Running Head: POLITICS AND HEALTH CASE SYSTEMS IN US POLITICS AND HEALTH CARE SYSTEM IN US. 12 Politics and Healthcare System in US Student’s Name Institution Date Abstract It should be noted that the U.S health care delivery system is constantly undergoing transformation through new legislation or improvement and amendments of the existing legislations. Some of the most common areas that are often improved concern the financing sector, insurance sector, delivery sector and quality sector. New laws are often introduced in these sectors with the purpose of ensuring that the resultant health care is of high quality and that it is cheaper and accessible to many. Affordability is another crucial component of health care delivery system. The four basic functional components of the U.S. health care delivery system include financing, insurance, delivery and quality would be discussed. The paper will explore and analyze the association between the politics and the health care reforms in the United States. The analysis will try to find out the role of politics in the key healthcare reforms such as Medicare, Medicaid, Managed care and even the most current act called Affordable Care Act. The paper will demonstrate that politicians have been using gaps in the healthcare system to campaign for their consideration for being elected as Congress or senetors. It will also demonstrate that some politicians such as Clinton plan to initiate reforms to suit their political interest. The paper will conclude by indicating how the politics and politicians manipulate the health care reform as their campaign strategies of winning voters. Politics and healthcare system in USA A closer look at the health care reform in United States reveals that any reform is politically orchestrated. In fact it is as if one of the campaign strategies of most of the politicians is to come up with a reform that can improve cost of care, quality of care and access to care. A closer look at the history of the United States reveals that politics started intervening in health care between 1930s and 1960s (Patel & Rushefsky, 1999). During this time, there was depression, unemployment insurance and hence the government was in pressure to provide cheaper if not free medical care or reimbursement for its cost (Patel & Rushefsky, 1999). In 1935, the Social Security Act of 1935 was formed to provide for unemployment compensation, old-age pensions and other benefits (Patel & Rushefsky, 1999). It should be noted that the political party in leadership had to be careful on how it handles the issue of health care lest it lose the confidence in people. Before the idea of insurance was introduced, the American Medical Association was strongly opposing it. On the other hand, the politicians and the ruling political government had to force it happen because that was the only option in which politicians could help its citizens and p.

1. Running Head: POLITICS AND HEALTH CASE SYSTEMS IN
US
POLITICS AND HEALTH CARE SYSTEM IN US.
12
Politics and Healthcare System in US
Student’s Name
Institution
Date
Abstract
It should be noted that the U.S health care delivery system is
constantly undergoing transformation through new legislation or
improvement and amendments of the existing legislations. Some
of the most common areas that are often improved concern the
financing sector, insurance sector, delivery sector and quality
sector. New laws are often introduced in these sectors with the
purpose of ensuring that the resultant health care is of high
quality and that it is cheaper and accessible to many.
Affordability is another crucial component of health care
delivery system. The four basic functional components of the
U.S. health care delivery system include financing, insurance,
delivery and quality would be discussed.
The paper will explore and analyze the association between the
politics and the health care reforms in the United States. The
analysis will try to find out the role of politics in the key
healthcare reforms such as Medicare, Medicaid, Managed care
and even the most current act called Affordable Care Act. The
paper will demonstrate that politicians have been using gaps in

2. the healthcare system to campaign for their consideration for
being elected as Congress or senetors. It will also demonstrate
that some politicians such as Clinton plan to initiate reforms to
suit their political interest. The paper will conclude by
indicating how the politics and politicians manipulate the health
care reform as their campaign strategies of winning voters.
Politics and healthcare system in USA
A closer look at the health care reform in United States reveals
that any reform is politically orchestrated. In fact it is as if one
of the campaign strategies of most of the politicians is to come
up with a reform that can improve cost of care, quality of care
and access to care. A closer look at the history of the United
States reveals that politics started intervening in health care
between 1930s and 1960s (Patel & Rushefsky, 1999). During
this time, there was depression, unemployment insurance and
hence the government was in pressure to provide cheaper if not
free medical care or reimbursement for its cost (Patel &
Rushefsky, 1999).
In 1935, the Social Security Act of 1935 was formed to provide
for unemployment compensation, old-age pensions and other
benefits (Patel & Rushefsky, 1999). It should be noted that the
political party in leadership had to be careful on how it handles
the issue of health care lest it lose the confidence in people.
Before the idea of insurance was introduced, the American
Medical Association was strongly opposing it. On the other
hand, the politicians and the ruling political government had to
force it happen because that was the only option in which
politicians could help its citizens and possibly get reelected.
After World War II, the Truman administration initiated the
expansion of hospitals, increased support for public health and
federal aid for medical research and education. This was
reinforced by the passage of Hill-Burton Act in 1946, which
provided federal funds to subsidize construction of hospitals in
areas of bed shortages.
In 1960, Kerr-Mills Act, which is also known as Medical

3. Assistance Act was passed by Congress. This provided federal
matching payments to states and allowed the state to include
medically needy or vulnerable groups such as the elderly, the
disabled and the poor. However, the act failed to offer
significant relief for the substantial portion of the elderly
population. This is because it was found that only one percent
of the nation’s elderly received help under the program. The
program was curtailed by stringent eligibility rules and high
administrative costs of state government. The issue therefore
remained on political agenda. When Kennedy became president
in 1961, one of his political agenda was to increase access to
health care for millions of Americans. However, it is indicated
that Kennedy won a narrow victory and was not in a position to
push for a universal insurance program. This is because he had
a Congress that was not very amenable to his legislative
proposals. Kennedy’s key achievement is that he was able to
keep the issue of healthcare needs of elderly alive and on
political agenda.
However, his assassination in 1963 left the task of carrying on
the fight for Medicare to Lyndon Johnson, who adopted most of
Kennedy’s unfinished legislative proposals. He also initiated
the Great Society’s War on Poverty program (Patel, Rushefsky
& McFarlane, 2005). It should be noted that after civil rights,
Medicare was second in priority with the Johnson
administration. Johnson recognize Medicare as crucial part of
his fight on poverty. As a result, he won a landslide victory,
which enabled him carry out his political agendas successfully
(Patel, Rushefsky & McFarlane, 2005). It is also important that
during that time, the Democrats won major victories in
congressional elections. This means that the administration had
enough votes in the House and the Senate for the passage of its
health care proposals.
When Nixon took the leadership, he proposed moderate changes
in the health care programs (Patel, Rushefsky & McFarlane,
2005). He signed into law various acts meant to extend
community mental health centers, migrant health centers and

4. programs designed to support training of health care personnel
(Patel, Rushefsky & McFarlane, 2005). It should be noted that
Nixon was interested in vying for the president in 1972 again.
He felt compelled to respond to Kennedy’s political challenge
(Patel, Rushefsky & McFarlane, 2005). He end up proposing
the National Health Insurance Partnership Act. This comprises
of the Family Health Insurance Plan, which is federally
financed to offer health insurance for all low-income families.
The second component of this act is the National Health
Insurance Standards Act. This act is financed by private funds.
Its goal is to set standards for employer health insurance and
expected coverage of employees.
Another Nixon’s proposal was to provide federal funds for the
development of health maintenance organizations (HMO) (Patel,
Rushefsky & McFarlane, 2005). In this system, enrollees are
allowed to pay a fixed fee in advance, and in return, received a
comprehensive set of health care services. Such organizations
promote competition with traditional health care delivery
system. This is because they create incentives for shifting
health services utilization from more costly impatient services
such as hospitals and skilled nursing facilities to less costly
outpatient services such as visits to doctor’s offices (Patel,
Rushefsky & McFarlane, 2005).
Jimmy Carter, on the other hand, pledged his support for a
comprehensive national health insurance program (Morone &
Belkin, 1994). This was a response to his opponent, who was
also seeking the Democratic party’s nomination. However, when
he finally assume the office in 1977, he could not meet his
pledges because he was hindered by financial constraints
(Morone & Belkin, 1994).
Roosevelt administration did not want to jeopardize the
enactment of Social Security Act. The 1980s political
leadership, which was under the leadership of Reagan and Bush
healthcare system target mostly on the cost of health care
(Morone & Belkin, 1994). They uses such to influence voters.

5. Ironically, during that time, the key reforms that were expected
especially by various experts and policy makers concerned
access to care and quality of care delivered. However, because
of the political influence, a number of legislation meant to cut
the cost of health care were passed (Morone & Belkin, 1994).
In fact it is during this period that the legislations related to the
Medicare and Medicaid programs were implemented. They both
focus on how to control rising health care costs. The impact of
this was positive because it is indicated that there was a
reduction in health care costs in 1990s (Shi & Singh, 2010).
When Clinton was elected as the present, the politics targeted at
ensuring access to health care insurance and health care
services. The Clinton administration really pushed for this. The
polls that was conducted in 1992 reveals that most of American
were in favor or reforming the health care system. George Bush
announced new health care initiatives. He proposed a series of
reforms. Under the proposal, the self employed were to receive
a tax deduction equal to the size of the premiums and that small
business would receive tax inducement.
A closer look at Bush initiative reveals that it was in response
to the coming presidential election and was a way of assuring
Bill Clinton that he would offer a plan for comprehensive
reform of the U.S. healthcare system. The Bush government
and Clinton later endorsed managed care. The Clinton’s
administration was doing this as one of his pledges he made
during election. It is apparent that during the campaign of
1990s, the Clinton was convicted that health care was an issue
which could allow him go back to the White House for a
Democrat. During this time, the political analysts were certain
that health care was an aspect that could define a presidency
(Jacobs & Skocpol, 2012). In fact it has been established that it
is during the Clinton’s time when the United States experienced
a push for major health care reform. It was during this time
when the health care reform began to take shape seriously.
There are a number of politically motivated reforms that took
place during the Clinton’s time (Jacobs & Skocpol, 2012). The

6. first reform that is as a result of the political motivation is the
changes in health insurance coverage. Health insurance
coverage was one way of increasing the access to health care
services in the United States. Politicians were looking at every
possible way in which they can improve the healthcare system
in the United. For example, after the initiation of private
insurance, the problem of lack of healthcare of lack of health
insurance coverage became a problem of special groups such as
the aged, the poor, and more recently, the unemployed (Jacobs
& Skocpol, 2012).
A closer analysis of the health care system and reforms in the
United States reveals that the exact time when the healthcare
reform was politicized is in 1990s. It is during this time that
most of the trends such as the rising numbers of Americans
without health insurance and the rising fears of the middle class
about not having health insurance. The change started in 1991,
when Harris Wofford aired a television commercial during the
campaign that argued “ if every criminal in America has the
right to a lawyer, then I think every working individuals or
citizens have the right to see a doctor when they are ill.
Using this as campaign strategy, Harris managed to defeat his
opponent. It is envisaged that it was during this time that the
Democratic Party started realizing that access to health care was
an issue on the minds of the public (Jacobs & Skocpol, 2012).
In fact during the following Democratic debates, health
insurance was one of the issue that was given a lot of weight.
The different candidate from the different states started
developing well-thought and comprehensive proposals related to
health reform (Jacobs & Skocpol, 2012). For example, history
shows that Senator Robert Kerry introduced a comprehensive
plan in mid-1991. Kerry proposed a government-financed and
government-run plan. However, other Democratic competitors
and contenders adopted less comprehensive reforms positions.
Paul Tsongas, for example pushed an approach which later
became publicly identified as the Jackson Hole Plan. This plan
was partly contributed by Paul Ellywood. It resembles the

7. managed care (Jacobs & Skocpol, 2012). It was proposed that
managed competition envisioned a health care system that relied
largely on market forces of supply and demand. It was during
this time that an agreement was made that it is better if
employers can pay a portion of their workers’ coverages, but
not necessarily pay the whole insurance amount (Jacobs &
Skocpol, 2012).
Another major significant reform took place when Clinton
became president. It is shown that President Clinton initiated a
reform led by the President’s Task Force on National Health
Reform. The goal of the reform was to make health care reform
legislation that could be submitted to Congress within 100 days
(In Selker & In Wasser, 2014). The Task force was headed by
Clinton’s wife. Clinton, according to analysts, wanted to tackle
the entire issue of health care reform. He wanted a
comprehensive proposal from the task force (In Selker & In
Wasser, 2014). The idea that Clinton chooses his wife to head
the task force is an indication of political intentions. It is also
shown that the way the commission was created and the secrecy
around its actions leave a lot of questions related to the task
force and the Clinton’s administration (In Selker & In Wasser,
2014).
Medicare is another health care program that has some political
elements. It was initiated during the Clinton’s administration.
It should be noted that Medicare is a very crucial reform as far
as health care is concerned (In Mason, In Leavitt, & In Chaffee,
2014). This is because it currently serve more than 39 million
people, who get insurance and health care through Medicare (In
Selker & In Wasser, 2014). Although Medicare is meant to
reduce the cost of health care, there are evidence that the
Medicare costs have been growing even faster than general
health care costs since it was formed. This is attributable to the
increase in the share of population over 65 years. It was agreed
that the only way of reducing the Medicare cost is to control the
rate of growth in costs per beneficiary (Faguet, 2013). It was
also proposed that the cost reduction can only be accomplished

8. by a fundamental restructuring of incentives for beneficiaries,
and also adoption of fee-for-service Medicare (In Selker & In
Wasser, 2014). Two key proposals were thus made. The first
proposal is Breaux-Frist proposal. This comprises of the Bi-
Partisan Commission’s plan and President Clinton’s plan.
Managed care plan is also envisaged to have some political
association. This plan was developed as a way of containing the
costs in 1970s and 1980w. This was the time when the health
care costs increased rapidly.
The last form of healthcare reform is the Affordable Care Act,
which was recently passed under the Obama administration
(Pratt, 2012). A closer look at the act reveals that it is a
political document. It is not a healthcare document (Pratt,
2012). In fact the main reason why the Act was initiated is to
create more tax revenue to support a bigger government, and to
create a large voting block dependent on government for their
healthcare services (Pratt, 2012). It is apparent that the public
dependency related to the act provide politicians enormous
political power (Pratt, 2012).
Depoliticizing the healthcare system can result in poor quality
reforms. This is because the politicians compete based on how
best they can improve the health care. However, care should be
taken to analyze any given policy before it is amended because
some policies such as Affordable Care Act may appear good
superficially, but is not actually good.
Conclusion
It should be noted from the foregoing discussion that failure or
success to provide universal health insurance coverage can be
attributed to fundamental political ideological differences
between liberals and conservatives. The two are in conflict
about the role of the public and private sector in health care. It
is apparent that one of the factors that determine whether a
given candidate would become president is the nature and the
role of the health care act he or she initiates.

9. References
Top of Form
Patel, K., & Rushefsky, M. E. (1999). Health care politics and
policy in America. Armonk, NY [u.a.: M.E. Sharpe.
Top of Form
Patel, K., Rushefsky, M. E., & McFarlane, D. R. (2005). The
politics of public health in the United States. Armonk, N.Y:
M.E. Sharpe.
Top of Form
Morone, J. A., & Belkin, G. S. (1994). The politics of health
care reform: Lessons from the past, prospects for the future.
Durham: Duke University Press.
Top of Form
Shi, L., & Singh, D. A. (2010). Essentials of the U.S. health
care system.
Top of Form
Pratt, L. L. (2012). Let's fix medicare, replace medicaid, and
repealthe affordable care act: Here is why and how.
Bloomington, Ind: AuthorHouse.
Top of Form
In Selker, H. P., & In Wasser, J. S. (2014). The Affordable Care
Act as a National Experiment: Health Policy Innovations and
Lessons.
Top of Form
Faguet, G. B. (2013). The Affordable Care Act: A missed
opportunity, a better way forward. New York: Algora Pub.
Top of Form

10. Jacobs, L. R., & Skocpol, T. (2012). Health care reform and
American politics: What everyone needs to know. New York:
Oxford University Press.
Top of Form
In Mason, D. J., In Leavitt, J. K., & In Chaffee, M. W. (2014).
Policy & politics in nursing and health care.
Bottom of Form
Bottom of Form
Bottom of Form
Bottom of Form
Bottom of Form
Bottom of Form
Bottom of Form
Bottom of Form
Bottom of Form
Quiz 1 Questions
What are the three main divisions that have brought about the
current fragmentations of Christianity? Provide centuries for
each division AND explain what churches each generated.
Orthodoxy is organized into several autocephalous (literally
“self-headed”) Churches. What does “autocephalous” mean?
self-centered;
self-governing;
self-evident.

11. Are all Orthodox “Greek Orthodox”?Yes;
No.
If not all Orthodox are Greek Orthodox, name two other
Orthodox “kinds” from nations that are predominantly
Orthodox.
According to Ware and our class discussions, what holds
together the family of autonomous Orthodox Churches? Name
these two bonds.
Does Orthodoxy have any position equivalent to that of the
Pope in the Catholic Church?Yes;
No.
Explain the special position of the Ecumenical Patriarch, the
Patriarch of Constantinople. First, in what sense is he the leader
of Orthodoxy? Is this a leadership of supreme and final
authority? Second, does he have the right to interfere in or
dictate the affairs of all auto-cephalous churches?
According to Ware, the Orthodox Church understands its unity
in terms different from those employed in the Catholic Church.
A difference particularly significant is: (circle one)Orthodox
Churches can have different beliefs from each other, while
Catholics must share the same faith;
Orthodox have no single individual with the final authority to
decide matters, like the Pope; the final authority belongs to the
synod or the council of bishops;Orthodox think that the unity of
their Church is only manifested in their common beliefs, but it
does not have to extend to sacramental communion, which is
contrary to the Catholic emphasis on the sacramental unity of
the Church.
Why did the Russian presence on Mount Athos decline after
World War I or 1917, to be exact?
Explain the difference in the quality of the monks on Mount
Athos particularly noticeable after the 1980’s.
The Church of Sinai consists of one single monastic community:
(circle one)the monasteries at Meteora;
the monasteries at Mount Athos;
St. Catherine’s monastery;

12. the monasteries in Constantinople.
There was a considerable decline in the life of the Greek
Orthodox Church after the 1960’s. According to Ware, this was
to a certain extent due to this period in the history of Greece,
when the Church has been considered a collaborator of a reviled
regime. Identify the period and explain the main factor that led
to the collapse of the Church.
The communist authorities in Russia took from the very
beginning a very strong attitude toward the Orthodox Church.
Describe this attitude.
The new communist legislation of 1918 simply erased the legal
status of the Church. List two legal rights that the Church lost
with this legislation.
At the outbreak of World War II in 1939 only a very small
number of bishops were allowed to function in Russia. The
number was:200;
4;
100;
12.
Stalin allowed for somewhat of a revival of the Church in the
1940’s because of a catastrophic historical event that made him
need the help and cooperation of every single Russian. What is
this tragic historical event? (circle one)the beginning of atheism
in Russia;
the beginning of World War II;
the beginning of anti-Communist resistance;the opposition he
faced in the communist party.
How many Orthodox churches did the communist regime
destroyed in Bucharest alone?
How many Orthodox bishops were sacked and/or killed in
communist Romania?
Out of the 2,455 Orthodox churches functioning in Georgia in
1917, how many were still active in the 1980’s, at the end of the
communist regime there?
With 1917 western Europe saw a greater influx of highly
educated Orthodox from Russia first and then from other

13. Orthodox countries. What generated this influx?
The relatively low level of conversions to Orthodoxy in the
West until the 1970’s is probably mostly due to this aspect of
Orthodoxy kept so much alive by first generation Orthodox
immigrants. Explain the reason for which the Orthodoxy of
these early immigrants did not attract many converts.
Explain the problem of parallel hierarchies, what situation
generated it and what keeps it alive.
Explain the generational tensions sometimes at play between the
first generation Orthodox immigrants and the second generation.
The Orthodox Church in America exists in a contradictory state
of partial recognition and full communion. Explain where this
contradiction lies.
Relate in short the story of the Evangelical Orthodox Church.
What is the main reason behind the affinity that many African
Americans have recently felt toward Orthodoxy?
What is the significance of 1922 for the multiplicity of
Orthodox presence in North America?
Two common characteristics of Orthodox missionary activities
are: (select two only)Orthodox missions are only concentrated
in areas in which missions were suppressed under Communism;
Orthodox missions strive to establish immediately clergy from
the native population;
Orthodox missions are quite quick to translate the Gospels and
the Liturgy into the native languages;Orthodox missions are
only undertaken by bishops or patriarchs.