Bittersweet Victory

Published in La Razón
(Spain) on 23 March 2010
by (link to originallink to original)
Translated from by Adam Zimmerman. Edited by Patricia Simoni.
Barack Obama passed health care reform in the United States House of Representatives. The vote, which was 219 in favor and 212 opposed, was the last significant hurdle for an emblematic bill that now goes through some final steps in the Senate. Its historic character is defined not only by the transformation of a 100-year-old system of social coverage, based on private medical insurance, but on the fact that other residents of the White House have tried without success. Obama staked the future of his presidency on this reform, and he took on the mission of raising the necessary support. His agenda during the last few weeks reflected that determination; he gave 55 speeches in favor of reform, participated in four conferences on the matter, spoke personally with nearly 90 congressmen and even put off a visit to Indonesia and Australia so that he could be there for the end of the negotiations. His presence was, without a doubt, definitive, among other things, because it helped obtain support from Catholic Democrats, once the important commitment was made that federal funds would not be used to finance abortions.

The satisfaction of the Obama administration contrasts, however, with the state of public opinion after nine months of struggle and tension. The president’s popularity has fallen 50 percent, because, rather than it being a popular reform, 55 percent of Americans are opposed to the bill. Symptomatic of this are the divergent impressions of the bill inside and outside the United States. While in Europe, for example, many have the feeling that the plan is an extraordinary advancement, the majority of Americans, who already have medical insurance, are opposed because they do not see how they will benefit. The increase in taxes to finance the extremely expensive system — almost a trillion dollars — and the fact that people are required to purchase some type of medical insurance, with penalties if the new legislation is not accepted, have fed an understandable resistance. In the U.S., society does not easily stomach the injection of politics into matters that affect individual choice, and this is exactly how this law should be interpreted.

In spite of everything, we understand that the change has aspects that are unquestionably positive. It is true that this is far from Obama’s original bill, that there will not be universal health care nor the possibility to sign up for public health care (the public option), but it’s also true that medical coverage will be extended to more than 32 million people — giving coverage to 95 percent of the population — that generous public subsidies are expected for those who cannot afford the cost of private insurance and that insurers will be prohibited from denying coverage to people with pre-existing conditions or terminating coverage from those who suffer from a serious illness.

We understand that Obama might feel relieved, but the reality is that this is a bittersweet victory because we are seeing a reform that is watered down, that has divided the country, that will be denounced by at least 11 states and that does not have the support of the majority of its citizens.


Barack Obama sacó adelante la reforma del sistema sanitario de Estados Unidos en la Cámara de Representantes. La votación, que se saldó con 219 votos a favor y 212 en contra, era el último escollo de importancia para un proyecto emblemático que ahora cubrirá otras etapas en el Senado. Su carácter histórico está definido no sólo por la transformación de un sistema de cobertura social centenario, basado en la contratación de seguros médicos privados, sino en el hecho de que otros inquilinos de la Casa Blanca lo intentaron antes sin éxito. Obama empeñó el futuro de su Presidencia en que la reforma se convirtiese en realidad y asumió la misión de lograr los apoyos precisos. Su agenda de las últimas semanas refleja esa determinación: pronunció 55 discursos en favor de la reforma, participó en cuatro mítines sobre el asunto, conversó personalmente con cerca de 90 congresistas e incluso aplazó una gira por Indonesia y Australia para poder estar presente en la recta final de la negociación. Su presencia fue, sin duda, definitiva, porque sirvió, por ejemplo, para que los demócratas católicos respaldaran la reforma tras el importante compromiso de que no se usarán fondos federales para financiar abortos.

La satisfacción de la Administración Obama contrasta, sin embargo, con la respuesta de la opinión pública tras nueve meses de luchas y tensiones. La popularidad del presidente ha caído un 50%, entre otras razones porque, lejos de tratarse de una reforma popular, el 55% de los estadounidenses se opone a ella. Resultan sintomáticas las lecturas divergentes que del proyecto se realizan dentro y fuera de Estados Unidos. Mientras, en Europa, por ejemplo, se tiene la sensación de que el plan es un avance extraordinario, la mayoría de los norteamericanos, que ya tiene seguro médico, está en contra, porque no sabe en qué va a salir beneficiada. La subida de impuestos para financiar el carísimo sistema –casi un billón de dólares– y la obligación de adquirir algún tipo de seguro médico, con penalizaciones si no se acepta la nueva legislación, han alimentado una comprensible resistencia. En Estados Unidos, la sociedad digiere mal la injerencia del poder político en asuntos que afectan a la libertad individual, y así es exactamente como debe interpretarse esta ley.

Pese a todo, entendemos que el cambio tiene aspectos positivos incuestionables. Es cierto que está lejos del proyecto original de Obama, que no habrá Sanidad universal ni posibilidad de acogerse a la sanidad pública pagando una cuota (opción pública), pero también lo es que la cobertura médica se amplía a más de 32 millones de personas, –con lo que estará cubierto el 95% de la población–, que se prevén subvenciones públicas generosas para quienes no puedan sufragar el coste del seguro privado, y que se prohibirá a las aseguradoras no dar cobertura a personas que padezcan alguna enfermedad o desentenderse de enfermos con patologías graves.

Entendemos que Obama se pueda sentir aliviado, pero la realidad es que se trata de un triunfo agridulce, porque estamos anta una reforma descafeinada, que ha dividido al país, que será denunciada por al menos once estados y que no cuenta con el respaldo de la mayoría de los ciudadanos.
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