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

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

4 CONGRESS AND HEALTH CARE

Congressional Structure and Process

Comparing the House and the Senate

In the opening chapter we saw that one of the explanations for the failure of health care reform was the structure of government. In this section we briefly look at some structural features of the House of Representatives and the Senate and how they have an impact on policy making.

An important difference between the House and the Senate is size. The Constitution requires that each state have two senators, so the Senate has 100 members. The size of the House has been fixed in law at 435. Size differences lead each house to develop rules and procedures that affect how they operate.

Because the House is much larger than the Senate, it has adopted rules to make it more orderly. Bills that come to the floor of the House must be accompanied by a rule stating what and how many amendments may be made to a bill and limiting the amount of debate. It is unlikely, therefore, that without leadership support, a nongermane amendment (one not directly related to the bill) could be added. This makes the Rules Committee important, and congressional leaders of both parties sit on that committee.

The Senate is smaller and more informal than the House. Bills that make it to the floor of the Senate have no rules attached to them. Senators can add amendments on the floor and debate is usually unlimited. This allows a small group of a bill's opponents to delay Senate consideration by holding on to the floor through a filibuster.

The Senate has a procedure to end debate, called cloture. Ending debate requires a positive vote by sixty senators. In the 103d Congress ( 1993-94), the Democrats did not have sixty votes. In the 104th Congress ( 1995-96), the Republicans did not have sixty votes.

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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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