Academic journal article Generations

Health Reform, Politics, and Conflict: Is This Any Way to Serve America's Elders?

Academic journal article Generations

Health Reform, Politics, and Conflict: Is This Any Way to Serve America's Elders?

Article excerpt

The debate over healthcare reform is not over, and issues of reform remain controversial. To educate the public, professionals in aging must stay informed, filter political rhetoric, and synthesize complex information.

When asked to contribute to this edition of Generations with commentary on the political climate surrounding the passage and implementation of the Patient Protection and Affordable Care Act (ACA), I struggled to find the right approach. The assignment requires in-depth, expert analysis to dissect what was happening as the debate rolled (some might say dragged) along.

I have done my best to synthesize my thoughts into story form, but want to begin with a couple of disclaimers. First, it is necessary and appropriate to approach health reform with a sense of humor. Humor helps lighten the examination of the often chaotic approach this country takes to addressing serious problems. Believe it or not, this method has worked well for some time now, and I hope it will continue to be successful. Second, no matter where you stand on this debate, it is important to remember that the parties involved are pursuing what they believe to be valid and appropriate points of view.

But it has not been pretty to watch.

If I were to analyze all that went on in the health reform debate, it would require applying a number of disciplines. Certainly, the skills of a political scientist would be useful. The legislative strategies and machinations of Congress generated considerable argument and public foment. It would be helpful to understand the reasoning behind the strategies of the political parties, which seemed to have a tremendous impact on the conduct of the debate.

The skills of a semanticist, especially one studied in communications and media, would also come in handy, as the rhetoric was so heated and voluminous that it was hard to follow-even for the well-informed and dedicated observer. The language was so florid and the statements so frequently disconnected from fact that a follower of the process could reasonably conclude that the intention of much of the material was to mislead, inflame, or dissemble. Being a student of history might also be helpful, in that America has a long record of loud, undisciplined, and discordant debate on important public policy matters (the deficit, environmental policy, women's rights, going to war), the results of which are still uncertain.

But I'm not an academic, nor am I formally trained in any of the applicable fields. However, I will press on with one more caveat. Much of the conflict that occurred up to the passage of the ACA is ongoing. The attempt to manage and maneuver the legislative process inside Congress, and stimulate and manipulate public opinion, has simply moved on to a new phase. The situation is evolving even as this article is being written. By the time this issue of Generations is published, some of my observations will probably be off target, and some facts will have aged gracelessly. Then again, health reform is so complex and the debate so contentious, that maybe the situation will stay the same. Only time will tell.

Building the Healthcare Reform Beast

It is axiomatic that public opinion has to be shaped in order for it to be moved in any direction. The general public in the United States, like in most countries, is so involved in its day-to-day affairs that it is not thinking about how to frame a specific proposal to solve a specific problem. That is left to elected leaders. It is also incumbent upon whoever develops a proposal to tell the public why they want to do something, why they want to take a specific approach, and why their idea will work better than another.

In health reform, there were numerous challenges to be faced. For starters, healthcare- reformed or otherwise-is complicated. And almost everyone has some direct experience with healthcare: everyone has an opinion. Plus, peoples' beliefs are emotionally charged by the personal and anxiety-laden nature of the beast. …

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