Being Sick in America

The word is an analytical cliche and is often used for a lack of a better. But the ambition of President Obama to reform the American health care system really gained “momentum” this week.

Tuesday, the Senate Finance Committee agreed on a draft text that opens up the way for a law that can radically change the current system.

In the United States, a sixth of all citizens (almost 50 million people) do not have health care insurance. And citizens who are insured run the risk of losing their insurance when they, for example, become unemployed, because their insurance policy is often handled by their employer, or even when they become chronically ill. For private health care insurers in America, the balance between payments and benefits is lost. Also, for those people who always pay their contributions, coverage is not always guaranteed. Only the retired, the disabled and children from low income groups can turn to a meager government program like Medicare or Medicaid.

Obama has made the reform of this system the main point of his policy. Therefore, it is important that one Republican senator has voted with the majority this week in the committee. The White House was able to secure that vote by, among others, renouncing the initial idea of forcing the insurers to a more social attitude by means of a competing state health care fund. By means of concession to the opponents of that [initial idea], who also reside in the Democratic House, he dropped the public option and suggested the intermediate form of cooperative insurances.

Despite these compromises, the vote in the Senate is a small breach in the anti-front that pulled out all stops last summer in the political committees, with so-called town hall meetings and via the media, to fight the reform plans. Especially in Republican circles, the debate on the health care system escalated to a kind of cultural war. With his reforms, Obama would be after ‘socialization’ and betray the individualistic soul of America.

But the real work only starts now. Because the legislation process in the direct American democracy is complicated – compared to the musjawara [Indonesian custom of determination of the opinion of the people] in the House and Senate, the polder model is an oasis of transparency – the devil can still slide into the legal details. For the leftist part of the Democrats, giving up on the public option is indigestible. For the conservative wing, this option is unacceptable. The Republicans can make use of this tension. Either that one along-voting senator (Snowe) can have a disproportionate large influence on the final text, or she will be pressured in such a way by her kindred spirits that she will withdraw her support after all.

But that does not change the fact that a step has been made towards a health care system that will be more fair for the majority of the citizens than the current system, which is no longer tenable for social and financial reasons.