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© 2008 Delmar Cengage Learning.
Chapter 4
Congress
Mark A. Peterson
© 2008 Delmar Cengage Learning.
2
U.S. Congress: A Unique Institution
• Few other legislatures play such a powerful role when it comes to initiating policy
• Accords with the “consensus” model of policy making– Interests must bargain with numerous
institutional actors in order to achieve positive outcome on any given issue
© 2008 Delmar Cengage Learning.
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U.S. Congress: A Unique Institution
• Lack of competing national (unifying) institutions– Tradition of bureaucratic government ensures
Congress retains powerful role in policymaking
© 2008 Delmar Cengage Learning.
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The ChangingFace of Congress
• Party unity/discipline has changed over time– Generally lower than in majoritarian systems
• House started 20th century as a highly centralized institution– Power gradually decentralizing over time – Up to the 1990s
© 2008 Delmar Cengage Learning.
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The Fate of Health Care Reform in Congress-1
• National health care reform legislation first introduced (gingerly) by Robert Wagner in 1939
• President Truman made health care reform a priority– Further reform attempts were made in the
1970s – Most recently, in 1993-’94
© 2008 Delmar Cengage Learning.
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The Fate of Health Care Reform in Congress-1
• Not a single piece of health care reform legislation ever made it to the stage of debate on the floor of the House or Senate
© 2008 Delmar Cengage Learning.
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The Fate of Health Care Reform in Congress-2
• Despite Democratic majorities in mid-20th century and party leadership commitment to health care reform– Party cohesion in Congress was low
throughout the period
© 2008 Delmar Cengage Learning.
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The Fate of Health Care Reform in Congress-2
• Conservative southern Democrats managed to scuttle reform efforts through the mid-1960s
• Next, the American Medical Association (AMA) became an obstacle to reform
© 2008 Delmar Cengage Learning.
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The Fate of Health Care Reform in Congress-2
• Newer groups such as the National Federation of Independent Business (NFIB) led interest group opposition to health care reform legislation over time
© 2008 Delmar Cengage Learning.
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Presidential Strategy and Health Care Reform
• President Clinton waited too long to unveil reform plan– Too close to the midterm elections
• Ordering of process also proved faulty– Administration hoped to prevail in the House
before moving on to the Senate but this did not work
© 2008 Delmar Cengage Learning.
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Presidential Strategy and Health Care Reform
• Lengthy (secretive) process of formulating reform plan gave interest groups time to galvanize members against it
• Intensity of opposition generated greater than expected enthusiasm among natural allies
© 2008 Delmar Cengage Learning.
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Chapter 4 Summary
• Congress is unique among the legislatures of the world
• Structural profile of Congress has changed significantly over time
© 2008 Delmar Cengage Learning.
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Chapter 4 Summary
• Congress has often served as the graveyard of health care reform legislation
• Clinton health care reform package died largely as a result of poor legislative strategy
