Good Morning,

Please respond to the below post to a classmate. It only has to be 1-3 references of our own but not the same ones used in the post. A quick response, nothing fancy, this is easy money. The purpose is to give feedback, see the attached document for the sample reponse.


1a. Share your opinion: Did the policy leaders use the utilitarian premise of “The end justifies the means” to get the policy known as Obamacare passed?  

Policy leaders did use the utilitarian premise of “The end justifies the means” to get Obamacare passed.  After years of failures with health care reform, enactment of the Patient Protection and Affordable Care Act was done in 2010. Obamacare learned from prior failures and made sure to correct those mistakes so it would not be a failure again.  The most important decision that reformers made in 2009 was to work with, rather than against, health system stakeholders (insurance companies). The Clinton administration fought an unsuccessful two-front war against the insurance industry and the small-business lobby. In 2009, the Obama administration stopped any stakeholder opposition. The administration negotiated deals with health industry groups to support reform in exchange for the promise of newly insured patients to treat. These deals included promises from Pharmaceutical Research and Manufacturers of America (PhRMA) and the American Hospital Association to contribute to health reform financing through reduced Medicare and Medicaid payments (Oberlander, 2010)

b. Was the leadership justified in their actions?   Locate at least one other source that agrees with you, and in a couple of sentences provide a summary of the supporting position.

Leadership was not justified in their action.  Even though Obamacare was passed it was not passed in the right way.  First Nancy Pelosi passed the bill using a technicality. Democratic majority leader in the House of Representatives was unable to pass their version of a healthcare law. Because all revenue bills have to originate in the House, the Senate found a bill that met those qualifications: HR3590, a military housing bill. They essentially removed the bill of its original language and turned it into the Obamacare (Sussman, 2013) Using this type of deception might work in the short term, but in the long run American people will not accept this. This was seen in 2014 midterm, when Twenty-eight Senators who voted for Obamacare were out of Senate for one reason or another (Brown, 2014)

c. Locate at least one other source that disagrees with you, and in a couple of sentences provide a summary of the opposition position.

Healthcare cost has been on the rise and if Obamacare did not get passed the United States would be unable to maintain its healthcare expenditures.  As leaders, it was important to get this bill passed to protect the American people. Obamacare includes a number of cost cutting measures which have led to health care spending growing at the slowest rate on record (since 1960) in 2014.  The healthcare system cost nearly $3 trillion and per capita spending about $9,000, but the ACA’s provisions were expected to cost more at first but curb premium growth, health care consumer spending, and industry spending over time. The US healthcare system is the most expensive in the world. That is due to many factors including the quality of our care, the general cost of things in America, the amount of people employed by healthcare system, and general fraud, waste, and abuse. The ACA tries to address every aspect of these problems (Obamacare, 2016).

2. Describe another situation as an example of a case when you think it can be said that “lies, damned lies, and statistics” were used to create (or stop) health care policy?

The President’s recent budget includes a $1.8 billion request from Congress to respond to the Zika virus, which is a mosquito-borne illness discovered in Uganda in 1947 but has since spread across Asia and to the Americas.  The association of the Zika virus to microcephaly is small, but because of the recent media coverage this has come into mainstream news. In fact, it is interesting to see that there is a 40 times higher chance of microcephaly in United States then in Brazil after appropriate adjustment for population size and other factors (Thomas, 2016) Based on the fact that the Zika virus was only found in 17 cases of microcephaly in Brazil, and Zika did not cause the 25,000 cases of microcephaly in the United States; it is obvious that Zika is a very unlikely cause of microcephaly. There must be other causes, which need to be explored both in Brazil and in the United States (Stone, 2016)

3. Suggest a philosophical premise that you think provides a better basis for making public policy.

Compassion creates a better basis for making public policy. People area the driving force for compassion.  The foundation of caring is the willingness to deal with our vulnerable and mortal human condition in a humane way. The philosophy that helps spelling this out should be part of any public policy (Leget 2015).  Economy began to reign over healthcare and this lead to the role of compassion shifted from a central organizing value to a commodity (Hochchild, 1983)

Kingdon’s Analysis.

The Affordable Care Act (2010)

Problem Stream: What can be done to provide better health care to the uninsured in the United States? The United States is the highest spender on health care (OECD Health Data; 2015) Data from the OECD show that the U.S. spent 17.1 percent of its gross domestic product (GDP) on health care in 2013. This was almost 50 percent more than the next-highest spender. Despite its high spending on health care, the U.S. has poor population health (OECD Health Data; 2015)  The U.S. had the lowest life expectancy at birth of the countries studied, at 78.8 years in 2013, compared with the OECD median of 81.2 years.

Policy Stream:

ACA would deal with all factors of health care in the United States. This includes quality, cost, waste and abuse. This stream is discussed further in question 1c.

Political Stream:

Democratic party majority in power.  This stream is discussed further in 1a.

“Window of opportunity” opened because the political stream was gotten from the White house, the Senate, and the House being controlled by the democratic party and issue of rising cost of health care in United States.





Oberland, Jonathan; Long Time Coming: Why Health Reform Finally Passed Health Affairs 29, no.6 (2010):1112-1116 doi:10.1377/hlthaff.2010.0447

Brown, Tim; November 10, 2014; Freedom Outpost;  Obamacare Architect: “The Stupidity of the American Voter” Helped us Pass the Law;  Retrieved June 23rd 2016; http://freedomoutpost.com/obamacare-architect-stupidity-american-voter-helped-us-pass-law

Sussman, Brian; How Obamacare Became Law; Retrieved June 23rd 2016; http://www.briansussman.com/politics/how-obamacare-became-law/ 

Obamacare 2016; How Does Obama care control cost; Retrieved June 23rd 2016; http://obamacarefacts.com/obamacare-control-costs

Stone Jim,  Ford Kathy, The Fullerton Informer, Jim West, Martin Maloney, and Claus Jensen; “Zika Freakout: the hoax and the covert op continue,” Jon Rappoport’s Blog, 1/29/2016. https://jonrappoport.wordpress.com/2016/01/29/zika-freakout-the-hoax-and-the-covert-op-continue/ 

Leget, Carlo; Why Good Quality Care Needs Philosophy More Than Compassion Comment on "Why and How Is Compassion Necessary to Provide Good Quality Health” Int J Health Policy Manag. 2015 Oct; 4(10): 677–679.

Hochchild A. The Managed Heart: The Commercialization of Human Feeling. Berkeley: The University of California Press; 1983.

Organization for Economic Cooperation and Development, OECD Health Data 2015 (Paris: OECD, June 2015).



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