Chapter 16. The battle for health care reform and the liberal public sphere

The battle over health care reform in 2009 and 2010 was the most important domestic policy debate in decades and therefore provides a good case to test the performance of the public sphere in the United States. The most appropriate means of carrying out that test is with liberal public sphere theory based in foundational conceptions of liberal democracy, especially the writings of James Madison. Under this theory, four key actors – the public, representatives of the public, the media, and the expert community – each must carry out key responsibilities. In the essay, the course of the debate is described and the performance of each actor assessed. While there were flaws in the performance of each of the key actors, the media and the expert community largely carried out their responsibilities. While much of the debate was inauthentic, the representatives of the public eventually enacted a reform effort. The performance of the public was more troubling with sizable percentage either uninformed or misinformed about the legislation. Overall, the liberal public sphere worked, but only by the barest of margins.