May 20, 2013
The policy process is an ongoing event according to Kronenfeld (1997). When a policy is formulated there are two major parts; agenda setting and development of legislation. After these stages then the implementation stage begins. The way issues emerge can bring public awareness to a situation, such as the need for healthcare reform in the United States and eliminating the uninsured population. There are various stages of the policy process required to address this issue which include the formulation stage, legislative stage and the implementation stage. Policy formulation begins with problems, possible solutions and political circumstances (Kingdon, 2009). Identifying problems and agenda setting is the first step in the policy formulation process. The problem in this scenario is that 46 million Americans are without health insurance in the United States (Census Bureau, 2008). With the number of uninsured American’s, policy formulation is critical; issues need to be straightforward, who is involved in the process, and what needs to be done has to be clearly defined in order for policy to be considered at this stage (Fafard, 2008). The Institute of Medicine reported that between 2000 and 2006, 137,000 American’s died due to lack of health insurance (Dorn, 2008); this number includes 22,000 alone in 2006. This is evidence enough for health reform to be on a political agenda for policy formulation and for a proposal to be written for debate and approved by federal Congress making it law. During the legislative stage a policy is assigned letters by the clerk; for example, H.R., and then followed by the legislative number. Once the number has been assigned, the policy will be referred to as the assigned number (Johnson, 2003). Understanding the legislative branch is important because each branch of the government has specific duties. The main responsibility of the legislative branch is to confirm and approve laws and regulations. The executive branch is responsible for administrating and executing the laws and regulations approved by the legislative branch. The chief executive on the federal level is the President of the United States, whereas the chief executive on the state level is the Governor. The judicial branch enforces the laws. Both the state and federal government have separate judicial systems (Children’s Hospitals and Clinics of Minnesota, 2009). On the legislative level, if a proposal is not enacted by the end of the Congressional session that it was introduced, it will die and have to be reintroduced into the next Congress. After a bill is introduced to Legislation, it is then sent to the appropriate committee for review. A bill is first reviewed at a subcommittee level at which time it may be accepted, amended or rejected. Only after the subcommittee decides to move forward with the bill will it be presented to the full committee for additional review. During the hearing process the committee will check the validity of the bill and may invite experts, advocates and opponents to testify (Johnson, 2003). If the committee votes to approve the bill, then the majority party leadership schedules the bill for consideration. Major hurdles are still in the way at this stage for a bill to be passed. If the bill reaches the floor, a House Rules Committee must propose a special rule in order for the bill to be discussed. If this committee does not report a rule, then the bill dies, like many others, and will not be considered. The legislative process is very complex. Over the years Legislation has denied many proposals for health reform. The battle for health reform for the uninsured and underserved population dates back to Franklin D. Roosevelt; health reform proposals died at the Congressional level many times under his leadership (Morone & Litman, 2008). Although Roosevelt set agendas, formed committees, and had health plans, these plans were never...