Can “Dr. Obama” Cure The Chronic Disease That Is Health Insurance?

Since U.S. President Obama took office in January, healthcare reform has become the second most important domestic task after having to deal with the economic crisis, and it is the most controversial issue at hand.

Obama's healthcare reform aims mainly to realize two objectives through broadening the government's function in the health insurance system: to provide public (government) health insurance benefits for approximately 46 million people who currently do not have any health insurance, as well as to curb the trend of rising medical expenses across the U.S. through the competition between government and private insurers.

The implementation of healthcare reform was an important promise Obama made during his campaign. Its success or failure would directly affect his reputation and determine his governing capability from there on.

Having learned from the White House's experience of "working behind closed doors" during the Clinton era, where healthcare reform was drafted by the then-First Lady Hillary Clinton, which later failed miserably in Congress, Obama is determined not to let the White House interfere with healthcare reform legislation too much this time, but to entrust the important job of pushing for the legislation to the Democrats in Congress.

A Difficult Start for Healthcare Reform

According to Obama's plan, both the House and the Senate should come up with an integrated solution for national health insurance before Congress is adjourned in August. The reform was unexpectedly difficult at the beginning. At the time of Congress's adjournment, it was still at the voting stage with the congressmen.

The healthcare reform debate is a competition among political powers, as well as a conflict between economic interest and values. Though the Democrats hold a majority of the seats in both the House and the Senate, resistance from opposition parties is still strong. Public approval ratings are also not as high as expected.

The conservative Republicans in Congress are Obama's direct challengers to his dream of national healthcare reform. Taking the House Energy and Commerce Committee's vote on July 30 for example, the committee barely approved of the healthcare reform with 31 votes for and 28 votes against it. Those who cast the no votes were all 23 of the Republicans and five Democrats.

The Republicans deemed that Obama's present solution is equivalent to the government taking over the entire health insurance system. They were worried that as Obama introduces the public health insurance institution to compete with private insurance organizations, it will lead to the government being too deeply involved in the market and cause an inflation in the government's power. House Republican leader Boehner said that Obama's proposal might lead to too much government intervention in people's lives.

Another strong obstacle to Obama's dream of healthcare reform comes in the form of private insurers, healthcare unions and individual medical practitioners. Those in the industry are worried that the government's public health insurance option will take 65 to 70 million clients away from private insurers, while doctors and hospitals are worried that the drop in fees will affect their income.

Pushing for Healthcare Reform Shows Leadership Capability Being Weakened

Some commentators described Obama's healthcare reform as "moving the cheese" of individuals with vested interest in the current healthcare system. It is no wonder that they see the reform as a scourge.

In addition, the reform is expected to run up a huge expense, reaching about $1.2 trillion. With the current economic gloom and a huge government deficit, who will foot such a heavy bill? Time magazine commented in the middle of the year: "The current economic situation is a headache. The healthcare reform seemed to have come at a wrong time, but it is necessary for us to push it through."

The conservative Republicans in Congress objected to the method of increasing the taxes of the wealthy to pay for the expenses incurred from carrying out the reform. Many Americans, on the other hand, are worried that if the current healthcare reform is carried out, middle-class families will be most severely affected, as they would have to pay a higher premium to make up for the expenses incurred by the government for increasing the medical insurance of the poor.

The result of a public poll released by the New York Times and the Columbia Broadcasting System (CBS) at the beginning of the month showed that many Americans are worried that the healthcare system may lower the quality of medical services and increase the amount of out-of-pocket payment for medical and healthcare services, as well as imposing limitations in areas such as the choice of doctors, treatments and tests.

These doubts show that Obama's leadership capability in pushing for the healthcare reform is being weakened. As a result of this, support for Obama has been sliding recently. North Carolina Republican Senator Jim Jacumin has even predicted that the healthcare reform will be Obama's "Waterloo," his downfall.

The healthcare debate is intensifying, and it has become headline news in current affairs periodicals. The previous issue of Time magazine put an image of Obama as a doctor, as well as the headline "Health Care Special Report: Paging Dr. Obama" on its cover, reporting on Obama's all-out effort pushing for healthcare reform.

The article said that Obama's greatest challenge is to clear out the obstacles of healthcare reform. He has to employ his debating skills, as well as some new moves, in order to persuade Congress to approve the reform. Obama admitted in an interview that this is one of the toughest moments he has faced since taking office.

August Is a Critical Period

August is a critical month to see if the national healthcare reform will materialize. White House Chief of Staff Rahm Emanuel calls August a "period where danger and opportunity coexist." If healthcare reform is not approved by Congress by autumn, it may never be approved.

The senators took the opportunity to leave Washington during Congress's recess and to return to their own constituencies to organize gatherings in town halls to interact with the voters. Obama, who had been leaving it to Congress to handle healthcare reform, is also taking up the lead at this point in time to turn defense into offense. Under his lead, the Democrats set in motion a canvassing of votes, not unlike during the presidential electoral campaign. They activated grassroot supporters across the nation to start a publicity campaign in every state, sparking nationwide discourse.

This week, Obama has been giving speeches everywhere without stopping. In his speech at the town hall of Portsmouth, New Hampshire, Obama openly accused insurers of "holding policy holders and the healthcare system hostage," and was criticized by the opposition of misleading the people with his words and creating fear, as well as attempting to create confusion.

According to reports, before Obama flared up, the public event started by some Democrat senators to sell national healthcare reform was disrupted by Republicans and those supported by the insurance sector. Some Democrats in the Senate have even received death threats.

The Democrats have also launched a "truth website" to counter rumors spread by the Republicans, such as that the reform would result in “death panels,” so-called by the conservatives, political terrorists who would resort to any tactics to achieve their goals.

The debate over healthcare reform has turned into a rigorous test of Obama's ruling capability. The returns of the economic stimulus package have been slow, and there are already complaints from the people. If the reform fails or is difficult to push, it would certainly affect the people's support for and confidence in Obama adversely.

Obama has placed a huge political stake on healthcare reform. If his efforts do not come to fruition by the end of the year, many will begin to doubt Obama's ability to lead. The Democrats will then be placed in a passive position, and Obama will be facing even greater political challenges ahead, be it in the midterm election next year or the presidential election in 2012.

Presently, the Senate has two healthcare reform plans awaiting voting, while the House has one, and any measures that either of them have approved would still require them to coordinate with the measures approved by the other to come to a consensus. Therefore, it is yet uncertain if Congress will be able to propose a healthcare reform plan that encompasses all of the measures in the end.

Will Obama meet with failure just like his predecessors did, or will he achieve a miracle cure for a chronic disease that is healthcare reform? Based on the intense debate over the reform, analysts think that its prospects remain unclear.

However, the main article in the current issue of Business Week has asserted that, as says its title, "The Health Insurers Have Already Won: How United Health and rival carriers, maneuvering behind the scenes in Washington, shaped healthcare reform for their own benefit."