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Books > Social sciences > Politics & government > Central government > Central government policies
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When Bad Policy Makes Good Politics - Running the Numbers on Health Reform (Hardcover)
Loot Price: R3,308
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When Bad Policy Makes Good Politics - Running the Numbers on Health Reform (Hardcover)
Series: Studies in Postwar American Political Development
Expected to ship within 12 - 17 working days
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From all outward appearances, the American policymaking process has
been revolutionized in the last half century. Beginning in the
1970s, new safeguards were put in place to prevent the kind of
free-wheeling and sometimes reckless policymaking environment of
earlier periods. These changes-including the creation of the
non-partisan Congressional Budget Office-were widely hailed as
ushering in a new era of accountability in Washington and putting
an end to the days when cagey political operatives could rush major
legislation through Congress without any real consideration of the
economic costs. But what if the supposedly new and improved
policymaking process that resulted from these 'good government'
reforms is every bit as prone to manipulation as the one it
replaced? As Robert Saldin shows in When Bad Policy Makes Good
Politics, that has unfortunately been the case. As in the past, the
new politics of the policymaking process encourage savvy political
actors to game the system. The very rules that were designed to
thwart financially irresponsible legislation now incentivize the
development of fundamentally flawed and unworkable policies. To
uncover the pathologies of the American policymaking process,
Saldin traces the sad tale of the Community Living Assistance
Services and Supports (CLASS) Act. While few outside the beltway
are aware of it, it was a major piece of legislation that played a
central role in the passage of the Affordable Care Act (ACA), the
most important social policy law since the 1960s. The CLASS Act
targeted an intractable problem: the ever-increasing demand for
costly long-term care services. For decades, both Republicans and
Democrats have recognized the problem as a major one, so the
question has not been whether we should tackle it. Rather, the
debate centered on how we should do it-that is, how we should pay
for it. The problem was always that the costs were staggering, and
there was little political will to fund such a program (Medicare
did not fund it). Long term care advocates realized this, and
therefore focused on passing a law that effectively ignored the
economic costs. They finally shuttled it into the larger Affordable
Care Act, which was passed into law in 2010. Saldin traces the
process, showing how an array of perverse incentives allowed such a
flawed law to come into being. In fact, Kathleen Sibelius, the
Secretary of Health and Human Services, announced in late 2011 that
the administration would no longer try to put the law into effect
because of its basic unworkability. Saldin's book is ostensibly
about this one piece of legislation, but it's about much more than
this: the near-impossibility of passing 'clean' laws that are not
doctored by special interests adept at gaming the system. Essential
reading for anyone interested in the policymaking process, the book
establishes that our current policymaking environment produces
outcomes that are just as perverse as the ones enacted by the old
system.
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