Politics, Power & Policy Making: The Case of Health Care Reform in the 1990s

By Mark E. Rushefsky; Kant Patel | Go to book overview

3
PRESIDENTIAL LEADERSHIP AND POLICY MAKING

The American constitutional system of government, with its separation of powers and checks and balances, reflects a strong antimonarchical conviction and distrust of a strong leader. Thus, it was designed to keep its leader, the president, in his place ( "The Search for the Perfect President" 1995). It is no surprise then that the American Constitution does not assign a significant role to the president and that his powers are stated very briefly. The Constitution makes him the commander-in-chief, yet he is not given the power to declare or finance war. He is given the power to negotiate international treaties and appoint ambassadors, federal judges, and other high-level executive officials with the advice and consent of the Senate, and he may grant pardons for crimes committed against the United States. Finally, the Constitution states that "he may from time to time give to the Congress Information on the State of the Union, and recommend to their consideration such Measures as he shall judge necessary and expedient" ( Constitution of the United States, Art. II, sec. 3). This suggests a very limited role was intended for the president in the policy-making process.

Yet presidents have intermittently been cast in the role of legislative leader. Especially in the twentieth century the president has been expected to act as chief legislator. He is expected to propose legislative initiatives, and Congress is expected to react and act on these initiatives. The conventional wisdom states that "the president proposes and Congress disposes." Presidential success in securing congressional approval for major legislative initiatives, such as Roosevelt's New Deal and Johnson's Great Society, has come to be regarded by some as the norm for presidential leadership in policy making. Others, however, have argued that such leadership expectations are too excessive and that examples of great presidential successes are rare, representing an unusual convergence of opportunities and presidential abilities.

In this chapter we first examine various theories of presidential leader

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Politics, Power & Policy Making: The Case of Health Care Reform in the 1990s
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • List of Tables and Figures ix
  • Preface xi
  • Acknowledgments xii
  • 1 - Setting the Stage 3
  • 2 - Health Care Reform Returns to the National Agenda: The Winds of Change 16
  • Conclusion 49
  • 3 - Presidential Leadership and Policy Making 51
  • Conclusion 86
  • 4 - Congress and Health Care 89
  • Conclusion 137
  • 5 - Interest Groups 140
  • Conclusion 169
  • 6 - The Role of the Mass Media in the Policy Process 173
  • Conclusion 209
  • 7 - Public Opinion and Health Care Policy 211
  • 8 - Politics, Power, and Policy Making 243
  • Chronology 255
  • References 273
  • Index 297
  • About the Authors 313
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