Presidential Healthcare Reform Rhetoric

This book analyzes the rhetorical strategies employed by the four Democratic presidents, Truman, Johnson, Clinton and Obama, who tried to expand access to and affordability of healthcare in the United States. It considers how they made such arguments, the ethics they advanced, and the vision of America they espoused. The author combines rhetoric analysis, policy analysis, and policy history to illuminate the dynamic nature of the way American presidents have imagined the moral and social bonds of the American people and their exhortations for governance and policy to reflect and honor these bonds and obligations. Schimmel illustrates how Democratic presidents invoke positive liberty and communitarian values in direct challenge to opposing conservative ideologies of limited government and prioritization of negative liberty and their increasing prominence in the post-Reagan era. He also draws attention to the ethical and policy compromises entailed by the usage of specific rhetorical strategies and their resulting discursive effects.

One of the most persistent puzzles in comparative public policy concerns the conditions under which discontinuous policy change occurs. In Remaking Policy, Carolyn Hughes Tuohy advances an ambitious new approach to understanding the relationship between political context and policy change. Focusing on health care policy, Tuohy argues for a more nuanced conception of the dynamics of policy change, one that makes two key distinctions regarding the opportunities for change and the magnitude of such changes. Four possible strategies emerge: large-scale and fast-paced ("big bang"), large-scale and slow-paced ("blueprint"), small-scale and rapid ("mosaic"), and small-scale and gradual ("incremental"). As Tuohy demonstrates, these strategies are determined not by political and institutional conditions themselves, but by the ways in which political actors, individually and collectively, read those conditions to assess their prospects for success in the present and over time. Drawing on interviews as well as primary and secondary accounts of ten health policy cases over seven decades (1945—2015) in the US, UK, the Netherlands, and Canada, Remaking Policy represents a major advance in understanding the scale and pace of change in health policy and beyond.

Campaign rhetoric helps candidates to get elected, but its effects last well beyond the counting of the ballots; this was perhaps never truer than in Barack Obama’s 2008 campaign. Did Obama create such high expectations that they actually hindered his ability to enact his agenda? Should we judge his performance by the scale of the expectations his rhetoric generated, or against some other standard? The Rhetoric of Heroic Expectations: Establishing the Obama Presidency grapples with these and other important questions. Barack Obama’s election seemed to many to fulfill Martin Luther King Jr.’s vision of the “long arc of the moral universe . . . bending toward justice.” And after the terrorism, war, and economic downturn of the previous decade, candidate Obama’s rhetoric cast broad visions of a change in the direction of American life. In these and other ways, the election of 2008 presented an especially strong example of creating expectations that would shape the public’s views of the incoming administration. The public’s high expectations, in turn, become a part of any president’s burden upon assuming office. The interdisciplinary scholars who have contributed to this volume focus their analysis upon three kinds of presidential burdens: institutional burdens (specific to the office of the presidency); contextual burdens (specific to the historical moment within which the president assumes office); and personal burdens (specific to the individual who becomes president).

Citizens, political theorists, and politicians alike insist that political or partisan motives get in the way of real democracy. Real democracy, we are convinced, is embodied by an ability to form collective judgments in the interest of the whole. The Rhetorical Surface of Democracy: How Deliberative Ideals Undermine Democratic Politics, by Scott Welsh, argues instead that it is our easy rejection of political motives, individual interests, and the rhetorical pursuit of power that poses the greatest danger to democracy. Our rejection of politics understood as a rhetorical contest for power is dangerous because democracy ultimately rests upon the perceived public legitimacy of public, political challenges to authority and the subsequent reconstitution of authority amid the impossibility of collective judgment. Hence, rather than searching for allegedly more authentic democracy, rooted in the pursuit of ever-illusive collective judgments, we must find ways to come to terms with the persistence of rhetorical, political contests for power as the essence of democracy itself. Welsh argues that the impossibility of any kind of public judgment is the fact that democracy must face. Given the impossibility of public judgment, rhetorical competitions for political power are not merely poor substitutes for an allegedly more authentic democratic practice, but constitute the essence of democracy itself. The Rhetorical Surface of Democracy is an iconoclastic investigation of the democratic process and public discourse.

This comprehensive analysis of presidential immigration rhetoric quantifies the frequency, tone, and efficacy of public mentions of immigrants and immigration policy by the presidents from Washington through Biden. The book also explores the intersection of the presidential role with that of the other key actors in the immigration policy system—notably the press, the public, and Congress. For students of immigration studies, presidential studies, and political communication, this book also poses the question of which is of the greatest significance to the immigration policy agenda: presidential leadership making immigration a top priority or existing legislative support for comprehensive immigration reform.

The recent rise of “Medicare for All” in American political discourse was many years in the making. Behind this rise is a movement composed of grassroots activists and organizations that have been working for more than three decades to achieve the goal of establishing a single-payer healthcare system in the United States. In the past decade, the Single Payer Movement has grown and garnered more public and political support than ever before. This relative success cannot be attributed to any one political figure or political era. The story of how this happened, and how it is tied to a turn against establishment politics on both the left and right, as well as the rise of outsider politicians such as Senator Bernie Sanders, takes place during the Clinton, G.W. Bush, Obama, and Trump administrations. During each of these eras, activists experienced shifting opportunities that they interpreted through the telling of stories. These narratives of opportunity encouraged participation in particular forms of grassroots mobilization, which then affected the outcome of each era. This has had lasting effects on the development of healthcare policy in the United States. In this book, Hern conducts a political ethnographic analysis in which she uses historical records, interviews, and participant observation to tell the story of the Single Payer Movement, establish the lessons that can be learned from this history, and develop a framework—the Environment of Opportunity Model—that involves a holistic understanding of social movement activity through the analysis of narrative practice.

Named a 2013 Doody's Core Title! "With great timing, the editors of Rights-Based Approaches to Public Health offer a targeted and innovative strategy to combat global health problems. Balanced, comprehensive, and steeped in the historical traditions of human rights, the book persuasively moves the reader from abstract conceptions of inalienable human rights to evidence-based, pragmatic solutions that highlight the systematic integration of human rights principles in human development work."--PsycCRITIQUES "The human rights framework as eloquently described in this book offers a new way for us to think about how we approach our work: from deciding when and how to intervene, to how we plan, the goals we establish, and the metrics we use to gauge the success of our efforts. Public health instructors will find many of the chapters useful for illustrating, in very concrete ways, the link between human rights and public health, providing students (and practitioners) with a new framework for analyzing public health topics and for designing and evaluating interventions. Ultimately, civil rights and civil liberties are only of value when exercised. This book will contribute to the advance of human rights by leading increasing numbers of public health practitioners to advocate for, and promote, their realization."Score: 95, 4 stars --Doody's Medical Reviews "Rights Based Approaches to Public Health provides a new perspective on addressing public health problems. It is an evidence based and cutting edge approach that provides important insights into solving ethical dilemmas. It is essential reading for anyone interested in ensuring health equity and justice." Georges C. Benjamin, MD, FACP, FACEP Executive Director of the American Public Health Association "At root, those working in health and human rights are both animated by a similar concern: the well-being of individuals and populations. The book will be an invaluable asset to both communities as they work to achieve their common goal." From the foreword by Paul Hunt UN Special Rapporteur on the Rights to the Highest Attainable Standard of Health (2002-2008) Rights-Based Approaches to Public Health presents a variety of public health professionals who utilize rights-based approaches in their work, the challenges they face, and the lessons they have learned. This expansive volume includes rights-based approaches with a variety of populations and across international settings. It explores environmental issues such as the right to clean air, water, and food. It examines the rights of the vulnerable, including women and children. It also includes work in difficult locations, such as prisons, high-conflict areas, and New Orleans post-Katrina. The useful tools and diverse case studies in this text provide the best models available for those interested in implementing or furthering a rights-based agenda. Key Features: Contains an overview of the key international documents regarding the right to health Provides an exploration of the efficacy of rights-based approaches to health Covers professional and ethical issues in rights-based approaches Presents systemic and policy implications, including a rights-based approach to health care reform Includes global case studies from a wide variety of noted organizations and practitioners

On July 30, 1965, President Johnson flew to Independence, Missouri to sign the Medicare bill. The new statute included two related insurance programs to finance substantial portions of the hospital and physician expenses incurred by Americans over the age of sixty-five. Public attempts to improve American health standards have typically precipitated bitter debate, even as the issue has shifted from the professional and legal status of physicians to the availability of hospital care and public health programs. In The Politics of Medicare, Marmor helps the reader understand Medicare's origins, and he interprets the history of the program and explores what happened to Medicare politically as it turned from a legislative act in the mid-1960s to a major program of American government in the three decades since. This is a vibrant study of an important piece of legislation that asks and answers several questions: How could the American political system yield a policy that simultaneously appeased anti-governmental biases and used the federal government to provide a major entitlement? How was the American Medical Association legally overcome yet placated enough to participate in the program? And how did the Medicare law emerge so enlarged from earlier proposals that themselves had caused so much controversy?