The document discusses the failure of the US government to pass comprehensive healthcare reform through bipartisan cooperation. When President Obama called on Congress to reform healthcare by the end of 2009, the result was a lack of teamwork between Republicans and Democrats. Numerous attempts at reform over the past century have also failed due to partisan polarization and conflict between the two parties. The most recent reform efforts in 2009-2010 saw Republicans and Democrats offer hundreds of competing amendments without finding much common ground. Democrats were eventually able to pass reforms through reconciliation without Republican support. The document argues this history demonstrates that the liberal ideal of using democratic institutions to resolve conflicts cooperatively does not apply to healthcare politics in the US.

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

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Running Head: The Mechanism Is Broken
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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Running Head: The Mechanism Is Broken
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
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