A Victory

Barack Obama won a great political victory on Sunday, March 21. He has succeeded where all of his predecessors failed: the reform of health insurance in the United States. The last Democratic president, Bill Clinton (1992–2000), attempted it. He failed, and this defeat weighed heavily on his presidency. Republican George W. Bush (2000–2008), who succeeded him, renounced any ambition in the matter. The subject is particularly difficult in the United States for several reasons: the importance of health care in the economic life of the country, the power of lobbying groups connected to the sector and the powerful ideology in America that is defiant of government intervention.

President Obama has prevailed in his own way: calm, patient and determined — a far cry from the hysterical conception of politics displayed by his Republican opponents. A failure would have permanently weakened Mr. Obama. Success strengthens him in the United States and on the international stage, even if the aforementioned success is incomplete. Mr. Obama wanted all Americans to have health insurance. Like a number of his compatriots, he could not accept the unacceptable: 50 million Americans — out of over 300 million — do not have medical insurance. In a country as rich as the United States, the cost of treatment, of an operation, of a prolonged hospital stay can ruin a middle-class family.

By a narrow majority, on Sunday evening, the House of Representatives adopted the health insurance law the Senate voted on in November. This bill will allow some 31 million Americans to have medical insurance. Contrary to what Mr. Obama wished, the law does not create a system of public insurance. It provides for a mechanism of public subsidies to help Americans who need assistance to purchase private insurance. This is still not a system of universal insurance, but it is progress, as the United States has not experienced any in this area since the middle of the 1960s. Mr. Obama was not able to go any further, as public opinion is reluctant, in these days of huge deficits, to increase the national debt.

The bill must go back to the Senate for a vote on several amendments. The Republican opposition will use every procedural trick to prevent a vote. But they have lost the battle. Without boasting, Mr. Obama was able to say on Sunday evening: “We march on, with renewed confidence.”