Breaking the Taboo
Chapter 7: Beyond vertical interventions
Breaking the Taboo
Health care reform has been one of the most debated and visible projects of President Obama. Of course President Obama’s interest in health reform was not new for the country, as literally dozens of plans and programs have been proposed to increase access to health care and reduce its cost, starting during the Great Depression. A common problem has been that, until President Obama, no president had a sufficient mandate to enact comprehensive health system reform. What then happened was that there was stalemate after stalemate as factions of both the public and Congress fought to a draw – with no side willing to compromise enough in order to enact meaningful legislation. Though President Obama was able to convince Congress to enact comprehensive reform, the story did not end there. The opposition chose not to leave the field and accept major changes to the health system, but to continue to fight – this time, in order to obstruct implementation which, in many dimensions, was left to the individual states. There was also a case brought before the US Supreme Court over the law’s constitutionality. The High Court finally ruled during the Summer of 2012 that, for the most part, the reform is consistent with the nation’s Constitution. Though opponents have been defeated by Congress and by the Supreme Court, health reform is still strongly opposed at the national and state levels, and it is not entirely clear if the reforms can actually be implemented nationally.
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