U.S. May Get Health CareReform, But What Kind?

The United States will have health care reform. After weeks of battling in Congress, that much is clear. But it is a reform with a bad taste, not only because of thinner content than Barack Obama would have wanted, but also because of the way it came about. In the House of Representatives, all but one Republican (who abstained) voted against a proposal, saying that health care reform would not be even debated before Christmas.

The debate on health care in America has developed into an absurd theater, where two groups of actors are performing on the same stage in different plays. The opposition in the Republican Party is not really discussing the health care reform the president has asked for. They claim they are fighting a bill to introduce communism into America, to make death-lists with the names of patients coming for treatment, and about ruining American society for generations. Lies are not unusual in political discourse. But in the American debate on health care reform, the distortion of reality is so great that it would make Baron Von Münchhausen (the German officer who said he had ridden a cannonball) blush with envy.

The problem is that, in American politics today, there is polarization and confrontation that shuts the door to reform that would help society. There is no doubt that many Republicans are focused only on hurting President Obama through their fight against this health care reform. The hate against America’s first African-American President makes the far right glow. Racist groups are experiencing a renaissance, and even if these are fringe groups, this is a danger signal to America as a nation. The Republican Party is increasingly dominated by the right, spiced up with racist attacks or coded messages. (Example: Sarah Palin who is touring small, white towns and claiming them to be the “real America”). The goal is obviously to politically weaken Obama so much that his charisma and his ability to attract voters will not be enough to secure a new term in three years.

Congress has been almost impotent when it comes to legislating reform. Forty-four years have passed since President Lyndon B. Johnson passed 80 bills in six months through Congress, among them, Medicare, the voting rights act, and federal support for education. After that, it has been the Supreme Court that has been the most important reformer, by legalizing abortion through Roe vs. Wade. Bill Clinton could not even get his and Hillary’s health care proposal up for serious debate in Congress before it drowned in a maelstrom of scaremongering and corrupting lobbyism.

Unless the pro-reform group can get 60 votes in the senate, 41 from the opposition will be able to prolong a debate into eternity, thereby stopping the proposal from coming to a vote. Democrats have 60 of 100 Senators today, but this majority is not waterproof. Joseph Lieberman, who was Al Gore’s vice presidential candidate 10 years ago, is an elected independent and will vote against any health care reform containing a public option to compete with private insurance. Also three or four Southern Democrats are threatening to vote no for the same reason. Only one Republican, Olympia Snowe of Maine, has shown any sign of willingness to compromise.

The health care proposal, now in the Senate, contains a limited public insurance option. Also, the reform will only cover 31 million of the almost 50 million Americans who are without health care coverage. The proposal is only about half of what the president wanted. But it is about reform and one step further in the work to bring America in line with universal health care systems of other Western nations. Today, America spends 16 percent of its gross domestic product on health care; in Europe, the average is eight percent. But while European systems cover the entire population, one in six Americans is left out.

If you have a good health insurance in America, you can count on the finest medical treatment in the world. But many insurance policies are poor, and some can even be canceled if the holder gets a chronic disease. The premiums do not go only for treatment, either; they disappear in a large hole of private bureaucracy, profits and inefficiency. Everyone wants his “slice of the pie,” from doctors and hospitals, to the pharmaceutical industry, lawyers and insurance companies. For American business, health care is an enormous expense. And yet, there are few business leaders who dare to stand up against the financial waste that is everywhere in American health care.

Even if some type of health care reform could be passed, the result is far from guaranteed. Moderate Democrats can, with a compact Republican group, still tear up a bill that has already shrunk considerably. But symbolically, one reform or another would be important. In that case, President Obama would be the first president who has managed this since Theodore Roosevelt in the early 1900s.