In Putting Politics First by Jacob Hacker - Term Paper Example

?Putting Politics First: A Critique In Putting Politics First, Jacob Hacker has put forward an interesting argument about how to successfully achievethe comprehensive health reform in the United States. His point is that, according to past experiences, policies are not merely approved based on its merits as best-laid plans cannot on its own and implemented without political support. Hence, it was emphasized that there is a need for health care reform policy to be designed not according to policy but rather according to political compromise. Learning from the Past The fundamental principle by which Hacker posited his proposal for health care reform was the experience of the Clinton administration. President Bill Clinton also attempted to pass a universal health care plan and it failed dismally. Hacker pointed to the fact that Clinton’s policy designers obsessed on the grand policy design that they overlooked the fact that the plan has to go through a policy network that is characterized by “hyperpolarized” polity. He explains: The plan embodied an elaborate political strategy that rested on the reconciliation of elite conflict over the appropriate path toward universal coverage… The problem was that this strategy placed policy development ahead of coalition building, bridging elite disagreements ahead of building public support. (p. 718) The strategy supposedly backfired because, in the words of Hacker, instead of building bridges of compromise, the plan has burned bridges behind them. Now this argument very much reflects the truth because of one critical variable in the United States policy network – polarization. If one looks at the way the US Congress conducts its affairs, one would unmistakably identify the congressional vitriol and how the political parties are each other’s throats whenever a policy is being introduced and debated upon, which are played up even more by intensive media coverage. This can be attributed to the way the ideologies of the Republicans and the Democrats have grown far apart, which saw, ordinary Americans aligning themselves more tightly with the parties that reflect their core beliefs. This is the reason why in policymaking there is always a need to consider the political component. This does not only make sense but this is a political principle in democratic societies. According to Whittington, Kelemen and Caldeira (2010), involving political parties is crucial because it is tantamount to integrating the voters that they represent in addition to the fact that “political parties remain the most important organizational entity through which democracy is organized, mobilized, and made effective.” (p. 27) To put it simply, the executive department, in designing and implementing policy, cannot effectively function alone. There are just numerous parties, stakeholders and pressure groups involved that the political parties remain capable in uniting them either through ideology or political muscle. Failure to use a political strategy, such as an emphasis on political compromise could lead to a protracted policymaking process or, worse, a plan itself would be shut down by the sheer strength of the partisan skirmish. The Clinton health plan was the most potent example of this. And, certainly, Hacker pointed this fact out by explaining how the Clinton plan was so complicated, that the administration lost its momentum along the way while the administration tried to salvage the initiative by building a coalition, which proved to be already too late. (p. 719) He added that the in-house policy development also attracted political resentment as the executive department was perceived to have blindsided other sectors of the policy network. Evidences Besides the discourse on the Clinton’s health reform plan, Hacker cited several other points to support his thesis. There is the case of strategy, for instance. In integrating politics in the health reform plan, it was posited to take into account the concept of fear. The idea is that health reform policy designers should take into account the fear of the public that strongly influence the way policymakers behave. Two circumstances were provided: the public fear that the employment-based coverage will be destroyed; and, the fear for enlarged government role, which also include the perceived increase in taxes to augment the public spending for universal health care coverage. Political opposition to national health care coverage can capitalize on these issues to derail reform policy. This argument is valid. Biggs and Helm (2007) used the example of the public opinion poll to demonstrate this issue. It was recognized that business organizations and politicians go to such lengths – spending enormous money and effort to sponsor, conduct and analyze public opinion polls. The authors cited how, at aggregate level, scholars have discovered a strong correlation between public attitudes and public policies, stressing the fact that “at the national level, the public mood tends to lead and not lag public policy. When the mood of the public turns liberal, liberal policies ensue, and when the mood shifts in a conservative direction, conservative policies are enacted.” (p. 115) By making sure, hence, that policy strategy combats fear mongering, the political community can be swayed or even manipulated to favor a policy such as the health coverage reform. Then, Hacker finally discussed the ideal solution of coalition-building. It is supposedly bigger than the public engagement designed to address the issue of fear. He emphasized that coalitions can engage Americans constructively in the policymaking process while urging politicians to act positively. (Hacker, p. 721) The available corpus of literature that explores the same subject appears to be divided in this area. The first school is idealistic and argues that consensus is the best approach to engage and persuade policymakers to agree on an issue. According to Castles et al. (1988), it is an important strategy in democratic societies because it aggregates interest and covers decision-making comprehensively, leading to an effective and efficient policy-making. (p. 56) This researcher would like to differ in this area. Consensus-building might be a good idea and appear noble and effective when heard or read as a theory or as a strategy. But the real world is another story. Hacker asked his readers to learn from the past. But it appears that he was only referring to the Clinton experience and no further than that. The fact is that the experiences of the past administrations before Clinton show how consensus building could fail policy. The process of this approach can prove tedious, wasting precious times and could, in the end, undermine the very policy it seeks to effectively implement. For example, at the core of the consensus-building paradigm, differing interests are brought together and discussed in an effort to come up with the best possible solution wherein everyone mutually benefits. (APA 2006, p. 66) This is actually ideal and abstract and has no specific real-world application that we could attribute to. The academics of the second school criticizing consensus-building is in agreement to this point. For example, Morales (2003) cited that consensus in the actual regulatory process never really reflects agreements of all those affected by regulatory policy. (p. 187) This is in addition to the most important point which is the argument that consensus actually pushes participants away from squarely confronting the most pressing problems and instead shifts their efforts to less important problems where agreements is more likely. (p. 187) I am not saying the consensus is a bad strategy in itself. I am merely disagreeing with the way Hacker has considered it as the all-encompassing solution to passing the health coverage reform policy. But if America would follow this strategy exclusively, then the future of medical care can either have a watered-down reform policy or a long process of negotiations and bartering that may end up with nothing. Taking everything into consideration, with Hacker’s position, the insights provided by our political policymaking history and my personal perspective as a health care consumer and professional, there is a need for a multidimensional policymaking strategy instead. Rather than having to design policy in a manner that addresses one issue alone such as politics, policymakers should adopt a strategy that both covers the political and policy areas. We cannot achieve a meaningful consensus if the policy design is weak or if the executive department does not have any leverage over the Congress or the public is antagonistic to the plan. Hacker, hence, provided a one-dimensional case that, although may have sufficient evidences, is still incomplete to address that multi-faceted issue of health care and the multidimensional American political system. References American Planning Association (APA). (2006). Planning and urban design standards. Hoboken, NJ: John Wiley and Sons. Biggs, S. and Helms, L. (2007). The practice of American public policymaking. New York: M.E. Sharpe. Castles, F., Wildenmann, R., Lehner, F. and Schmidt, M. (1988). Managing mixed economies. Berlin: Walter de Gruyter. Hacker, J.S. 2008. “Putting Politics First.” Health Affairs, 27(3): 718-723. Morales, A. (2003). Renascent pragmatism: studies in law and social science. Burlington, VT: Ashgate Publishing. Whittington, K., Kelemen, D. and Caldeira, G. (2010). The Oxford Handbook of Law and Politics. New York: Oxford University Press. Read More