landmark legislation in America’s social reforms extends to most American citizens, the benefit of health insurance, as a fulfillment of ‘a century-long journey’ towards bringing the U.S cover at parity with other industrialized states. Through the Act, control of the rapidly rising costs (in health care), and by extension, the present disparities between the majority citizens and the few elite, are tackled. It aims at enabling millions of citizen’s access both protection and benefits from the myriad of abuse cases by insurance companies (Laszewski, March 7, 2008).
Prior to its legislation, political battles between 2009 and 2010 raged between the Democratic administration and their Republican rivals among other interest groups (Ornstein, 2011). White House employed a number of strategies, some tough while others were more compromising, such as their deals with concerned interest groups. Agitation was greatest from both progressives and Tea Party members in addition to the firm, if not hostile stand of the Republican Party. In the end, an amicable solution was reached, which in the future either could prove to be highly successful and therefore very beneficial to Americans in general, or un-executable and therefore weakened.
The above is a positive closure to efforts that began as early as 1993 (January), when President Bill Clinton (a Democrat) named his wife first Lady Hillary Clinton a chairperson to head a 500 person task force tasked with the mandate of developing inclusive health reform policies/ legislation. This unfortunately ended in utter failure when both Congress and Senate could not agree on any policy issues. This was partly blamable for Democrats loss of control in both the above legislative arenas, during the mid-term elections of November 1994 (Tanner & Chris Edwards, June 2009).
Nichols, the conference organizer, rightly observed that the single utmost weakness is the belief that the plan could not be successful. This was stated during the Minnesota conference that was called to chart the best way forward pertaining to Obama’s Health Care plan. Also present was Congressman Jim Cooper (D-TN), the sole elected official present, and the then top House Democrat, whose opposition to the Clinton plan had led to its defeat. He brought in his experience over the issue and his consideration of the best way forward in resolving it. He pointed to the events that had happened in the past fifteen years. He said, “Congress has dumbed down so much so that I have to explain to members the difference between Medicare and Medicaid. I want change to happen. Quick or not, I want it to be inevitable. The last time got a whole lot of nothing. The Wyden-Bennett bill has the best chance right now. It’s controversial stuff, but if there is a bipartisan center, it’s this bill” (McDonough, 2011, p 3).
After the unsuccessful conference, Republicans of their side bitterly complained that the Democrats did not consult with them even on the moderates. They expressed their frustration stating that if they had consulted, the issue could have been resolved (Feldman, 2011). Democrats on their part were equally critical with such statements as, “These Republicans never wanted deal. Every time we approached them on their terms, they changed the terms of the deal” (Feldman, 2011, p 1). Of the eight Presidents (from both Parties) who undertook serious steps at achieving some percentage of comprehensive reform in National Health care, Obama was finally successful.
Democrat Senator Edward M. Kennedy made the initial calls for ‘universal health insurance’ during the Boston City Hospital speech. He was/is perceived as the leading proponent of these reforms often moving from right to the centre and to the left (as far as possible). It is at the centre, where real change was initiated and the overall improvement of the safety of millions of Americans took shape. His contributions are everlasting and Americans are forever grateful to him, his strength and commitment to the cause being best espoused in his statement declaring that the time for success had come (McDonough, 2010).
The long road can be best espoused by President Obama’s parting shot after 6 hours of heated, tempered and humorous televised talk, with various lawmakers. He stated that the US could not afford another yearlong debate about the healthcare debate (McDonough, 2010). He further commented that if Republicans were not going to respond to his calls and join in the effort, the government would forge ahead and make the crucial decisions and the elections would decide further steps into that. The President stated that honest disagreements about the vision for the country are there but the country has to forge ahead and test the move over the coming months (Laszewski, March 7, 2008). Unfortunately, the Republican side was unrelenting.
Senator Mitch McConnell emphasized this by stating that the country must begin from a rather unclear point moving forward (Laszewski, March 7, 2008). The Republicans held the view that Obama’s plan was encroaching on Federal territorial powers, and thus such an action was irredeemable through negotiations. They have been proved best, when they upset the votes in a special Senate election in the city of Massachusetts. This resulted in a 60+ vote extra delaying ability on the part of Republican Senate strategy that further proved to be another obstacle.
This result, together with a variant of poll opinions, acted as a statement from the people that they, the Democratic administration, should instead put focus on job and employment creation instead. This situation favorably changed later at the bipartisan summit. Here, the longest-serving House Representative Democrat John Dingell famed for introducing a bill on ‘Universal Health Care’ since 1957. He remarked, “We have before us a hideous challenge… The last perfect legislation that was presented to humankind was delivered to the Israelis at the base of Mount Sinai. It was on stone tablets written in the fingers of God… What we are going to do is not perfect. But it sure will make it better and it’s going to ease a huge amount of pain” (Woodward, 2010, p 261).
In the industry, several tactics are used vigorously for political gain. Therein lies surprise twists, setbacks and withdrawal measures, all aimed at stalling, mitigating or even upsetting a vote on crucial bills/ policies. Thus, the health care Bill remains one of the most heated and critically evaluated path loved and hated in almost equal measures. The 111th Congress was feted with the tremendous accomplishment of 2010; the substantial costs, such as inter- or intra- party battles notwithstanding.
Daschle (2010), a long-term former Senate Majority leader, set golden standards pertaining to the best path to follow on matters of health policy issues, after he experienced the long and painful path of health care reform. At the worst of moments, Americans had difficulty in understanding the Democrats prioritization on the bill because their focus was on jobs and more jobs. Through it all, he was optimistic because of the presence of other like-minded people who put the public’s good over theirs.
To say the least, he said, “Over the years, I have confidently used the word transformational to describe the historic and extraordinary consequential passage of comprehensive health reform. It will rank among the most important accomplishments in social policy in the U.S., and will have meaningful ramifications for every citizen in our country, perhaps in all perpetuity” (Holahan & Blumberg, 2008, p 6).
In conclusion, the road to ‘Universal Health Care’ has not been easy. To some, priorities have been focused on job creation, reduction of costs and more monies to the industry players, as effective measures to further economic collapse. Obama’s administration, through its utter zeal and will, has been finally able to present to America, Health Care Reform. There is a lot to be done, many more obstacles to be faced, but the Democrats, and Americans in general, are glad in their attainment of first score in a battle to ensure Universal Health Care for all Americans.
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