Curing the U.S.

Published in Oriental Morning Post
(China) on 29 December 2009
by Song Guoyou (link to originallink to original)
Translated from by Eugene Tan. Edited by Jessica Boesl.
Every American should have medical insurance – this was the most attractive campaign promise regarding domestic politics that Obama made during his run for presidency. As the Senate voted before Christmas to pass the Affordable Healthcare for America Act, this campaign promise finally took a large step toward realization.

In fact, in 1993 President Clinton also ambitiously vowed to pass a bill for universal healthcare, in addition to specifically appointing First Lady Hilary Clinton to be responsible for this. However, in the end, because of opposition from Congress, this act faced a dismal finale. Hilary also felt the effects of this failure, having been criticized during last year’s presidential campaign for not having enough political clout.

In view of Clinton’s experience, Obama’s success was definitely related to his strong promotion of the bill, but what Obama must also admit is that he happened to come upon a prime opportunity – Democratic control of Congress. Especially in the Senate, if one Republican crossed party lines, the Democrats would actually have 60 seats, which is the first time in 30 years that the Democrats would have the advantage. According to Senate rules, Democrats could use this 60-seat majority to bring a halt to debates regarding a bill and directly enter the final voting process. This is the reason why the vote on this healthcare bill was able to proceed this past Christmas Eve. One can imagine that if the Democrats lose just one seat after the mid-term elections for Congress next year, the result of a re-vote could be totally different.

The reason Obama is pushing for healthcare reform is that the current healthcare system, in his eyes, has several fatal flaws. However, objectively speaking, the past few administrations have all known that the issue of healthcare insurance is a “cancer” in the long-term, healthy development of the U.S. Steps must be taken to control and cure it, but because reforming the current healthcare system would inevitably hurt the vested interests of some groups, past bills were not able to get the political support they needed. This allowed the problem to drag on until today and set the stage for President Obama and Congress to become the new Surgeons-in-Chief, who will come and cure the U.S.

The three main ingredients of Obama’s prescription are no additional taxes, universal healthcare for all and no increase in the government deficit. The first two ingredients are mainly for the purpose of winning more support from the people, and the last ingredient was originally the important goal of healthcare reform. Under normal circumstances, these three requirements hold some inherent contradictions. Under the preconditions of not increasing the government deficit and not increasing taxes, where will the money to support universal healthcare come from? According to Obama’s diagnosis and treatment plan, the money will ultimately be taken from the pockets of insurance companies. Obama has always firmly believed that health insurance companies have driven up the cost of healthcare in their pursuit of profit, which is obviously unreasonable. Therefore, passing this reform bill would make their profits decrease, and decreasing insurance expenses would make health insurance affordable to even the lowest wage-earners.

In light of this, insurance companies would be the greatest casualties in this era of healthcare reform, which would undoubtedly spark an extreme response and intensive lobbying. However, this type of response and lobbying would not have a substantial influence on Democrats. Not only that, the insurance industry only has itself to blame for the fate it will meet. Statistics on political contributions show that, in each mid-term election between 1992 and 2008, insurance companies’ political contributions to Republicans have largely surpassed those to Democrats, the proportion being about 63 percent to 37 percent on average for the past 16 years. In view of this historical record, despite strong support from Republicans, insurance companies would still be helpless under the strong force of the Democrats, who have the majority of seats in this session of Congress. The insurance industry has no choice but to become the sacrificial lamb.

It is important to point out that, with all their political resources and staunch support for healthcare reform, the Democrats definitely intend to solve the country’s problems. However, this political party is undeniably motivated by self-interest, too. When 40 million low-income individuals gain the opportunity to have health insurance due to a reform bill passed by a Democratic president and Congress, won’t they express their gratitude and support through votes in future mid-term and presidential elections? Therefore, even though this bill may meet the opposition of some interest groups, it is still worth a try, considering the large number of potential supporters that could be won.

Nevertheless, there is still some hidden danger behind the Democrats using their collective party power to ensure the passing of this healthcare bill. In case Obama’s prescription is proven to have no noticeable curative effect for the “American patient,” his political reputation would undoubtedly be severely damaged by this major “medical error.” The political backlash Democrats would face would be suffocating and the potential benefits that they had awaited would not only fail to be realized, but Republicans would also have more fire to add to their criticisms. Fortunately, Democrats have decided to let this reform bill come into effect in 2013 at the earliest. Before any attention can even be paid to its effect, the next presidential election will have already ended.


医治美国
2009-12-29 2:34:32

宋国友

“每个美国公民都要享有医疗保险”是奥巴马在竞选总统期间做出的最具吸引力的国内政治承诺。随着参议院在圣诞节前表决通过了《患者保护与可负担医疗法案》,这个承诺终于朝最终实现迈进了一大步。

  事实上,克林顿总统在1993年也曾雄心勃勃发誓要通过全民医保,并且委派第一夫人希拉里具体负责,但最终不得不因为国会的反对而以失败惨淡收场。希拉里也受这次失败拖累,在去年竞选总统时被攻击政治能力不足。

  基于克林顿的经历,奥巴马的成功当然与其坚决推动有关,但他自己更要承认的是,他碰上了一个绝佳的机会——民主党控制了国会。特别是在参议院,如果把一位共和党的改换门庭者包括在内,民主党实际拥有60个席位,这也是民主党人30年来首次占据如此优势地位。根据参议院议事规则,民主党可以凭借这 60个占绝大多数的席位,随时叫停法案辩论直接进入最后表决的环节。这就是为什么本次医疗法案投票可以在圣诞前夜进行的原因。可以设想,如果明年国会中期选举之后,民主党只要失去一个席位,重新投票的结果就可能完全不同。

  奥巴马之所以要如此推动医疗改革,是因为现有的医疗体系在其看来存在诸多致命缺陷。不过公正地说,其实最近几届政府都知道医疗保健问题是美国长期健康发展的一颗毒瘤,必须要采取措施将其控制和医治。但由于对现有医疗体系的任何改革必然会损害某些既得利益者,而以往的方案并不能获得必需的政治支持,所以才让这一毛病拖延至今,促成奥巴马总统和这一届国会成为新的主刀医生来医治美国。

  不额外征税、全民享有医保,以及不扩大政府赤字构成奥巴马处方的三大关键药剂。前两项主要是为了获得更多民众的支持,而最后一项本来就是医疗改革的重要目标。在通常情况下,这三大诉求存在内在矛盾,在不增加政府赤字、不征税的前提下哪里拿钱来支持全民医保呢?在奥巴马的诊疗方案中,钱最终从保险公司的口袋里掏出。奥巴马一直认定,医疗保险公司追逐利润的行为推高了医疗费用,具有明显不合理性。所以要通过立法使其减少利润,降低保险费用让医疗保险变得底层民众可负担。

  由此看来,保险公司将成为医疗改革的最大利益损失者。这当然会面临保险行业的极度反弹和密集游说,不过这种反弹和游说对于民主党而言,实在没有太大实质影响。非但如此,保险行业面临这种结局甚至可以说是“咎由自取”:政治捐款统计表明,1992年到2008年期间的每次国会换届选举,保险行业给共和党的政治捐款都要大大超过给民主党的政治捐款,此16年间平均捐款分配比例为63%比37%。在这种历史纪录下,虽有共和党力保,但无奈遭遇在本届国会席位中占绝对优势的民主党强力打压,保险行业不得不成为牺牲者。

  要指出的是,民主党人投入如此多的政治资源,如此坚决地推动医疗改革,固然有解决国家问题的真实想法,无法否认的是,也有巨大党派私心在内。可以想象,当4000万左右的社会底层民众因为民主党总统和民主党国会的改革方案而获得了医保机会,在以后的国会换届选举或者总统选举中,难道不会因此而用选票来对其表示感激或者肯定吗?所以,即便是这个方案可能会遭致某些利益受害者的反对,但与这么多的潜在支持者相比,值得一试。

  然而民主党举全党之力确保此医疗方案过关也隐藏着巨大风险。万一奥巴马开出的处方被证明对于“美国病人”没有显著疗效,那么这将毫无疑问是一起极度损害自身政治声誉的重大“医疗事故”。民主党所面临的政治反冲将令人窒息,期盼的可能收益非但不会兑现,共和党人还将因此大加声讨笔伐。还好,民主党人把这一改革方案最早的生效时间设定在2013年。在疗效能够被观察以前,下一届总统选举已经结束了。
This post appeared on the front page as a direct link to the original article with the above link .

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