The purpose of this paper is to understand why President Clinton’s Health Plan was unsuccessful. I will discuss the features of the health care reform plan and provide reasons why it was said to be unsuccessful from articles I researched about the healthcare reform plan. I will describe the interplay that is expected between demanders, suppliers and interest groups, and the policy process and environment.
The Medicare Catastrophic Coverage Act, which President Bill Clinton’s proposals for national health care reform, and the deliberations of the National Bipartisan Commission on the Future of Medicare, proposals before and after the 2000 presidential election, and the adoption of prescription drug coverage and other reforms in late 2003 (Oliver, 2004).
History reveals that from the late 1960s to the late 1990s, prescription drug coverage for Medicare beneficiaries was always linked to the fate of other proposals for health care reform and that only at the end of the Clinton administration did the issue take on a life of its own (Oliver, 2004).
The Clinton administration’s health plan called for the creation of purchasing cooperatives where people without large-group insurance could buy coverage centered medical homes (Huclo, 2019).
Reasons Why the Health Plan Was Unsuccessful
President Clinton’s goals may not survive the hidden details, as claimed by the author of this article (Clark, 1994). He identifies four fundamental flaws in the Health Security Act of 1993. First, the act does not link the benefit package of coverage offered to all Americans with the funding available from employers or government to pay for these benefits; second, the act does not provide incentives for consumers to use health resources wisely; third, the act relies too much on government regulation; and fourth, the act provides few incentives for medical research, new drugs, and improved technology (Clark, 1994).
The health care debate is in many ways an illustration of a process that is increasingly evident, whenever legislation is proposed affecting large numbers of people (Bok, 1998). On such occasions, it is now common not merely to debate the issues in Congress but to engage the people directly in ways that are like an election campaign (Bok, 1998).
Interest groups also participate more and more actively by televised ads, electronic messages, and other forms of modern technology to reach the public and urge them to communicate with their representatives in Congress (Bok, 1998). When one adds in media reporters, talk show hosts, open ended writers and expert commentary of various kinds, a major piece of legislation, for example, Clinton’s health plan it can set off a national debate of formidable proportions (Bok, 1998).
Some major participants in the debate especially powerful interest groups may have much more money than other interested parties and thus enjoy a substantial advantage in carrying out an effective mass campaign of persuasion (Bok, 1998). The media are always there to help the public sort out the problems and understand the proposals and the relevant arguments, but reporters often seem more interested in describing the political tactics and conflicts than in discussing the substance of complex policy issues (Bok, 1998). Finally, no debate can succeed without an attentive, interested public, yet Americans seem increasingly disinterested in politics and distrustful of what they hear from politicians and public figures (Bok, 1998).
Surrounding all of government and more, the understanding of health policymaking is large and complex, and needs policymakers to supply the public policies that demanders seek (Longest, 2016).
The goal of health policy is to protect and promote the health of individuals and the community. Government officials can accomplish this goal by respecting human rights, including the right to self-determination, privacy, and nondiscrimination (Longest, 2016).
The demanders of health policies are anyone considering a policy relevant to health, for example patients, health care organizations, hospitals. Interest groups are demanders, such as ANA (American Nursing Association), AARP (American Association of Retired Persons) (Longest, 2016).
The suppliers of a healthcare policy are the government, legislators, and law makers. Legislators as one group of public policy suppliers is elected legislators, whether members the Suppliers of the U.S. Congress, state legislatures, or city councils (Longest, 2016). Few aspects of the political marketplace are as interesting, or as widely observed and studied, as the question of motives for the policymaking decisions and actions of elected legislators. To a substantial extent, this intense interest in the motivations of policy suppliers reflects the desire by policy demanders for some effective means to pursue their desired policies by exerting influence over the suppliers (Longest, 2016).
Each policy effects one or more interest groups. Rules established to implement health related public target members of the interest groups. These groups routinely look to influence rulemaking (Longest, 2016). Regulatory policies are implemented to prescribe and control the actions, behaviors, and decisions of certain individuals or organization (Longest, 2016).
Policies provide income, services, or other benefits to certain individuals or organizations at the expense of others. Interest groups that represent the individuals and organizations directly affected by such policies are actively interested in all aspects of policymaking, including rulemaking. Interest groups in policy markets tend to be well organized and aggressive in the rulemaking process to satisfy their preferences, while seeking and influencing the formulation and implementation of policies that affect them (Longest, 2016).
For any individual in an organization, it can be difficult for those developing policies to participate in an effective manner. For example, to participate the individuals must have a significant amount of policy information relevant to the policy they are trying to promote, which can require a large amount of time, money and influence (Oliver, 2004). Individual participants or demanders often must be prepared to have additional resources such as money and time in support of achieving any desired policy. Demanders who participate in the political markets for policies are not always successful in the policy making process, because they don’t have the important recourses they need (Oliver, 2004).
Organizations, who have valuable resources, have a significant advantage over individuals in the political marketplace. They may have the necessary resources both to garner needed policy-relevant information and to support their efforts to achieve desired policies (Oliver, 2004). Their large market of resources is not their only advantage over individuals in the political marketplace.
The most effective demanders of policies are the well-organized interest groups. Interest groups are groups of people or organizations with similar policy goals that enter the political process to try to achieve those goals, for example, ANA and AARP (Oliver, 2004). By combining and concentrating the resources of their members, interest groups can have a much greater impact in political markets than either individuals or organizations. Interest groups provide their members, whether they are individuals or organizations, with greater opportunities to participate effectively in the political marketplace (Oliver, 2004).
The integrated delivery networks of the 1990s and the accountable care organizations of today resemble each other strongly (Huclo, 2019). An example for instance is that both the networks and the accountable care organization are supported by the federal legislation to include what is call the “Triple Aim”, which is the improved quality of care, improved population health and reduced cost (Huclo, 2019).
Some of the similarities that exist between the two are structure, care, payment and providers. The structure was the “Triple Aim”, the care was to develop a continuum of care emphasizing on care coordination and focus on disease management (Huclo, 2019). For payment the focus was on populations health management, stay away from the volume of fee-for-service, and then rely on risk contracting, capitation, and employed physicians (Huclo, 2019). The provider part is using centralize contracting of many providers in the network.
As new policies in any organization are implemented there is a need for managers who can develop and instill a common vision of what the organization is to accomplish and how the vision’s goal will be reached. The managers must focus on decisions and activities that affect the entire organization, including those intended to ensure its goal, vision and overall well-being is carried out. The key for the manager and for myself as a manager is to get the employees engaged in the policy and have the employees invested in the policy for it to be carried out. They must establish right strategies and objectives by managing the organizational cultures, respond to challenges and opportunities presented by the environment. The managers play a huge role in leading their department and staff in upholding the purpose of the policies that are put forth.
I take a position in supporting the implementation of policies, for example, we implement policies for many reasons. One policy we have implemented in our Medical Group practices is the ADMIN Policy#105, Patient Arriving Late for an Appointment. The purpose of this policy is to have a primary goal of maintaining an ongoing relationship with all patients with in the communities we serve to effectively meet their needs for their medical services. This policy is designed to maintain effective office flow for all the providers of the practice, without hindering the appointment of the patient or other patients to follow.
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