The problem of healthcare reform is topical for present-day society. The President wants to change the whole system of healthcare with the purpose to create a universal healthcare system. The aspects of the project planning and practice performance are linked to the attitude of society towards the resolved problem. One part of the society is against the reform claiming to numerous problems created by its implementation, another part of the society supports the idea pointing to its profit.
The main purpose of this paper is to analyze the problem of healthcare reform, which was raised in the documentary Obama’s Deal, and to evaluate the impact of lobbyists’ efforts on the legislative process. The documentary sheds light upon the debates between the President, other political powers, insurance companies, drug manufacturers, attorneys, and medical workers which were lobbying the interests of their groups to cut a deal and pass the law. One more important theme developed by the author is Obama’s contribution to the legislative process and evolution of the public opinion concerning the current President and his program. The narrator’s comments interrupting the actual debates help raise the spectators’ awareness of the problem and need to be taken into consideration for critical evaluation of the speakers’ words and comprehensive analysis of the situation. Viewing the law from the perspectives of various interested parties, this film is effective, enabling a spectator to get an insight into the existing alignment of forces, their interaction, and the consequences of the healthcare reform.
Reform Review and Attachment to the Concepts
The key point of the movie is the discussion of Barack Obama’s initiative on the matter of establishing the universal healthcare system. On the one hand, this initiative is a brilliant idea which should not be delayed. On the other hand, most consider this idea as an enormous financial investment and lobbying of the interests of particular politicians’ groups. The idea of universal health care was discussed in the 1990s within Bill Clinton’s administration. Chris Jennings, Clinton’s health care advisor states that the problem in the 1990s was not solved due to several reasons. Clinton understood that the idea was in the air but he could not solve it. Still, it was obvious that there was no sense in delaying the implementation of the reform (Kirk, Gilmore & Wiser, 2010). However, the political community and the attitude of the US society towards the problem, in general, makes the President and the followers of this idea similar to population-at-risk. Hence, it is explained by the fact that various innovations are often criticized, and if people see or hear something strange, they need to discuss it. Innovations and their evaluation need to be culturally sensitive to the population at risk. This principle is described in detail by Chin (2005):
Community-based participatory research (CBPR) techniques include the community as true partners in the research process to accomplish these goals are promising and have attracted significant attention, exemplified by rising interest by journals in this work. In CBPR, the community is involved as an equal partner in all aspects of the research process including choosing the research question, designing and implementing the study, analyzing and interpreting results, and disseminating findings (p. 448).
It should be emphasized that the actual importance of the traditional values of innovations is closely connected with the necessity to attract those who are interested in innovations. Nevertheless, it may be regarded as lobbying of others’ interests (Kirk, Gilmore & Wiser, 2010). Thus, those “others” will be regarded as the population-at-risk, as they are heading against the general mass of political and social forces which are against innovations.
Movement Analysis
The circumstances that initiated the social movement are closely connected with the historical aspects of healthcare reformation. The reformation is explained by the necessity to adjust the mechanisms of healthcare regulation and to implement innovative insurance principles (Kirk, Gilmore & Wiser, 2010). Because universal healthcare presupposes the universal coverage of the population with a sufficient level of medical services by combining the regulation mechanisms for health financing and providing medical services, it means that everybody should buy insurance. On the one hand, it seems that the insurance system will be one of the ruling forces for the reform; on the other hand, healthcare reformation presupposes the reformation of insurance system which is not supported by insurance companies, as Jonathan Cohn states (in Kirk, Gilmore & Wiser, 2010). As it is claimed by Gorin (2009):
Why not regulate our health care system and extend coverage to people without insurance? Government provision of health care promotes what economists call moral hazard. Moral hazard occurs when insurance insulates or protects individuals from the consequences of their actions. In terms of health care, if individuals know that the government or an insurance company will pay their bills, they will be more willing to engage in reckless behavior than they would if the burden of cost fell to them (p. 4).
The actual importance of the reformation initiation may be explained by a strong necessity to adjust the healthcare system towards the realities of the contemporary world. This decision made Obama bet his presidency and even mid-term elections, as it is not supported by the political majority, and most of his opponents and even political followers are against this idea (Kirk, Gilmore & Wiser, 2010).
The beginning of the process is featured with the initiative by the US President and the powerful opposition by political opponents. David Nexon, former Kennedy Aide is sure that in the state of recession after the crisis, the country cannot afford any big spending program (in Kirk, Gilmore & Wiser, 2010). While some consider this initiative as lobbying of commercial interests, Obama’s followers claim that this will make the healthcare system more effective and reliable. This may be explained by the requirement to coordinate the efforts by various components in the sphere as healthcare is mainly represented by a private sector. Hence, the insurance system is the ruling force for healthcare development. Additionally, it is regarded as the motivational factor to develop the private sector and to offer high-quality services in the insurance companies. Nevertheless, if the system is subjected to reforms, the healthcare private sector, as well as insurance factors, will be obliged to adjust the service sphere towards the innovative norms which entail the coordinated single regulation of the entire sphere (Kirk, Gilmore & Wiser, 2010).
The key participants of the reformation process represent the interests for or against the healthcare reform. Thus, the participants who support the idea are the two liberal groups — Health Care for America Now and the National Physicians Alliance. These groups realize the utilization of the offered reform and presuppose that the high costs required for the proper implementation of the plan are quite reasonable. In reality, lobbying of commercial interests is the inevitable part of any reform. Some participants in the discussion lobby the interests of those who do not wish to improve the existing situation, while others wish that commercial interests were regarded as the motivational factor for business, insurance, and healthcare development (Tumulty, 2009).
The discussion initiated between the mentioned groups on the one hand, and the group of critics headed by Thomas Andrew Daschle on the other hand, has ended with the start of the program implementation. The initiative is strongly supported by a group of veterans. Daschle and the group of democrats found numerous miscalculations and weak links in the taxation aspect of the program. The entire investment purpose is closely associated with the traditional representation on the matters of speaking for particular groups. Hence, while the healthcare reform efforts are in the confrontation point of commercial and political powers, all the discussions will be based on the principles of satisfying the interests of commercial groups and the necessities for the US Community. The actual result of all the negotiations has led to the impossibility of a direct deal between the President and the congressional representatives. Hence, as it is emphasized by Tumulty (2009):
Obama has gotten this far in part because he has put off the thorniest questions of who should pay and how big a role government should have. These, he says, are the issues that deepen “some long-standing ideological divisions in our Congress and, frankly, in our society.” They are also the ones that have defeated Presidents who have tried to solve the problem, going back to Teddy Roosevelt. But what looked like shrewd politics early in the process is increasingly being viewed on Capitol Hill as a failure to lead (para. 5).
Current Status
The status of the deal and the movement, in general, has entered the phase of initiative implementation. Even though medical groups were afraid of lowering the costs of financing the medical sphere by the government, they should realize that this reduction is associated with the reformation of the insurance system. Still, medical workers will not be left apart. The financial support of the reform is based on the necessity to change the entire approach towards providing medical services and unification of the separated elements of healthcare. The current status of this unification is in the discussion phase.
Conclusion
The discussion, in general, is rather effective, as all the aspects of possible reformation are discussed in detail and the opinions of all the parties are expressed. The aspect of lobbying is represented from the perspective of analyzing the interests of the medical sphere, drug manufacturers, attorneys, insurance companies, and political powers. Most of them agree to support the President. Still, some groups represent their interests and try to find weak points in the presidential initiative.
The views that could be changed after viewing the documentary are associated with the aspects of courage and determination of the President. Any solution, no matter whether it is successful or not, creates numerous discussions. Hence, the President’s decision aimed at making the healthcare system more effective impresses. Another important advantage of the documentary is an analysis of the motivation and methods of most of the lobbyists’ groups. The documentary helps get rid of misconceptions concerning the impact of the reform on the population-at-risk and other interested parties. Emphasizing the importance of reformation in all spheres involved in the reformation process due to their interdependence and interconnection, the author makes the spectators’ understanding of the reform more comprehensive.
References
- Chin, M. (2005). Populations at risk: a critical need for research, funding, and action. Journal of General Internal Medicine, 20(5), 448-449.
- Gorin, S. (2009, February). ‘Long time coming: are we on the brink of universal health care coverage? Health & Social Work, 4-7.
- Kirk, M., Gilmore, J., & Wiser, M. (2010). Obama’s Deal. Fronline PBS.
- Tumulty, K. (2009, July 30). Can Obama close the deal on health care? Time.CNN.