Formulation of U.S. National Health Policies, Essay Example

The U.S. approaches its health policy formulation on an issues basis because there is too much at stake politically to be guided strictly by scientific and mathematical evidence and dispassionate and logical conclusions drawn from such evidence. Doing that wouldn’t win elections. This is how health and medical policy issues emerge to corrupt any funding system.

There are an infinite number of real and potential health problems that individuals face, and they tend to increase as people get older. Voters over 65 have long been the most politically active segment of the voting population, and also the most government-entitled (Leonhardt, 2012). Although there is a finite amount of money for treatments or research for treatments, any failure to expand health services wanted by constituents has negative electoral consequences.

Elected leaders cannot make a stand for hardline fiscal responsibility when the costs of failing to take a stand will probably not truly be felt during the political lifetime of a Representative, Senator, or President — or the relatively short physical lifetime of an important bloc of voters. This dynamic cuts across party lines, as can be seen in the expansion of Medicare’s prescription-drug coverage by President George Bush, a Republican, even though there was much evidence that this was a very bad conservative policy (Cannon, 2008).

The people who make issues important are the constituents themselves and their blocs, and key Congressional and Senate leaders who can get funding bills through Congress for the President’s signature. Politically acceptable evidence is needed to justify programs wanted by voters, which is why members of Congress place loyal contacts in Federal agencies and bureaucracies (Weatherford, 1985). Those contacts will generate or suppress evidence as needed.

With Social Security first, and then Medicare and Medicaid, initial public spending politicized future public spending. The perception of issues determines electability, then policy.

References

Cannon, M. (2008, September 23). In Creating Medicare Part D, Republicans Slit Their Own Throats. Retrieved from http://www.cato-at-liberty.org/in-creating-medicare-part-d-republicans-slit-their-own-throats/

Leonhardt, D. (2012, June 22). Old vs. young. New York Times. Retrieved from http://www.nytimes.com/2012/06/24/opinion/sunday/the-generation-gap-is-back.html

Weatherford, M. (1985). Tribes on the Hill: The U.S. Congress–Rituals and Realities. (p. 87). South Hadley: ABC-CLIO. Retrieved from http://www.abc-clio.com/product.aspx?isbn=9780897890724