The policy and law making process set forth by Jefferson, et al. in the constitution of the United States is designedly difficult and time-consuming. While it is true that many avenues to policy creation exist, the delicate intricacies of constitutional checks and balances on which the system relies, makes an outwardly simple process more complex than perhaps those unfamiliar might have anticipated. (Teitelbaum, 2007) Briefly stated, any party wishing to make policy must contend with three governmental branches, each of which wield different but equally efficacious weaponry to modify or dismantle proposed policy. Differences over jurisdiction between state governments and the federal government do exist and while that fact certainly changes the game to some degree for policy makers at the state level, structurally both policy making processes are very analogous. (Teitelbaum, 2007)

Riddled with the inefficiencies encumbered upon them by the inherencies of politics and unanticipated externalities, policy advocates, such as the President, are not always able to fully accomplish their agendas. (Zelman, 1998) It should be noted that compared to other policy advocates such as public interest groups or individual legislative branches, the President enjoys significantly more power to direct policy in the form of media exposure and executive order. (Teitelbaum, 2007) None the less, tackling intricate issues such as healthcare reform are no easy task. For one, the amount of people affected by proposed changes and the powerful nature of vested interests to influence public and legislator opinion has, in the past, derailed non-incremental changes. (Zelman, 1998)

Walter Zelman, adviser to the Clinton administrator, outlines some of the pitfalls experienced by that administration in their attempt to accomplish their campaign goal of universalizing coverage, despite seemingly endless political capital to start. He suggests that of the many possible reasons for policy to fail, the inexperience of new administrations to effectively leverage their political capital combined with their tendency to overstate their ability to change policy leads the administration to overreach. (Zelman, 1998) Zelman claims that by making sweeping changes, an administration is required to provide more details on how to accomplish those changes and thus invites more criticism from the opposing interests. (Zelman, 1998)

Teitelbaum, J. B., & Wilensky, S. E. (2007). Essentials of health policy and law. Sudbury, MA: Jones and Bartlett.

Zelman, W., & Brown, L. D. (1998). Looking back on health care reform: ‘No easy choices’. Health Affairs, 17(6), 61-68.

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