Public Policy and the National Health Care Legislation

Subject: Healthcare Research
Pages: 3
Words: 563
Reading time:
3 min
Study level: School


The process of policymaking can be considered in terms of various approaches, reasons, and the primary beneficiaries. Some analysts believe the reasons and consequences to be the most important element while regarding the policymaking models; other political observers try to establish relations between the performers and the main beneficiaries from certain decisions, acts, and bills. Thus, Dye introduces two policymaking models where the first one presupposes that the decisions concern the government, while another is targeted at the implementation of the values and interests of one social group into the public policy of the whole country. The importance of health care can scarcely be overestimated. Different health care laws are adopted in order to guarantee free health care or to develop different strategies related to the health care laws.

National health care legislation

The formulation of the bill was one of the most burning issues encountered by the actual president’s administration in terms of debates and discussions in the press and in public. It is obvious that most issues presented in the bill concern certain beneficiaries, though as argued by Hingle, the bill enhances the opportunities of “hard-working people […] to get access to affordable private health insurance coverage, […] to get targeted tax breaks/credits to help them buy the insurance and to allow them to choose from a wide choice of private insurance plans.” (par. 2) It is obvious that this is not the only reason for the legislation to be so generous towards industrious people that could not afford medical insurance; moreover, the world financial crisis influenced greatly the economic situation within the country and each separate citizen in particular.

However, some politicians and political observers claim that “the law did little to address the challenge of restraining the nationwide rise in health-care costs, and premiums are continuing to rise, particularly for small businesses.” (MacGillis par. 6) It is obvious that some people remain unsatisfied with the adoption of certain laws because it interferes with their business and activities related to the area in which the law has been passed. Though there are discontented people, the overall effect leaves a great space for discussion which is sure to accompany the bill for some time.

The bill has been passed, so, it is necessary to find out who benefited from this the most. According to Dye, it is possible to consider the bill and in terms of the policymaking model. The bottom-up policymaking model presupposes that the most important activity occurs within the government which means that the currently discussed bill cannot be considered the bottom-up policymaking decision because of its public orientation. When we talk about the cleanup of corruption in government, this concerns the bottom-up policymaking model. The legislation on health care suggests that it is the top-down policymaking model where the national elite introduces its interests, preferences, and values into public policy (Dye 4).


The health care bill can be considered the decision of the top-down policymaking model in terms of its orientation. When the national elite tries to transform some interests into public policy, it is top-down policymaking. As healthcare is extremely important and it is an issue that concerns the population of the whole country regardless of the culture, ethnicity, and social status, it is obvious that this bill is sure to influence the whole country, whereas the bottom-up decisions impact the national elite mostly.


Dye, Thomas R. Top Down Policymaking. New York, N. Y.: Seven Bridges Press, LLC, 2001.

Hingle, Susan. “In My View: Health-Care Reform Bill Is Only 1st Step.” State Journal-Register, 2010. Web.

MacGillis, Alec. “Massachusetts Health-Care Reform Leader Could Play Larger Role Nationally.” The Washington Post, 2010. Web.