In this context,
the 2010 Affordable Care Act (ACA) reflects a major accomplishment. Yet, it has not resulted in universal
coverage nor made much of a dent in health care costs. In “The Road to Somewhere: Why Health Care Reform Happened?” Jacob
Hacker poses two questions to be addressed in this paper: “(1) Why, after
nearly a century of defeat, did health care reform pass in 2010?” and “(2) Why,
nonetheless, was the legislation so limited compared with the scale of the
problems it addressed and with the aspirations of reformers?” Your paper should
provide an explanation for why it took so long for the U.S. to adopt comprehensive
health care reform, why it was finally able to pass in 2010, and why it passed
in a form that built on the existing hybrid system of public and private
insurance – rather than replacing it with something like a single-payer system
– and contained no promise of guaranteed universal coverage and few binding
cost control measures.
Structure: The paper should be 5-7 pages, double-spaced
in Times New Roman font. Make sure to include a title page (which is not part
of the page limit) and page numbers. you should include a “Works
Cited” page and reference sources cited in the text in your paper in
parentheses. This is the Author-Date
form of citation in the Chicago/Turabian style manuals.
You should provide an
introductory paragraph that contains a clear, concise thesis statement of what
you are going to argue.
The next part of your paper
should provide a brief “literature review” that summarizes the major theories
or schools of thought explaining why the U.S. has a more limited welfare state
compared to other countries. Here you
should reference the course readings (For an example of a more
lengthy literature review see Hacker’s “The Historical Logic of National Health
Insurance” article, pg. 60-80 or Steinmo and Watts’ article, “It’s the
Institutions Stupid”, pg. 331-336.) You
should give a paragraph or two for each school of thought (not each individual reading), but your overall literature review
shouldn’t be much longer than two pages.
Focus on the core arguments of each school of thought and author.
The next and most important part
of the paper should provide an argument addressing the three questions posed
above – why did health care reform take so long to achieve, why was it finally able
to pass in 2010, and why did it pass in the form that it did? You can choose to argue in favor of one of
the theories from the literature review or combine several of them (as Hacker
does). Whichever route you take, make
sure you are situating your argument in the literature covered in the
literature review – e.g. which school(s) of thought you think the passage of
the ACA undermines (or are simply not helpful in understanding it) and which
schools of thought it bolsters. In this
section it is also very important that you back up your argument with references
to the political process of passing the ACA and specific provisions of the
bill. Addressing these three questions
should be the focus of the bulk of your paper.
For example, if you are making the institutional argument, you need to
show how the ACA managed to make it past institutional obstacles in the
legislative process and what impact this had on the policies in the ACA because
of the compromises necessary to get it through.
If you are making the cultural argument, you need to show how public
opinion shaped passage of the law and how American values impacted the content
of the law, etc.
In the conclusion, you should
address whether you think that policy-makers will continue to build on the ACA
or whether there is a chance it will still be repealed, in whole or in part,
and how your prognosis for the future reflects your overarching argument.
Readings to incorporate in lit
review:
Wilensky
Korpi
Lipset and Marks
Poen
Barr
King
Steinmo and Watts
Immergut
Hacker (Historical Logic…
article)
Use Oberlander and other Hacker
article for information on the ACA (Oberlander: Long time coming, hacker: the road to somewhere
(Please read the above instruction carefully, I will provide the sources and they should be used in order that they are written in the instruction – use all the sources. I will also attached the paper with th e feedback, please look into it carefully as well, and address the feedback according to the instruction above. )
