The Agenda Setting which led to the Patient Protection and Affordable Care Act
Agenda setting is the process that determines appropriate solutions to a certain problem of a given field (Kingdon, 3). The process itself consists of three streams: problems, policies, and politics (Kingdon, 16). These separate streams interact when windows of opportunity are open – solutions are fitted with problems, and the impetus for this relationship is amenable political forces (Kingdon, 20). Prominent agendas are determined by the problem or political streams, while solutions are crafted in in the policy stream (Kingdon, 20). In the field of health care, the agenda setting is based upon the high number of uninsured citizens, the rising cost of medical care, the development of Patient Protection and Affordable Care Act (PPACA) in response to this issue, and the key players that debate whether governmental involvement is the correct approach in the issue of universal healthcare.
In Kingdon’s framework, a problem of interest can be disclosed to the public via a change in indicator (17). In the health care system, the change of indicator is the rise in number of uninsured citizens (Cochran et al, 269). The access to health care is through health insurance, which in most cases is not easily attainable for those of low income (Cochran et al, 269). A person with no insurance is still capable of receiving care, albeit at a reduced quality, and by paying direct costs. This can lead to not receiving proper care from the medical staff, or the diminishing existence of safety net hospitals (Cochran et al, 269; Zwanziger and Khan, 494). Thus, insurance is an important factor in the well-being of citizens to gain access to high quality comprehensive medical care.
Since 2009, access to healthcare was believed to be one of the main problems facing the U.S., and many Americans originally believed that it was the government’s job to provide healthcare (Conway, 1). The government would not have acted without the perceived problems of costs, coverage, and consequences (Peterson, 430). The costs that led to this act were those of the government budget, businesses’ bottom lines, and the out-of-pocket expenses that individuals without coverage had to pay (Peterson, 430). The lack of coverage was visualized in several aspects, with one being the high amount of uninsured citizens. Another aspect involved was that healthcare providers benefited more than consumers; since individuals with pre-existing conditions were denied of coverage; the people who actually needed health insurance had to pay the full costs to receive help (Peterson, 430). The low quality of care provided, low international rankings for the U.S of overall health performance, and overall threat to population heath was part of the agenda setting that led to the PPACA (Peterson, 431).
The response to this issue culminated in the form of a new policy known as the PPACA. One main objective of the PPACA is to...