The Policy Process: Part II
HCS/455
March 18, 2013
Jay Cutspec
Introduction
Any significant policy amendment or introduction of new legislation in the United States is always fraught with the perils of partisan politics. Health care policy is a particularly divisive issue, one which seems to summon a lot of passion on both sides. President Barack Obama’s Patient Protection and Affordable Care Act (PPACA), which, combined with the Health Care and Education Reconciliation act (HCERA), formed the Health Care Reform Act of 2010, is a perfect example of how difficult it is in America to push through health care legislation. Together, Obama’s reforms were directed at solving many problems endemic to the American health care system: reform of private health insurance; better coverage for those suffering pre-existing conditions; improving Medicare’s coverage for prescription medication; and perpetuating the Medicare trust fund by twelve years (“Summary of Coverage Provisions”). President Obama signed the statute into law on March 23, 2010; however, not until extensive debate and politicking had taken place throughout the formulation, legislation and implementation of the policy. Any policy, once passed, must then undergo thorough evaluation, analysis and revision – the PPACA is no different in this regard.
The Process
Jerri Cockrel (1997) has stated that public policymaking is “obscure,” even “underhanded” (p. IP-19). He outlines the final stages of the policymaking process: the authoritative decision, implementation, and evaluation. In making an authoritative decision, “relevant authorities” must debate the advocates’ proposal, the opponents’ counter-proposal, or some compromise – or they can simply maintain the status quo (IP-19). If implemented, then there may be new regulations and enforcement procedures (IP-19). Relevant to this paper is the evaluation stage. Cockrel explains:
After a new policy is implemented, advocates, opponents, or...