The Health of Obama

During the last few months I have noticed a notable drop in support — both inside and outside the United States — for the presidency of Barack Obama. Memories are short. People forget that Obama inherited more problems than he created. In foreign policy, the Bush-Cheney administration established a set of principles completely opposed to the rights of nations: preemptive war and unilateralism. This policy overturned the internationalist structure created by Presidents Roosevelt and Truman and opened the door to conflicts in violation of international treaties, which would introduce, as then French Foreign Minister Dominique de Villepin warned at the time, “the principle of permanent uncertainty and instability” into international relations.

In domestic policy, the Bush-Cheney administration, far from being bound by the Republican principle of balanced budgets, increased the budget deficit by the same amount — almost $500 billion — by which the Clinton administration had reduced it and compounded the error by reducing taxes. These unfortunate policies — maximum debt with minimum tax — led, as predicted by Felix Rohatyn, to a recession, a drop in public investment and the impossibility of meeting social policy needs.

The negative effects came during the last year of the Bush presidency. Obama inherited them and offered solutions that were necessary but unusual in a country accustomed to a dynamic in which problems were put off and then never solved. Obama’s decision consisted of confronting the postponed national agenda and taking on the obstacles: national hubris, special interest groups (medical insurance companies, for example), stagnant partisan ideologies and a conflict between the national interest and local representation.

Obama initiated a reform of foreign policy by renouncing preemptive war in favor of diplomacy. In cases where diplomacy did not work, stronger options were available. In the Middle East, Obama brought two problems into the open. The first is Netanyahu’s Israeli government, determined to extend settlements into territories that would be, in any accord, part of the Palestinian state. The other is the Palestinian state itself, divided and incapable of negotiating its own future with political unity. In Iran, Obama offered negotiations that, with immensely bad faith, the Teheran government has sabotaged, so much so that Iranian civil society now finds itself facing a new reality: opposing the authoritarianism of the Ayatollahs and Ahmadinejad is not the same as opposing Iran. In fact the opposite is true. In Iraq, Obama has begun a withdrawal of the forces that were polluting the political environment and has let the Iraqis solve their own problems. In Afghanistan, Obama has deployed military units with the intent of preventing power vacuums as the local leaders — the real power in Afghanistan — force the Karzai government to give up illusions fomented by the previous Washington government and force the Taliban rebels to come to terms with the local forces, giving up alliances with al Qaeda (a dangerous bet) and expelling them from local politics, to the extent that they occupy the conflicted pulverized spaces in Afghan society.

I will limit myself to these striking examples. We could also speak of Europe, Russia and Latin America; they all deserve to be discussed separately and extensively.

Now I would like to concentrate on the domestic reforms of the Obama administration: fiscal reform, immigration reform and above all, the health care reform that the House of Representatives approved on Mar. 21 by a vote of 219 to 212.

It is important to remember that President Clinton did not succeed in his efforts at reform. Neither did Nixon, a Republican. We would have to go back to the Johnson administration to find a legislative approval related to national health: Medicare for retirees. Prior to that, Harry Truman was unable to overcome pressure groups and the American Medical Association to pass universal health care.

So Obama’s victory comes after more than a century of failed attempts due to the vested interests of the medical profession and the insurance companies, in addition to the general political apathy that sets in during the absence of leadership such as that exercised extremely intelligently by Barack Obama.

Let’s see: Obama established the need for a reform in health care that would cover the 46 million citizens who are not insured by privately paid coverage (15 million), Medicaid for those who lack insurance (37 million) or Medicare for retirees (42 million). That is to say, Obama’s proposal, without affecting existing insurance, universalizes access to medical care for uninsured citizens (46 million). In addition, it saves them from the savage practices of insurance companies that deny coverage to citizens affected by pre-existing conditions. The new law favors citizens with low incomes and the adult children of parents with insurance. Private insurers will no longer be allowed to favor the young and marginalize the old.

Moreover, the United States is doing nothing more than adhering to norms that have longed prevailed in the Western world. It was a dangerous eccentricity to be the exception to the rule already in place in Britain, France, Germany and Spain.

One must admire the steps, small and large, that Obama took to arrive at the desired result: the call for bipartisan support; the face-to-face negotiation with the Republican leadership in Blair House; the loss of the Democratic supermajority in the Senate upon the election of a Republican to Edward Kennedy’s seat; the abandonment of the 60-vote majority in favor of the tactic of “reconciliation” which can pass a law with 51 votes; the Republican motion to postpone the vote (yet again) in favor of re-starting the process in the distant future; concessions by Obama including the withdrawal of the “public option” in favor of a legal requirement to obtain medical insurance, extended nationally without exception.

Even so, the Republican legislators continued opposing the law, forcing Obama to campaign until the end. He was forced, as well, to issue an executive exception for abortion, with the goal to finally have health care reform, which, with all its conditions, was opposed by the Republicans and, with all its conditions, is today the law of the land.

This is called politics. It is a good example.

Note: Carlos Fuentes is a Mexican writer.