In this seminal text, Putnam analyses the total collapse of the American community in the context of the healthcare debate which is affecting the country. He argues that this debate has changed the way we view issues of society and that this is continually of importance when one has to analyze how American society has changed radically even in the 21st century.
Last year, after much acrimonious debate and threats to shut down Congress and the whole American political system, President Barack Obama managed to push a universal healthcare bill through to Congress although the political ramifications of such bill remain to be seen. In fact as we speak today, the Supreme Court is preparing to hear a case on the unconstitutionality of the healthcare bill based upon a ruling by a state court in Georgia. The main political actor in this issue must be the President but there were also other legislators in play including Senate Majority leader, Harry Reid (D-NV) and House Speaker John Boehner (R-OH) as well as Minority leader in the Senate Mitch McConnell (R-KY). Each of these actors contributed to the intense debate on the topic which eventually saw the health bill pass through Congress albeit in a much watered down version and with several pork and barrel deals where representatives and senators inserted numerous bills and clauses to make the most out of spending for their respective home states.
In the 1960’s, Americans got a form of universal healthcare which was called Medicaid and which offered some loose universal benefits without charge. However as years went by, Medicaid became more and more ineffective with the result that private healthcare companies and hospitals began refusing this form of payment and poorer individuals as well as the elderly began having to foregoe free medical services. One has to remember that the United States is a country where some form of medical insurance is mandatory for health services so the fact that several millions were without health insurance continued to rankle with the left leaning politician. As soon as President Obama got elected, he made a pledge to introduce free universal healthcare for all as one of his campaign promises and he set out to implement it without delay.
After the November 2010 mid term elections, the Democrats lost the House and swa their majority greatly reduced in the Senate thus making it harder for provisions of the new universal healthcare law to begin working. Due to the fact that to cut off debate, a two thirds majority is required in the Senate, House Minority leader, Mitch McConnel did his best to stall the legislative process of the bill but he more than met his match in Harry Reid who as majority leader for the Democrats negotiated, blustered and steamrolled his way to pass the bill. One also has to remember that several Democratic senators came from Southern states so they had to make the case for voting against party lines to placate their irate constituents who being of the conservative nature saw free universal healthcare as an impingement on their right to choose.
The battle in the House of Representatives was perhaps slightly easier when the Democrats held sway in the chamber and through their energetic Speaker, Nancy Pelosi, they could easily vote for the bill. However, the problem of the ‘Blue Dog’ Democrats was also an issue in the House as several of these had to placate their constituents also with several Southern states implacably opposed to the bill on almost every count. This resulted in long and acrimonious debate and intense lobbying on both sides of the aisle with House minority leader John Boehner also doing his very utmost to sabotage the bill. However after lengthy discussions, the first version of the bill sailed through the House only to become stalled in the Senate.
The healthcare debate obviously was pretty much influenced by what the people thought on the issue. While the poorer and more disadvantaged classes were much more liable to back universal healthcare, the same was not so for the wealthy and conservatives. Town hall meetings sprouted up across the country creating an acrimonious and ferocious debate on the whole issue with some meetings even resulting in blows and violence. Such was the temperature of the whole issue that everyone became involved in it, from the smallest and most insignificant person to the President of the United States. And although everything seemed to point towards the universal resolution of the issue, political actors continued to drag out the issue to please their constituents. In the final event, one has to realize that President Obama remained slightly short changed as he could not do much other than wait for the outcome in both Houses of Congress to take the appropriate action. The President himself toured the country far and wide to explain the legislation and although he was feted in some places, in others he was booed and jeered indicating the ferocious gamut of emotions traversed by the issue.
Public affairs implications
Democratic Majority Leader Harry Reid showed his mettle in more ways than one as he managed to pilot the bill through the Senate as he faced substantial opposition from several of his own senators. His thorough knowledge of procedural motions enabled him to skillfully legislate accordingly and also demonstrate that he could actually make the bill a reality for millions of Americans. On his part, the minority leader Mitch McConnell could only fight a rearguard action, inserting several changes in the bill which would eventually make it more watered down than it initially was and thus save substantially on the bill’s intrinsic impact. Speaker Nancy Pelosi also showed her political mettle by piloting the bill through the House without much opposition while Minority leader John Boehnor also tried his own rearguard action which ultimately did not work, however. One can observe the insightful machinations which make up Congress’ work here and also demonstrate how intricate and complicated the whole system is – obviously a haven for suave lobbyists and lawyers who will do their utmost to influence the legislators in favour of their clients. After all this is how the American political system works and nothing much can be done to change it.
Although the bill for universal healthcare has now become law, there still remain a number of grey areas to be tackled. First and foremost there is the issue of constitutionality which is being addressed by the Georgia case in the Supreme Court. Secondly there is the issue of how this bill can actually be implemented if it is opposed in several states. What is sure is that universal healthcare will continue to be an issue of national importance for a long time to come.
DeParle, Jason. 2004. American Dream. New York: Penguin Group
de Tocqueville, Alexis. 2003. Democracy in America and Two Essays on American. New York: Penguin Group 2003.
Drucker, Peter F. 2001. The Essential Drucker. New York: HarperBusiness.
Friedman, Thomas L. 2006. The World is Flat (Updated and Expanded): A Brief History of the Twenty-First Century. New York: Farrar, Straus and Giroux.
Fry, Brian and Jos C.N. Raadschelders. 2008. Mastering Public Administration. 2nd ed. Chatham House Publishers.