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The Politics of Health and Health Care


Politics has a strong influence on healthcare because major decisions that set the course for the whole range of specialists are made on higher levels (Patel & Rushefsky, 2014). Change of top-level executives and planners could result in shifts in healthcare policies, which can be either for the better or for the worse. Therefore, it is always a paramount task to track and review the reforms in healthcare outlining its key parameters and analyzing them.

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Timeline of Major Healthcare Reforms

After World War II, the government officials concerned themselves with the mental health of the veterans of the war. In 1945, Congress introduced it as National Mental Health Act, whose main stakeholders were veterans and their families suffering from mental illnesses induced by war and its consequences. It prioritized the treatment and diagnosis of such illnesses and created both interest and national financial support for the research in psychology and psychiatry.

In 1965, president Lindon B. Johnson introduced Medicare and Medicaid. The reform was initially proposed by Eisenhower in 1961 who held a conference on aging and social security where he outlined the need for better insurance. The newly created insurance policy addressed the security of the elder population and the people with low incomes, who became its primary stakeholders providing them with better access to healthcare.

Another major reform was the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) introduced by the U.S. Congress. The reform targeted a variety of issues concerning insurances for employed, unemployed, disabled, and served as an alternative healthcare plan to Medicare.

Further improvements to the sphere of health insurance were made in 1997. United States Department of Health and Human Services introduced the Children’s Health Insurance Program (CHIP), which addressed the poor insurance coverage of families with children who did not qualify for Medicaid due to their incomes being slightly above the requirement. The impact of this program proved to have both short-term and long-term improvements in access to health care among the stakeholders mentioned above (Committee on Child Health Financing, 2014).

In 2010, President Obama signed into law the Patient Protection and Affordable Care Act, which was initially introduced by Charles Rangel in the House of Representatives. “Obamacare,” as it was later nicknamed, identifies its main stakeholders in the face of insurers, and a whole range of populations with low and middle incomes. As a result of the enactment of the law, the year 2016 witnessed a 7% decrease in the uninsured population in the U.S (CDC, 2016).

Analysis of Major Healthcare Reforms

National Mental Health Act

The reform was adopted when the horrors of war still terrified the world, and many politicians were concerned with the help they could offer to those who suffered during the events. Now, the world has become relatively peaceful excluding the perturbations in the Middle East. Those issues still produce people in need of qualified medical attention in relation to their combat-associated mental issues.

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Medicare and Medicaid

The two insurances were introduced in the atmosphere of increasing healthcare costs and the rates of unemployment, which made politicians act on these problems. Today the issues are majorly addressed as more than 90% of the population participates in one or another insurance program (CDC, 2016). However, this burdens the federal budget, and improvements are still needed.


COBRA was to some extent a reaction to the problems that Regan’s economic reforms faced. As unemployment rates grew and insurances were terminated for former employees, the need for reform became obvious. Presently, unemployment rates are not that high, and the economy in the U.S. is rather stable. However, if the issues reoccur COBRA would help soften the blow.


CHIP was adopted in the atmosphere of controversy around Clinton’s health care plan of 1993 that was opposed by many for its excessive bureaucracy, and patient choice restriction. Currently, the complexity of the health insurance system and the choice of appropriate insurance plans could also be a problem.

Affordable Care Act

Healthcare reforms were a major topic during the presidential elections in 2008 as insurances were still unavailable to many. Obama and Clinton both proposed their reforms and made them one of the central points of their campaigns. Today the coverage issue is mostly tackled, but now is the budget, service range and quality are the issues.

Politics, Health and Healthcare

Public health is a topic that seems to have always persisted in U.S. politics. As a capitalist nation, America has to ensure that its citizens stay healthy enough to continue their active participation in the economy by being employed, paying taxes, buying and producing goods and services. Therefore, the politician who can devise the best healthcare policy often gets a higher appraisal.

On the other hand, insurance is a huge business, which developed into a considerable lobbying force. A certain portion of politicians may advocate for one or the other health insurance scheme in order to gain the support of the insurance corporations. Some party is always interested in making a profit even under the cover of caring for the health and wellbeing of citizens.


All things considered, health and healthcare are extremely politicized. A lot of changes were made to this sphere of life over almost 80 years, and it still undergoes reforms. The above-mentioned reforms are some of the most influential since the 1940s. The review of these reforms helps connect the dots and observe the present state of healthcare in order to enlighten the path towards further enhancements.

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Centers for Disease Control and Prevention (CDC). (2016) National health interview survey, January to June 2016. Web.

Committee on Child Health Financing. (2014). Children’s Health Insurance Program (CHIP): Accomplishments, challenges, and policy recommendations. Pediatrics, 133(3), e784-e793.

Patel, K., & Rushefsky, M. E. (2014). Healthcare politics and policy in America. Public Integrity, 17(1), 94-96.

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