Interest Groups Reflection Papers.
Interest Groups Reflection Papers.
Complete this week’s assigned readings, chapter 72 After completing the readings, post a short reflection, approximately 1 paragraph in length, discussing your thoughts and opinions about one or several of the specific topics covered in the textbook readings pertaining to health policy and politics. Identify which one MSN Essential most relates to your selected topic in your discussion.
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See bellow for chapter 72 and see attached for MSN Essentials
Chapter 72 Interest Groups in Health Care Policy and Politics
Joanne R. Warner
“Politics isn’t about big money or power games; it’s about the improvement of people’s lives.”
Paul Wellstone
The ink from President Obama’s pen was hardly dry as he signed the Patient Protection and Affordable Care Act (ACA) into law before interest groups were considering how to stall or prevent its implementation. In fact on that very day, March 23, 2010, a suit was filed declaring the law unconstitutional. Included in the suit’s supporters were private interest groups such as Citizens United who objected to the law’s mandate to buy insurance or pay a penalty. A legal conclusion to their questions came in a June 2012 Supreme Court ruling upholding the individual mandate, but striking down the requirement for states to expand Medicaid (Clemmitt, 2012). The legislative journey for the ACA presents many examples of interest group influence, including the citizen activists’ organization Americans for Prosperity, who continue to cast doubts on the ACA’s merits, warning that the implementation is “chaotic and frustrating” (Peters, 2013, paragraph 4). What promises to unfold for the ACA is the robust involvement of interest groups vociferously defending their preferences in the structure and financing of America’s health care system.
Interest groups play a significant role in health care reform. However, they are a paradox within our governing system. We need and value them but at the same time they annoy and distract us. We embrace them as empowered citizen involvement, and we resent the perception of buying elections and votes. The love-hate ambivalence is born, in part, from the way a 1787 notion has translated into today’s Washington-centric political era. Democracy within our individualistic society presents inherent tensions that are both our genius and our burden.
An interest group is a collection of people who pursue their common interests by influencing political processes. They are also known as factions, special interests, pressure groups, or organized interests. The original definition depicted them as “united and actuated by some common impulse of passion, or of interest, adverse to the rights of other citizens, or to the permanent and aggregate interests of the community” (Madison, 1787, paragraph 2). The mere act of organizing presupposes “some kind of political bias because organization is itself a mobilization of bias in preparation for action” (Schattschneider, 1960/2005, p. 279). Today, federal, state, and local political arenas experience the activity of organized groups who influence elections, votes, societal opinion, and the policy process itself.
This chapter gives context to the duality of distrust and appreciation for interest groups while also portraying them as a significant feature of our governing system. It traces the historical roots of interest groups, describes their functions and methods, and concludes that they embody the good, the bad, and the ugly of governance. It also describes the contemporary terrain of health care interest groups as well as a discernment framework for interest group involvement.
Development of Interest Groups
James Madison’s The Federalist No. 10 (1787) forms part of his treatise on the preferred structure of a republic. He proposes that rather than removing the causes of factions, the best wisdom is to control the effects of interest groups. To do otherwise is to undermine liberty. The legitimate roots of interest group organizing are therefore traced to the framers of the Constitution and the birth of the American version of democracy. Later, the French philosopher Alexis de Tocqueville observed the country from an outsider’s view. His Democracy in America (1835) endures as a classic description of our inclination to form associations for common purpose and to create a vibrant political structure independent of the state (de Tocqueville, 1835/2010).
The impetus to organize exists not only within the American people but also within the political structure. Groups can influence policy through elections, lobbying the legislature, and pressuring the executive branch of any level of government.This diffusion of power presents many opportunities for persuasion. It also allows interest groups to shop for a different level of government if they are unhappy with policy; for example, federal versus state government (Anderson, 2011).
Historically, groups formed around interests such as slavery and alcohol prohibition. At the turn of the twentieth century, interest groups based in Washington blossomed. The social activism of the 1960s generated more groups focused on civil rights, the environment, and specific economic and humanitarian causes (Nownes, 2013). As the power and money of interest groups grew, Congress acted to restrict their influence and limit direct contributions to candidates. However, the reforms that grew from the Watergate scandal of the 1970s inadvertently enhanced their power by promoting the formation of political action committees (PACs). The Bipartisan Campaign Reform Act of 2002 (the McCain-Feingold Act) revised the Federal Election Campaign Act of 1971 to control soft money contributions, that is, funds funneled through political parties to candidates, and the funding of issues ads (Federal Election Commission, 2013a). For good or ill, special interest money continues to grease electoral and political wheels.
From this historical perspective, several kinds of groups are in existence today: the trade unions and business associations that advance their economic interests, and the groups representing newer social movements (Fiorina et al., 2009). Within the latter group, there are interest groups that provide information and are active in the current health care reform debate. Examples include the U.S. Public Interest Research Groups (USPIRG), who “stands up to powerful interest when they threaten our health and safety” or when big money dominates the dialogue (U.S. Public Interest Research Groups, 2013); Essential Action, which wages campaigns on topics not visible in the mass media or on political agendas including access to medicines and the global effort to reduce tobacco use (Essential Information, 2013); and the Center for Science in the Public Interest (CSPI), whose consumer advocacy in health and nutrition involves novel research, providing information, and ensuring that science and technology serve the public good (Center for Science in the Public Interest [CSPI], 2012). These examples demonstrate the enduring nature of interest groups juxtaposed as an evolving list of groups and issues.
When is an interest group not what it appears? Astute citizens and policymakers need to be aware of front groups whose public persona is that of an unbiased group but whose funds and agendas are from an industry or political party. For example, the Center for Consumer Freedom, which has a message of individual choice but is a front group for the restaurant, alcohol, and tobacco industries. This group opposes public health messages of science, health, and environmental groups, calling them a “growing fraternity of food cops, health care enforcers, anti-meat activists, and meddling bureaucrats who ‘know what’s best for you’” (Source Watch, 2009). The popular Get Government Off Our Back (GGOOB) campaign was also exposed as a tobacco industry front group that rallied diverse groups to oppose policy. Analysis of GGOOB suggests that knowing the source of a group’s funding can limit harmful misrepresentation and highlight how ideological arguments can diminish the power of solid science and research in policymaking (Apolionio & Bero, 2007). The presence of front groups calls each consumer to vigilance about the bias and intention of groups who advocate and provide information. Interest Groups Reflection Papers.
Interest Groups Reflection Papers.