Bittersweet Victory

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.