US revision: Obama’s health care reform

In an echo of the MPs’ expenses scandal I have been swamped with requests by students about how reports about Obama’s health care plans can be rolled into US politics exam answers.

In case you have missed the story, a key plank of Obama’s campaign was aplan to reform America’s health care policy in order to try and provide universal coverage and thereby bring the 40m or so Americans not covered at the moment into the system.

This is a pledge that defeated numerous presidents over the last half century and could make or break Obama’s first term. Where does it fit into the syllabus?

The Constitution
The separation of powers can be viewed as an impediment to effective government since public backing and a mandate for reform may not be enough for Obama to get even some of his plan through Congress.

If he fails, however, we could argue that the Constitution works since Congress may refuse to back a bill that did not have a consensus and was unworkable in practice.

Both of these arguments have been applied to Bill Clinton’s failed proposals in 1993-94 and could equally well be applied today.

The President
The President is now de facto chief legislator and Obama is to spend a major amount of political capital on this issue. If he fails he could well face a public backlash and he would possibly have to reframe the parameters of his presidency. In 1994 Clinton faced a so called referendum on big government and the Republicans captured Congress for the first time in over 40 years. Obama will rely heavily on public support and has been appealing over the head of Congress directly to the people since congressmen ultimately like to do what their voters want them to.

Congress
It is often said that it is easier to defeat legislation rather than pass it. The number of different bills, and the number of deals being hatched in the capitol on health care illustrate in technicolor why this is often the case. Congress can be criticised therefore as a do nothin institution.

Pressure groups
A major reason why Hillary care failed in the mid nineties was the power of the medical and health care lobbies. This time round they will also prove instrumental. Is it democratic that these elite groups can derail a plan that the majority of the public are in support of, and which carries a presidential mandate? Obama just this week courted the AMA, the doctors’ lobby group that will have to be brought onside for this plan to succeed.

Hope these points are of some help, both for the US exams and the UK/US synoptics.