Will US healthcare reform break Obama?
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Associate Editor
David Stevenson Jul 31, 2009
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"It's crunch time for US healthcare reform," says Janet Adamy in The Wall Street Journal. "Even though the US spends $2trn a year on it, 46 million Americans don't have healthcare coverage, and a growing number of bankruptcies and home foreclosures are linked to medical expenses."
Healthcare insurance premiums have risen by 58% since 2000, compared with a rise in average wages of just 3%. As the recession grinds on, the number of uninsured seems to be rising. The Centre for American Progress Action Fund reckons that up to 14,000 people are losing their health insurance every day.
But "law makers who are trying to remake one sixth of the US economy say this might be the most complicated legislation they have ever undertaken. If the health bill passes, it will affect almost everyone." The stakes for the US in the struggle to pass healthcare reform "could not be higher", agrees Clive Crook in the FT.
"It ought to be unthinkable that a popular Democratic president, elected on a promise of comprehensive health reform, supported by big Democratic majorities in Congress and a filibuster-proof contingent in the Senate, should fail to get this done."
And unlike in the early 1990s, when the Clinton administration took on the challenge, "resistance from organised interests is weak". This time, "the usual suspects as good as surrendered in advance". Yet failure is all too imaginable – many commentators are now betting on defeat.
Ironically, it's strong opposition from fiscally conservative Democrats – worrying about the overall costs of a plan expected to cost at least $1trn over a decade – that's been the main bugbear. Meanwhile, the package being considered in the Senate is different from that being debated in Congress – the eventual reconciliation of the two versions will add further complications. Both chambers have already pushed back Obama's ambitious timetable for the legislation, warning they won't meet his deadline for a first vote on the two versions before they break for holiday on 7 August.
Nonetheless, "some kind of health reform is still likely to pass", says Crook. Otherwise, "the Democrats would be seen as incapable of governing. At worst, a scaled-down reform can be put together. So long as it provides a substantial widening of insurance coverage, along with the taxes and/or savings to balance the books, the party can claim victory and retreat. In this limited sense, Obama is right when he says 'don't bet against reform'".
But "the intensity of the national dispute over healthcare is consuming Barack Obama's presidency", says The Times's Bronwen Maddox. "He's right to have told Americans that they can't afford their medical system and that it's going to bankrupt their government soon. But he's wrong in the way he's trying to solve it – including his curious detachment from the details of the plan that will make or break his presidency."
Obama's "bold statement" that the Bills before Congress and the Senate will be 'revenue-neutral' is "simply untrue". Voters aren't fools, hence his plunging poll ratings and the chance that "Congress will throw the Bills right back at him". And now "he wants to salvage some kind, any kind, of legislation. Without a radical change in the script, the most important and expensive policy of Obama's presidency is heading in a direction that he won't want."
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