The History and Process of Health Policymaking in the U.S.

The History and Process of Health Policymaking in the U.S.
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Various social, political, cultural, and economic elements all have an impact on the evolution of health policy. These variables may affect the objectives, structure, procedure, and results of health policy. Health policy is influenced by many different organizations and individuals, including public opinion, political parties, interest groups, the media, professionals, and policymakers (Gordon, 2003). However, economic and political considerations generally take precedence when deciding which policies to accept, execute, and assess.
The 1965 U.S. Medicare program is an example of how politics and economics shaped health policy. Medicare covers seniors, people with disabilities, and people with chronic conditions. President Lyndon B. Johnson’s Great Society sought to reduce U.S. poverty and inequality (Starr, 2018). The American Medical Association (AMA) opposed Medicare because it would cut into their autonomy and income; the private insurance industry opposed it because it would cut into their market share and profits, and some conservative politicians opposed it because they feared it would expand the role of the federal government and increase taxes (Oxford Bibliographies, 2020). These organizations launched a public relations campaign, organized grassroots opposition, and lobbied members of Congress in an effort to derail Medicare.
The American Medical Association (AMA) launched Operation Coffee Cup in 1961, symbolizing this resistance (Braunold, 2022). Thousands of vinyl recordings with a speech by Ronald Reagan, who was then an actor and a spokesperson for the AMA, were distributed as part of the campaign. The speech expressed concern that Medicare might eventually result in socialized medicine and put Americans’ liberties at risk (Longest, 2016a). The AMA requested that its members send letters to their legislators in Congress and play the recordings at coffee gatherings with their friends and neighbors. Medicare’s approval was delayed by four years thanks to the campaign, but the effort backfired by increasing popular support for the program.
Ultimately, a political opening presen...