History of national healthcare reform
The quest for the universal healthcare in the United States has dominated political debates for the last 100 years (Shi & Singh, 2014). The proponents of a universal healthcare system have made frantic efforts to reform the system. However, each time they have attempted, they have often been met by challenges, which lead to defeat. Unlike other developed countries which have comprehensive health insurance for their citizens, the United States still struggles attain a universal healthcare system. In the initial days, the government made little efforts to subsidize access to healthcare. The federal government left the responsibility of healthcare to the state governments. On their part, the state governments transferred this responsibility to private organization which ran the healthcare sector. For the larger part of the founding years, many Americans were not insured. Wealthy working class relied on private organizations for insurance.
During the progressive era, there was an increased need to improve the social conditions for workers. However, this move received little support from the working class as it was viewed a socialist movement which did not define the American character. In the early 1900s healthcare reforms took place outside President Theodore Roosevelt’s government even though he was a proponent of social reforms (Shi & Singh, 2014). The subsequent leadership were conservative to the idea of healthcare reform. The control of Congress by the Republicans in 1946 further frustrated efforts to have a national health insurance. The Republicans held a conservative view on healthcare and openly defied pro-socialist tendencies. In late 1950s, Medicare and Medicaid programs took effect under the leadership of President Lyndon Johnson, in what brought to an end nearly three decades of Congressional debate on health insurance (De-Navas-Walt, 2010). The programs are still implemented to date. They focus on providing health insurance to vulnerable groups in America, particularly women, children and the disabled.
Political struggle to pass PPACA
As mentioned earlier, there has been a struggle to initiate federal health care reform. In 2010, United States President Barack Obama signed the patient protection and affordable care act (PPACA). Most republicans do not believe that the federal government can manage healthcare insurance, owing to the large percentage of the national economy that is devoted to healthcare. They have regarded the management of Medicare as wasteful and full of fraud and would, therefore, prevent another opportunity by which the government loses money. On the other hand, the democrats argued that the Act would provide insurance to about 32 million (Rosenbaum, 2011) Americans who had no access to insurance cover. They observed that the new law would cover a total of 95% of American citizens and put to an end the healthcare crisis which President Obama had described a threat to the U.S. economy.
Major issues from legislative and presidential perspective
Shortly after the signing of the PPACA, attorney generals of thirteen states went to court to challenge the new law. They argued that the law had contravened the constitution of the United States. During the time of petition, seven other states joined the process, bringing the total number of states to twenty. Seventeen of the twenty states were represented by republican-leaning attorney general, thereby elucidating the politics that had surrounded the development of the bill before it was signed into law (Rosenbaum, 2011). In the petition, the plaintiffs argued that the PPACA contravened Articles I and IV alongside the 10th Amendment. The republican argument has been pegged in the federal government’s failure to ensure efficient running of government programs. From the president’s perspective, PPACA would insure millions of Americans and end the long history of struggle to reform the healthcare system.
Political impact of Medicare and Medicaid on the push for national coverage
Medicaid provides grants to states in America so that they can offer insurance for Americans with low incomes. The program is an initiative if the federal government which is meant to bridge the gaps that have been occasioned by an eroding private insurance programs. Despite its apparent benefit, opponents of this program argue that a program for the poor is susceptible to erosion. They argue that such programs are meant for weak clientele. In this regard, conservative republicans have attempted to reduce the amount allocated for Medicaid which currently stands at $350 billion annually (National Centre for Health Statistics, 2012). The Medicaid program flourished during the reign of former president Bill Clinton. However, the reign of former president George Bush led to radical reforms into the Medicaid and Medicare programs. The election of president Obama in 2008 preceded a new look into these programs.
Politics surrounding the national health insurance agenda; impact on PPACA
The national insurance agenda in the United States has faced challenges for over a century. The failure by the founding governments to initiate a comprehensive insurance program is the major cause of the frustrations that have marred attempts to reform the healthcare system. The Republican Party represents a conservative wing of the political divide. From independence, the conservatives have rejected efforts aimed at establishing social reforms in the country. Since then, they have opposed efforts to provide affordable health insurance to millions of Americans who lack it. Any investments by the federal government towards meeting the needs of the poor have been met with criticism among conservative parties. The democratic view on the subject of national health insurance has always been premised on the need to enhance equality for all American people (Rosenbaum, 2011). Americans are currently anticipating a change in government with elections due in November. The issues under focus include the universal healthcare. Already, some republican candidates running for president have promised to scrap PPACA upon assumption of office. If they are voted in, the hopes of millions of Americans enjoying the provisions of PPACA would be frustrated.
References
DeNavas-Walt, C. (2010). Income, poverty, and health insurance coverage in the United
States (2005). DIANE Publishing.
National Center for Health Statistics (US. (2012). Health, United States, 2011: With special
feature on socioeconomic status and health.
Rosenbaum, S. (2011). The Patient Protection and Affordable Care Act: implications for
public health policy and practice. Public Health Reports, 130-135.
Shi, L., & Singh, D. A. (2014). Delivering health care in America. Jones & Bartlett Learning.
