No issue has been more dominant in national politics since 2009 than health care. President Obama made reform of health care his top priority during his first year in office, and Congress passed a sweeping reform plan in March 2010. But the issue has not lost its resonance in the ensuing four years. If anything, our political discourse has grown even more contentious, and the debate is certain to continue for several more years.

This issue stirs deep passions in part because it is about more than technocratic health care policy. It’s also about rights and responsibilities, the balance between governmental power and private action, and political power. How the issue is resolved could have important implications for the national economy, the federal budget, and our national political culture.

Images courtesy Obama White House (1 | 2) 

James Capretta on the health care law & federal budget

Faculty

James C. Capretta

James C. Capretta is a Resident Fellow and holds the Milton Friedman Chair at the American Enterprise Institute, where he studies health care, entitlement, and US budgetary policy, as well as global trends in aging, health, and retirement programs. Mr. Capretta spent more than 16 years in public service.

James C. Capretta

James C. Capretta is a Resident Fellow and holds the Milton Friedman Chair at the American Enterprise Institute, where he studies health care, entitlement, and US budgetary policy, as well as global trends in aging, health, and retirement programs. In 2015 and 2016, he directed two major studies: one on reforming US health care according to market principles and consumer choice, and the second on reforming major federal entitlement programs to promote greater personal responsibility, focus limited resources on those most in need, and lower long-term federal expenditures.

Mr. Capretta spent more than 16 years in public service before joining AEI. As an associate director at the White House’s Office of Management and Budget from 2001 to 2004, he was responsible for all health care, Social Security, welfare, and labor and education issues. Earlier, he served as a senior health policy analyst at the US Senate Budget Committee and at the US House Committee on Ways and Means. Mr. Capretta was also a fellow, later a senior fellow, at the Ethics and Public Policy Center.

Mr. Capretta’s essays and reports include “Improving Health and Health Care: An Agenda for Reform” (AEI, 2015); “The Budget Act at Forty: Time for Budget Process Reform” (Mercatus Center, 2015); and “Increasing the Effectiveness and Sustainability of the Nation’s Entitlement Programs” (AEI, 2016). His book chapters include “Health-Care Reform to Lower Costs and Improve Access and Quality” in Room to Grow: Conservative Reforms for a Limited Government and a Thriving Middle Class (YG Network, 2014); and “Reforming Medicaid” in The Economics of Medicaid: Assessing the Costs and Consequences (Mercatus Center, 2014).

He has been widely published in newspapers, magazines, and trade journals, including Health Affairs (where he is a member of the Editorial Board), The JAMA Forum, National Review, The Wall Street Journal, and The Weekly Standard.

Mr. Capretta has an M.A. in public policy studies from Duke University and a B.A. in government from the University of Notre Dame.

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Preview the Syllabus by Week/Session

Readings:

 

Discussion Questions:

  1. Why has medicine become a political issue?
  2. What are the main competing theories about why there are problems in U.S. health care? What are those problems?
  3. Are these problems unique to the U.S. situation or universally shared across the developed world?
  4. Do these competing diagnoses point in different directions in terms of public policy solutions?

Readings:

 

Discussion Questions:

  1. What are the main features of the PPACA?
  2. What are the main objections to the law? Are they valid?
  3. Are the estimates for the PPACA believable? If not, why not?

Readings:

 

Discussion Questions:

  1. Do health care costs need to be controlled? Why, or why not?
  2. Can the federal government control health costs? How? What are the pros and cons of turning cost control over to the federal government?
  3. Is there any evidence that a market-based system would work? If it did, what are the pros and cons? Would there be equity concerns?

Readings:

 

Discussion Questions:

  1. Is the prevailing perception that U.S. health care is inferior on costs and quality accurate?
  2. What explains the popularity of nationalized systems in most of the developed world?
  3. Are the data for international comparisons useful? What other factors beyond health might explain these differences?

Readings:

 

Discussion Questions:

  1. Is the PPACA here to stay?
  2. Will it work, and how well? Will it cover most people? Control costs?
  3. What is the likely scenario for changing or repealing it? What replacement plan is most likely, and would it meet the objectives of voters?

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