Public Health Policy

  • What are the issues of culture, politics, and special interests in the United States that have made health care reform difficult to achieve?

Politics: The political partisanship in the country has paralyzed the efforts to achieve health reforms. The initial objective was to make health care reform bipartisan, but the two political parties portray varied sets of principles. Similarly, the parties lack cooperation, and this has limited their willingness to overcome their differences and seek support for the interest of the people (Walling, 2010). The public has tried to support the reform; there have been numerous bipartisan agreements, but the legislators still fall into their circles of partisanship.

Special interest: The economic self-interest of key players in the U.S. has made it difficult to achieve health care reforms. Groups such as racial and ethnic minorities, low and middle-income workers, disabled and individual with pre-existing medical conditions have the right to gain a lot from the health care reforms (Walling, 2010). However, well-organized and financed health care industries fear that they might lose; therefore, they use their powers to influence and derail reforms.

Culture: The policymakers, educators and insurers lack the motivation to develop initiative in cultural competence, and this has derailed the efforts to achieve health care reforms (Betancourt, Green, Carrillo, & Park, 2005). The health care stakeholders lack the driving force, approaches and leverage points to enforce reforms that will advocate for high-quality care for every patient regardless of their culture, race and ethnicity.

  • Of these three issues, which issue do you find to be the most difficult to overcome? Why?


All the three issues are critical; however, from my opinion, the issue of special interest is difficult to overcome. There is quite a good number of special interest groups with tightly organized health care associations and industries who have the power to influence and derail the health care reforms. They dominate discussions on reforms, and since they fear losing profit, they will continue to propel inequalities and injustice in the U.S. health care. Similarly, the key players with special interest are mostly the legislators or stakeholders in government and managed care who block the progress.



Betancourt, J. R., Green, A. R., Carrillo, J. E., & Park, E. R. (2005). Cultural competence and health care disparities: key perspectives and trends. Health affairs, 24(2), 499-505.

Walling, L.H. (2010, May 4). Why is health care reforms so difficult? The Huffington Post. Retrieved from



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