trumps health policy hurdles

Healthcare has been a contested issue that has dominated both Democratic and Republican election campaigns and policy-making goals. The American healthcare system is far more costly than that of other developing countries such as Germany and Canada. The two political parties have repeatedly refused to find a compromise on an optimal healthcare program that would make healthcare affordable to the majority of Americans while holding prices to a minimum. The aim of this paper is to analyze the conditions that have stopped the Trump Administration from dismantling the Affordable Care Act. In this paper, the argument pursued suggests that it is the political forces rather than economic forces that have hindered the Trump Administration from implementing their healthcare reform bill. In presenting the argument, the paper will provide a brief background on the issue, provide scholarly evidence that support as well as oppose the paper thesis and eventually provide a sound opinion on the controversy.

Background

There have been numerous reform attempts on the healthcare of the United States that have been unsuccessful including one during Bill Clinton’s presidency. It was President Obama that managed to enact healthcare reforms through the Affordable Care Act commonly referred to as Obamacare. The bill lacked a single Republican vote in its passing since the Democrats had a majority in the House. It was from that moment that Republicans vowed to reform the Act to their desired standards.

The reforms surrounding the healthcare bill mostly relate to the level of control provided to the government and the level of control left to the private sector. The Democrats mostly argue for increased government involvement in the healthcare system while the Republicans tend to advocate for little government involvement and that the sector surrendered to the market forces in the private sector. Despite the different arguments, they both desire for an affordable and innovative healthcare system.

It has been established that the US healthcare system is more expensive than that of Canada, Germany, and the UK. In these countries, the government controls the health sector, and in some countries like the UK, the health services are free. Experts have however argued that such a system is not suitable for the American healthcare. It has therefore been left to the American politicians to devise an optimal healthcare system that is suitable for its citizens while retaining affordability. It has appeared that due to increased politicking in the reform process, the country is yet to reach an agreed healthcare Act. The Democrats enacted the ACA with no support from the Republicans. The Republicans, on the other hand, have spent the last seven years trying to repeal the ACA. In the 2016 election, the country elected a Republican president, and the Republicans had a majority in Congress and the Senate. It is the confidence in numbers that prompted President Trump to sign the Executive Order 13765 that anticipate the repeal of the ACA. Despite having the majority numbers, The Healthcare reforms have stagnated due to excessive politics rather than considering the economic and social impacts of the reforms. If a focus were on the social and economic aspects of the reforms, the Democrats and Republicans would have already developed a suitable Healthcare Reform for the nation.

Political Pressure

The political pressure in reforming the act has hindered the Trump administration from succeeding in the intended reform. In 2010, President Obama ensured that the ACA was in his early presidency days. The act was passed since the Democrats boasted a majority in the political arms. The rush, however, failed to incorporate the concerns of their democratic counterparts. The political rush in fulfilling campaign promises resulted in an implementation of an act that was opposed by the other half of the political divide. That has become the case for Trump. He is trying to rush a bill that is half-baked that despite having a majority in house and congress has failed to pass. The administration is trying excessively to deliver its campaign promises instead of considering the fine print of the potential social and economic impact. At one time the tried to pass the Bill without having presented to their fellow Republicans. It is quite clear that the Republicans desire to change the ACA, but they have yet to developed and appropriate replacement act that appeals to their party members. If the Trump administration were to ignore the political pressure and focus on developing the bill, they are guaranteed to pass the bill since they have the numbers. Thus, the political rush to reform the ACA has hindered the process despite the numbers enjoyed by the Republicans.

Political Career Protection

In the attempts of a repeal of the Act, the administration has failed to consider the impact of the bill on political careers. One of the key controversies in the ACA is the expenditure on Medicaid. The Government spending on Medicaid is considerably high and is anticipated to increase. The extra spending by the government ensures that those that cannot afford insurance are covered. The Republicans on the other hand desire that the government expenditure on Medicaid is greatly reduced. In their July attempt to repeal the Act, the cut in Medicaid anticipated being cut by a third of the current Medicaid expenditure. The political opposition emanated from Republican senators in Nevada, West Virginia, and Ohio. For them, the cut in expenditure would affect their political power in their states. By aggressively reducing the expenditure on Medicaid, the government will deny more Americans access to medical care. The Republicans that opposed the bill feared that their constituents would lose access to care and thus have an impact on their political careers. Those Republicans that were assured of the support of their constituents were in full support of the Bill. It is clear that the politicians did not regard the financial impact of the bill but rather their ability to be re-elected. The Bill will, therefore, be suitable when the support of the Republican politicians from their constituents is guaranteed. It is clear that the actual economic impact of the repeal is only considered if it affects the political career of those in support of the bill. Ultimately, it is the politics that determines the support and not the economic integrity of the bill.

Lack of a Superior Bill

Another reason the Trump administration is failing in repealing the Act is the lack of a clear alternative. The Obamacare was a bill that had been involved in extensive research before its implementation. Furthermore, the Act the preceded the Act was rather unpopular. The preceding Act allowed insurance companies to deny coverage to individuals that had pre-existing conditions and also allowed the insurance companies to increase premiums if one developed a chronic disease. The costs of premium payments were also rising and thus making healthcare unaffordable to many Americans. In that sense, the repealing of the Act was relatively easier. For the Trump administration, they have to offer an alternative that is better than Obamacare. In essence, they have the task of reducing the high costs of ACA while keeping the cost low and affordable to ordinary Americans. Doing that will require extensive consultations from the medical field and even the involvement of the Democrats. However, instead of focusing on creating a superior act to reform ACA, the administration is focused only on repealing the act. In the rushed attempt, the administration only manages to produce half-baked bills that end up being opposed by their party members. The Administration needs to consider creating a serious bill that addresses the necessary issues and is relatively superior to the ACA. The constant assumption of using the power of numbers to repeal an act without an actual act to replace it is futile. It is apparent that the Trump administration is focused on repealing the act without a superior act to replace ACA. Their focus is on the political agenda of repealing the act instead of providing America with an act that is socially and economically suitable.

Divisions

The reason the repealing of the ACA has been futile is the personal divisions within the Republican Party. In the presidential elections, not all Republicans were in support of the Trump presidency. The Trump received little support from the party during his campaign period. It is these divisions that do not warrant the president the full support of the Republicans. He has been involved in a serious tirade of words with some of his party members. There is also a personal division between the senators. Instead of reasoning with those opposed to the bill the administration targets them. For instance, McConnell openly rebuked Ohio Senator Rob Portman for opposing the Bill. Trump also criticised Dean Heller of Nevada for being opposed to the bill. Such open and personal criticism of the senators from the administration will continue to hinder the reforms. Instead of reducing the opposition, the Trump administration is extending the divide. In essence, the lack of unity in the Republican Party is a hindrance to the bill being passed.

Ignorance of Social Issues

The Trump administration has failed to implement healthcare reforms due to the ignorance of the social implications of the bill. The Democrats are mainly opposed to the repeal of the ACA due to its social implications. In repealing the Act, it has been considered that millions of Americans will lose access to medical care. The repeal of the Act will provide the insurance companies with more power. The proposed reforms include the proposal to allow states to opt out of the requirement that insurers have to provide service to people with pre-existing conditions. The proposals also desire for the elimination of the tax based charges in the healthcare. The ACA tried to provide healthcare to a higher group of Americans by charging high-income earners more. It also required that employers pay for their employees’ health insurance for at least eight years. Such provisions have ensured the redistribution of wealth in the American society. In repealing the Bill, the Republicans will ensure the continuity of social inequality. Since the social impact is considered negative, the Democrats and some Republicans are opposed to the reforms. The Republicans opposed to the reforms consider that their constituents might be locked out of the healthcare system. The government also has the mandate to ensure that all its citizens can access medical care. The reduction of government spending on healthcare affects its social obligations. The Trump administration in its proposed reforms has ignored such crucial social impacts and has therefore experienced immense opposition.

Lack of Stakeholders Involvement

The reform of the ACA is stagnated since the administration has failed to involve all the interested parties. In June, the administration in a hurry presented a bill to be passed that had not even involved the Republican senators. That is an example of how the shrewd secrecy of the bill costs the administration support. Healthcare is an integral issue that all parties concerned should be allowed to provide their input. The Republican has the majority in the house by they still need to involve the Democrats in the drafting process. The health providers, as well as the insurance companies, have to be involved. The involvement of such groups is guaranteed to take time, something which the administration has ignored. The failure to reach the required number indicates that some of the Republicans feel left out in the process. The president might manage to pass the bill without the support of the minority Democrats. However, such a move will lead to equal efforts from the Democrats to repeal the reforms. The Administration is trying to repeal ACA since they were not supportive of its implementation. It is clear that without any support from the Democrats, the repealed Act will get eliminated once the Democrats gain a majority in the house and senate at a future date. It is therefore clear that the current failure to repeal the ACA is the administration’s failure to involve most stakeholders who have an opposing view on the social and economic impacts of the bill.



Governance Checks and Balances

The Trump administration has not been successful in implementing the healthcare reform bill because of the politicisation of the checks and balances in the American governance system. The checks and balances of the legislative, the executive and the judiciary were established to curtail the behavior of the main actors in the governance of the American society. Upon ascension to the presidency, Trump made several promises that augured differently for people of different political divides. His views on immigration were considered extreme and divisive. He promised to repeal the Obamacare in his early days in office. Since he was president, the Democrats embarked on using the checks and balances available in blocking his agendas. The Democrats have consistently used the Congress and Senate to frustrate the passing of the healthcare reforms. The Democrats have at times absconded from the voting process or bluntly voted no, to hinder the reforms from being implemented. In some of his legislation, the Democrats have sought to pursue the president through the judiciary. It is clear that the Democrats have employed the checks and balances to frustrate Trump's agendas including that of the healthcare reforms.

Social Hindrance

There are those for the opinion that the reforms on healthcare have been hindered for social reasons and not political reasons. The healthcare system is integral to the livelihood of most Americans. The argument is that the reason for the delay is to ensure the proposed reforms are socially adequate. The Democrats want a bill that ensures that most members of the society have access to healthcare. The Republicans want a bill that ensures that all members of the society have the liberty to choose what amount they can contribute to their healthcare. It is the furtherance of a social agenda that has resulted in the stalemate in passing the bill. The supporters of the ideology think that it is social interest and not political interest that has frustrated the Trump administration.

Economic Hindrance

There are those that consider that the health reforms have stalled because of economic reasons. The Republicans want to repeal the ACA because they consider it to be costly and unsustainable. The Republicans are of the Opinion that eventually the ACA will collapse because of the unmanageable costs. They also consider that the ACA hinders the growth of the economy by trying to impose excessive government regulations on an industry that operates with free-market ideologies. They consider that such rules will frustrate innovations in the health industry. The Democrats, on the other hand, consider that the extensive investment in the health sector will lead to a healthier economy. Essentially the parties differ on the level of government control and the amount that the government spends in the health sector. The lack of economic congruence between the parties is thus deemed to be a hindrance to the passage of the bill.

Weaknesses of Opposing Arguments

The arguments that social and economic concerns are the main hurdles to the implantation of the healthcare reforms might appear convincing. The problem with the arguments is that they have ignored the political influence of the argument. The main reasons that social and economic arguments have not been settled is because of the political divide. The social concerns, as well as political concerns, have a political divide. If these were genuine reasons, then we would see politicians from both parties independently take sides on the issues they support. Instead, we see politicians taking sides on both social and economic arguments based on the political party they back. It is therefore apparent that such sidings are not influenced by economic preferences or social policy preferences and instead are influenced by political divisions. As such, the political opposition has been the main barrier to the health reforms proposed by the Trump administration.

Summary

The paper has established that The Trump administration has failed to succeed in reforming the healthcare mainly because of political reasons rather than social and economic reason. The Government has been in a rush to implement the bill without considering the social and economic impacts of the bill. Politicians have personal reasons such as protecting their image to their constituents. The open criticism of fellow republican by the administration increases disunity in the party that eventually downgrades the ability of the assumed power of numbers strategy by the administration. The Trump administration has failed to produce a superior bill to the ACA and has not involved all the healthcare stakeholders in the development of the new bill. It is because of that that the Democrats have successfully politicised the checks and balances of the American governance system to block the reforms. The social and economic arguments are weakened by the matter since the issues are backed based political affiliations other than the relevance of the issues.

Conclusion

It is my opinion that the constant politicizing of health care issues are denying Americans an efficient healthcare system. Since different groups propose their preferred agendas and use the tyranny of numbers to pass their bills, they result in a constant cycle of repeals and reforms. The American healthcare is a serious issue, and the political parties should be considerate of the long-term impact of their actions. It is prudent for the two parties to consider reaching a compromise in the healthcare reforms. Committees that comprise of members from both political divides and other stakeholders in the healthcare system should be formed to reach the desired compromise and provide America with an efficient and long-lasting solution to the healthcare issues. Reason and not politics should prevail in the matter.





































Bibliography

Béland, Daniel, Philip Rocco, and Alex Waddan. Obamacare Wars: Federalism, State Politics, and the Affordable Care Act. University Press of Kansas, 2016.



Bradley, Elizabeth, and Lauren Taylor. The American health care paradox: Why spending more is getting us less. Public Affairs, 2013.



Gaffney, Adam, and Danny McCormick. "The Affordable Care Act: implications for health-care equity." The Lancet 389, no. 10077 (2017): 1442-1452.



Hunt, Kattie. 2017. "Demystifying The US Health Care Debate: Here's What You Need To Know". CNN. http://edition.cnn.com/2017/07/28/politics/us-health-care-turmoil-explainer/index.html.



Jacobs, Lawrence, and Theda Skocpol. Health care reform and American politics: What everyone needs to know. Oxford University Press, 2015.



Kaplan, Robert. 2017. "Projected Drop In Medicaid Spending Heightens Hurdle For G.O.P. Health Bill". Nytimes.Com. https://www.nytimes.com/2017/06/29/us/politics/health-care-bill-senate-republicans.html.



Lee, Nancy S. "Framing choice: The origins and impact of consumer rhetoric in US health care debates." Social Science & Medicine 138 (2015): 136-143.



Lorenzoni, Luca, Annalisa Belloni, and Franco Sassi. "Health-care expenditure and health policy in the USA versus other high-spending OECD countries." The Lancet 384, no. 9937 (2014): 83-92.



McKee, Martin, Scott L. Greer, and David Stuckler. "What will Donald Trump's presidency mean for health? A scorecard." The Lancet 389, no. 10070 (2017): 748-754.



McKay, David. American politics and society. John Wiley & Sons, 2017.



Sean Sullivan, Juliet Eilperin and Kelsey Snell. 2017. "New GOP Health Care Bill Hits Hurdle In Resistance From Governors". Chicagotribune.Com. http://www.chicagotribune.com/news/nationworld/politics/ct-obamacare-repeal-graham-cassidy-20170919-story.html

Starr, Paul. Remedy and reaction: the peculiar American struggle over health care reform. Yale University Press, 2013.

The Economist. 2017. "Cite A Website - Cite This For Me". Economist.Com. https://www.economist.com/news/briefing/21719787-there-still-plenty-worry-about-americas-system-checks-and-balances-seems-be.