Democracy and Public Agenda - Essay Example

Democracy and Public Agenda of The system and delivery of health care are issues for academic research and repeated public discourses. Governments across the globe view health care as an important policy area and make efforts to influence, control, or manage the delivery of health care services. Discussions about who should be granted access to health care, the terms and conditions, and how it should be financed are common in almost all democratic societies (Smith & Moore, 2011). This essay analyzes the democratic concepts and principles embedded in the proposed Medicaid expansion.

As stated in the original proposal, Medicaid, which is a U.S. health insurance program for poor individuals and families, would undergo expansion to cover more low-income Americans. States that declined to take part in this expansion would lose federal subsidy for their existing Medicaid projects (Smith & Moore, 2011). The proposed expansion of Medicaid is consistent with the Universal Declaration of Human Rights’ Article 25, which states that “everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services” (The United Nations, 1948, para 25).

It is also compatible with the democratic principle that all individuals have specific basic rights, such as access to health care services. The main objective of democracy is to safeguard such rights (Machan, 2005). However, the opinions of numerous Americans on this issue are conflicting, which suggest that the public has not yet reached a ‘collective self-determination’. However, what is evident here is the existence of a ‘public discourse’. Majorities believe that the health care system has to undergo comprehensive reforms, and many argue that it is the obligation of the government to make sure that everybody has sufficient access to health care.

However, opinions differ when it comes to the possible costs of an expanded Medicaid (Smith & Moore, 2011). Even though there is a clear absence of consensus on the issue, the mere presence of a ‘public discourse’ makes the entire endeavor democratic. As stated in the article of Robert Post (2006, 28):If we use the term public discourse to refer to the communicative processes by which public opinion is formed, we can say that the public discourse continuously but unsuccessfully strives to mediate between individual and collective self-determination to produce “a common will, communicatively shaped and discursively clarified in the political public sphere” (Habermas, 1987, 81).

However, through public discourse Americans were able to reach a collective perception that lack of sufficient access to health care is the most important health issue at present. The public is now worried mainly about medical coverage (Smith & Moore, 2011). The tackling of the issue of Medicaid is thus far democratic in the sense that the state allows its citizens to take part in the issue through expression of public opinion. By drafting legislation for the expansion of Medicaid, the state made it known to the public that it is responsive to their opinions and beliefs.

The expansion of Medicaid is still largely debated. Nevertheless, the decision making process is influenced mainly by two democratic principles and concepts—protection of basic rights (e.g. health care), collective ‘self-determination’, and public discourse. ReferencesMachan, T. (2005). The Right to Private Property. Internet Encyclopedia of Philosophy. Retrieved from http://owl.english.purdue.edu/owl/resource/560/10/Post, R. (2006). Democracy and Equality. Faculty Scholarship Series, Paper 177, 24-34.

Retrieved from http://digitalcommons.law.yale.edu/cgi/viewcontent.cgi?article=1176&context=fss_papersSmith, D. & Moore, J. (2011). Medicaid Politics and Policy. New Brunswick, New Jersey: Transaction Publishers. The United Nations (1948). The Universal Declaration of Human Rights. Retrieved from http://www.un.org/en/documents/udhr/