The Mechanism is Broken

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  1. 1. 1 Running Head: The Mechanism Is Broken The Mechanism Is Broken Sarah N. DeCloux Webster University
  2. 2. 2 Running Head: The Mechanism Is Broken Introduction: In February of 2009 President Obama made an impassioned appeal to the U.S. Congress to reform healthcare by the end of the year. Congress responded eagerly to the challenge that lay ahead of them, yet the result of this task was a complete lack of teamwork. The United States institution of government is unable to compromise for the benefit of the American people and does not have hope of working together with other nations in progress toward democracy. The purpose of this paper is to challenge Liberal thinking of democratic politics in the United States by demonstrating the failure of congress, throughout history, to implement collaboration in an attempt to reform the current healthcare system. In essence, the Liberal ideology of institutions to work cooperatively to resolve conflict has no bearings on American politics in healthcare. Using the case of American healthcare reform politics, we can see that Liberalism fails to grasp the concept of conflict resolution by means of bipartisanship and negotiation. In place of this, we see that the result of interaction between Republicans and Democrats produced a stale- mate. The mechanism of democracy has been broken in the United States. The hope of liberalism is that people in institutions are willing work together to achieve synergy and prosperity for all; but in this instance we see the failure of this idea to produce the expected behavior from anarchy to democracy. In fact, we see the reverse. The ideological polarization that shapes this debate is explicitly the opposite from what Liberalism tries to teach us. Current Day Health Care Reform:
  3. 3. 3 Running Head: The Mechanism Is Broken From the first draft of healthcare reform legislation, Washington failed to show that they were capable of bipartisan progress. In mid-July, 2009, the Senates Health, Education, Labor and Pension Committee proposed a bill which took a mere month to mark-up. During the mark- up 788 amendments were suggested for consideration. Of those 788 only 197 passed. 161 amendments were Republican and the other 36 were Democrat. In an article by Christopher Beam he states, That disparity drew jeers that Republicans were trying to slow things down. Another explanation may be that they offered so many so they could later claim that most of their suggestions went unheeded. Indeed, only 29 of the amendments passed were viewed by Republicans to make any difference in the bill; the other 132 amendments passed were grammar related. The result of one of the longest mark-ups in congress was a direct split between the two parties; 13 Democrats and 10 Republicans (Beam, 2009). The Senate Finance Committee was the first to begin congressional research on healthcare, and conducted three roundtables where healthcare reform was discussed by a panel of experts in every related field. This committee, comprised of three Democrats and three Republicans, was led by Senator Max Baucus, a democrat from Montana (Smith, E., 2012). By August the committees work had come to a halt, with both sides firmly opposed to each others ideas. On September 9th President Obama gave speech to Congress criticizing the behavior of both parties and demanded action in order to move forward with a healthcare reform. During President Obamas speech he said, I am not the first president to take up this cause, but I am determined to be the last. (Office of the Press Secretary, 2009) Mr. Obama used phrases, such as Partisan spectacle and Short term political gains, to emphasize his point that the
  4. 4. 4 Running Head: The Mechanism Is Broken uncooperative arrogance between the two parties needed to come to an end. The president also acknowledged the Republican ideas and concerns for reform. Mr. John Iglehart touched on this key aspect in an article from the New England Journal of Medicine. In several instances, Obama sought to demonstrate his interest in bipartisanship or perhaps deflect criticism that he never sought it by embracing ideas favored by Republicans (Iglehart, 2009). President Obama also mentioned Senator John McCains proposal to protect people against bankruptcy if they became ill as well as the Republican stance to reform medical malpractice laws. Although President Obamas aim was to convince republicans and some conservative democrats to join his vision, his fixed approach seemed to divide the parties further still (Iglehart, 2009). In answer to the presidents plea, Senator Baucus promised that a proposal would be furnished by September 21 regardless of the Republicans choice to support it. Republican Senator Charles Grassley, of the Senate Finance Committee, did not seem to be swayed by the president, as he had consistently claimed that he would not support any bill if there were not enough Republicans to mandate a 70-80 vote (Iglehart, 2009). Meaning, he will vote on the Republican side unless there is a seventy to eighty percent majority in agreement. In four town hall meetings held in Iowa, Senator Grassley was grated over healthcare reform. A woman at one of the meetings commented, This is no less than liberty versus tyranny, good versus evil, and there is no middle ground. (CNN Politics, 2009) On October 13, 2009, after seven months of rebuttal, the Americas Healthy Future Act was finally passed by the committee despite both parties best efforts to refuse a bipartisan bill. With the bill passed first by the committee, the task of passing the bill through the Senate became one of the biggest hurdles of healthcare reform. Senate Republicans stood firm that they
  5. 5. 5 Running Head: The Mechanism Is Broken would do anything in their power to keep the bill from being passed in the Senate (i.e. using senate rule they insisted that the entire 383 page bill be read on the floor which bought them about seven hours). As the Republicans kept their filibuster, the Democrats turned to Ben Nelson, a conservative Democrat who was still on the fence. Only after conceding to some of Nelsons demands, did they finally secure his support to vote. "After a nearly century-long struggle, we are on the cusp of making health-care reform a reality," said Obama, who had dispatched senior administration officials to help lock down Nelson's support (Montgomery; Murray, 2009). Ben Nelson became the 60th vote to break the filibuster and pass the healthcare overhaul bill. The final tally was, 60 to 39. No Republican voted in favor (Democracy Now, 2009). The death of Senator Ted Kennedy, in August 2009, left democrats fearful at the prospect that the former majority they had previously enjoyed was at risk. President Obama quickly stepped up to the plate for democrat Martha Coakley speaking on her behalf during the Massachusetts elections to fill Senator Kennedys seat. In a close race, Republican Scott Brown won the election and replaced Massachusetts seat in the senate. This compelled the Democrats to take serious action. Knowing that they would no longer have the higher edge to push the bill passed the senate, they went to desperate lengths to keep the ball rolling (Smith, E., 2009). Although President Obama claims to adhere to a bipartisan policy, his address to Congress, during the Bipartisan Health Care Summit 5, threatened to use reconciliation in order to overthrow them entirely if they did not adhere to the desires of the Democratic party (Smith, E., 2009). Reconciliation, a process only historically used when dealing with issues regarding deficit and budget, was indeed used to defeat the Republican Party and pass the
  6. 6. 6 Running Head: The Mechanism Is Broken healthcare reform bill. In several instances the Republicans of both house and senate voted unanimously to throw out the proposals. At no time did either party attempt to compromise on any big issues. The result of this struggle can only support the fact that the mechanism of democracy within the Liberalist framework is now null and void in America. Historical Health Care Reform: In addition, healthcare reform has been shattered by Congress for nearly a century. It is important to see how rooted the trend of partisan attitudes is in the history of the United States Congress. This delineates how long democracy has been made a mockery of during the processes of legislative endeavors. In 1915 the very first attempt to establish national healthcare in America was proposed. All were in favor until the beginning of World War I when people became fearful of change and claimed that the idea of reform had been inspired by Germany. Health reform was not brought up again until President Harry S. Truman became the first U.S. president to propose legislation for national health insurance in 1945. The American Medical Association disagreed with the nationalized healthcare. It began a campaign to undermine the healthcare legislation by convincing the American people that socialized medicine was the beginning of communism and thus national healthcare reform in American ceased immediately (Oberlander, 2012). The American Medical Association continued their persistence to ban national healthcare for many years. They had gained unusual power through the large network of physicians they supported and had no plans to lose the autonomy they had worked hard to claim. The
  7. 7. 7 Running Head: The Mechanism Is Broken introduction of the Medicare/Medicaid program lessened the influence of the AMA and thus provided an opportunity for the idea healthcare reform to cycle back into thought (Oberlander, 2012). With stigma forgotten, President Richard Nixon proposed a healthcare reform bill to congress in 1971. Republicans contended that the bill was too broad, and Democrats argued that it was not comprehensive enough. Unable to gain momentum, President Nixon requested that the Health Department construct a new proposal that would contain the missing elements and take all points of view into consideration. Shortly after this new proposal was circulated, Senator Kennedy announced his disproval of the bill. In addition, the circumstances of the Watergate Scandal damaged the publics trust in government and yet again healthcare reform was rebuffed (Cengage, 2002). President Jimmy Carter also proposed a plan for cost containment of healthcare in 1977. Senator Ted Kennedy and Representative Henry Waxman offered an alternative plan. The debate between which plan Republicans and Democrats would choose to support; and the collective preference to keep the status quo, meant that both bills were shot down and the legislation to reform healthcare was expelled by partisan ideology (Cengage, 2002). Another attempt at reform was made by President Bill Clinton in 1993. First-lady Hillary Clinton was requested to lead a task force to suggest a plan for American universal health care. The task force independently took on the responsibility and alienated major groups from contributing which ultimately ended in a lawsuit. In 1994, Democrat George J. Mitchell brought forth a plan to reform healthcare which ended in bipartisan failure to agree to pass a bill. The Democrats were scattered and had no way to defend against the empowering Republican
  8. 8. 8 Running Head: The Mechanism Is Broken filibuster. The filibuster abruptly ended the bill and solidly proclaimed the defeat of legislative cooperation on the topic of healthcare (Antos, 2012). Later, Mrs. Clinton told the New York Times, "I learned some valuable lessons about the legislative process, the importance of bipartisan cooperation and the wisdom of taking small steps to get a big job done." (Hernandez, 2001) The discourse on American politics, referring to bipartisan rejection of health care reform, is a common theme among authors. Jonathan Oberlander said it quite well, In the face of escalating costs, uneven quality of care, and the growth of the uninsured population, there is broad agreement that the U.S. health care system requires reform. However, Democrats and Republicans remain sharply divided over how to reform it, (Oberlander, 2008). Even Machiavelli had a few words to contribute, There is nothing more dubious to manage, nor more doubtful of successthan to initiate a new order of things. The reformer has enemies in all those who profit from the old order and only lukewarm defenders in all those who would profit from the new order. (Fuchs, 2009) Reform takes place when two groups are able to set aside their differences for the betterment of all or when one group has more influence than the other and is determined to overthrow the opposition. As we have seen over the course of American history, reform of the healthcare system has been a battle that neither side was willing to concede. Each time there was an opening to produce change; reform was too tough for selfish human behavior or partisan ideology to overcome. Our countrys political system renders Machiavellis Law of Reform particularly relevant in the United States, where many potential choke points offer opportunities to stifle change. (Fuchs, 2009) Once the Democrats embraced the opportunity to monopolize on the circumstances surrounding the reformation of healthcare in 2009, there was little the Republican Party could do to keep from being trampled by their opponent.
  9. 9. 9 Running Head: The Mechanism Is Broken Reform requires that if multiple views are not able to be reconciled to a single idea, then one actor needs to have the ability to conquer the opposition. How does Liberalism play its role in democracy in the world today? When it comes to finding commonalities among people from different States, religions, values, backgrounds, and institutions; how should we interpret their actions? If we think others will easily surrender their claims to their own opinion, we must surely be deceiving ourselves. Democracy and the opportunity for Liberalism to benefit the United States have been hindered by the struggle for power of those in authority. Despite what President Obama and many of his predecessors have said, actions speak louder than words. The actions of the United States government, in their own sovereign state, do not adhere to the ideals of cooperation or working to find middle ground. If partisan politics remain to control the behavior of the American government, it poses high risks for other states who expect to be met with respect and fraternization. Conclusion: In conclusion, the mechanism of Liberalism in American politics is broken. This paper has demonstrated the failure of the United States Congress to treasure common ground repeatedly. Liberalism, which once stood for higher values and respect among congressional colleagues in the United States, is not a characteristic of healthcare reform or progress for American democracy today. Over time disconnect between U.S. politics and Liberalization has proven to become a normalization of modern America. Standards shape the future and commitment to this norm can only mark that more futility within politics will ensue.
  10. 10. 10 Running Head: The Mechanism Is Broken Works Cited Antos, Joseph. "Health Affairs." Lessons From The Clinton Plan: Incremental Market Reform, Not Sweeping Government Control. N.p., n.d. Web. 18 Sept. 2012. . Beam, Christopher. "What Do the GOP Amendments to This Senate Health Care Bill Actually Say?" Slate Magazine. N.p., 16 July 2009. Web. 11 Sept. 2012. . "Headlines December 24, 2009 Full Show | First Story." Democracy Now! N.p., n.d. Web. 15 Sept. 2012. . Fuchs, Victor R., Ph.D. "Health Care Reform - Why So Much Talk and So Little Action?" The New England Journal of Medicine 360.3 (2009): 1-2. Http:// The New England Journal of Medicine, 15 Jan. 2009. Web. 18 Sept. 2012. Hernandez, Raymond. "Health Care Is Mrs. Clinton's First Item on Senate Floor." The New York Times. The New York Times, 14 Feb. 2001. Web. 18 Sept. 2012. .
  11. 11. 11 Running Head: The Mechanism Is Broken Iglehart, John K. "The New England Journal of Medicine." Obama's Vision and the Prospects for Health Care Reform NEJM. N.p., n.d. Web. 18 Sept. 2012. . "National Health Insurance." Encyclopedia of Public Health. Ed. Lester Breslow. Vol. 3. Gale Cengage, 2002. 19 Sep, 2012 Oberlander, Jonathan, Ph.D. "The New England Journal of Medicine." The Partisan Divide. N.p., n.d. Web. 18 Sept. 2012. . Smith, Emily. "Timeline of the Health Care Law -" CNN. Cable News Network, 01 Jan. 1970. Web. 4 Sept. 2012. . "Tough Questions, Frustrations Continue in Town Halls." CNN. N.p., 13 Aug. 2009. Web. 15 Sept. 2012. .