Health Care History Lesson

nobull

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Sep 27, 2010
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History Lessons...Based on Washington’s record of health policymaking, ending or rolling back Obamacare is hardly implausible. The Medicare Catastrophic Coverage Act of 1988 (H.R. 2470) was enacted with huge bipartisan support in both the House and Senate and repealed one year later. The 1,342-page Clinton plan of 1994, its enactment initially considered inevitable, was brought to a grinding halt in the fall of 1994 and collapsed on the Senate floor. In both cases, despite positive support in early polling, a majority of Americans found the provisions of these proposals unacceptable.

In the case of Obamacare (enacted and modified as the Patient Protection and Affordable Care Act of 2010), its broad policy themes, such as protection of individuals from coverage exclusions because of pre-existing medical conditions, were also initially popular, but that popularity does not automatically translate into support for the law itself, which has been bedeviled by public scrutiny of its detailed provisions. Focus on troubling legislative details, combined with a spectacularly repulsive process of logrolling in the Senate, fueled a fearsome public backlash, and the massive national health legislation quickly lost popular support. Toward the close of the congressional debate and the bill’s narrowly partisan enactment in March 2010, opposition solidified. Since that time, major surveys have registered continued dissatisfaction and strong support for repeal.

In all three instances, the American public was on the receiving end of a series of unpleasant revelations and regular reports of unforeseen or unintended consequences.(the problem is in the details) In two out of three cases, liberal health care proposals failed. In the case of the Patient Protection and Affordable Care Act, despite its narrow legislative success, the powerful political dynamics that contributed to the Medicare Catastrophic Coverage Act debacle and the collapse of the Clinton health plan are very much in play.

Doug
 
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