the mechanism is broken

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1 Running Head: The Mechanism Is Broken The Mechanism Is Broken Sarah N. DeCloux Webster University

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Page 1: The Mechanism is Broken

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Running Head: The Mechanism Is Broken

The Mechanism Is Broken

Sarah N. DeCloux

Webster University

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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:

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From the first draft of healthcare reform legislation, Washington failed to show that they

were capable of bipartisan progress. In mid-July, 2009, the Senate’s 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 committee’s work had come to a halt, with both sides firmly opposed to each other’s

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 Obama’s 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

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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 McCain’s proposal to protect people against bankruptcy if they

became ill as well as the Republican stance to reform medical malpractice laws. Although

President Obama’s 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 president’s plea, Senator Baucus promised that a proposal would be

furnished by September 21 regardless of the Republican’s 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 America’s 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

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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

Nelson’s 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 Kennedy’s 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

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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

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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 public’s 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

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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 success…than 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 country’s political system renders Machiavelli’s 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.

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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.

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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.

<http://content.healthaffairs.org/content/27/3/705.full>.

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.

<http://www.slate.com/articles/news_and_politics/prescriptions/2009/07/this_is_what_bi

partisanship_looks_like.html>.

DemocracyNow.org. "Headlines December 24, 2009 Full Show | First Story." Democracy Now!

N.p., n.d. Web. 15 Sept. 2012.

<http://www.democracynow.org/2009/12/24/headlines/senate_passes_hea lthcare_overha

ul_bill>.

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://www.nejm.org/doi/full/10.1056/NEJMp0809733. 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.

<http://www.nytimes.com/2001/02/14/nyregion/health-care- is-mrs-clinton-s-first- item-

on-senate-floor.html>.

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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.

<http://www.nejm.org/doi/full/10.1056/NEJMp0908476>.

"National Health Insurance." Encyclopedia of Public Health. Ed. Lester Breslow. Vol. 3. Gale

Cengage, 2002. eNotes.com. 19 Sep, 2012 <http://www.enotes.com/national-health-

insurance-reference/>

Oberlander, Jonathan, Ph.D. "The New England Journal of Medicine." The Partisan Divide.

N.p., n.d. Web. 18 Sept. 2012. <http://www.nejm.org/doi/full/10.1056/NEJMp0804659>.

Smith, Emily. "Timeline of the Health Care Law - CNN.com." CNN. Cable News Network, 01

Jan. 1970. Web. 4 Sept. 2012. <http://www.cnn.com/2012/06/28/politics/supreme-court-

health-timeline/index.html?iphoneemail>.

"Tough Questions, Frustrations Continue in Town Halls." CNN. N.p., 13 Aug. 2009. Web. 15

Sept. 2012. <http://articles.cnn.com/2009-08-13/politics/town.hall.wrap_1_health-care-

health-insurance-system-reform-plans?_s=PM:POLITICS>.