Obama’s pledge of universal health coverage is no more

Posted in Blog by saraburke on January 29, 2010

In Obama’s State of the Union address, the president acknowledged mistakes made in his first 12 months in office and pledged to persist with health insurance reform. So where has Obama got to with his health reforms and how has his promise of universal health insurance coverage changed and diminished?

After nearly a century of trying — Democratic administrations, Republican administrations — we are closer than ever to bringing more security to the lives of so many Americans. The approach we’ve taken would protect every American from the worst practices of the insurance industry. It would give small businesses and uninsured Americans a chance to choose an affordable health care plan in a competitive market.

This quote from Obama’s speech gives it all away….In the first line he talks about democrats and republicans being closer than ever – many Americans who were wholly behind Obama a year ago feel he has compromised too much and in healthcare far too much to republicans and to vested interests – very much reflects Obama’s bi-partisan approach to politics and desire for unity.

Then he says ‘we are closer than ever to bringing security to the lives of so many Americans’.

However a year ago he promised coverage for every man woman and child – yet bill as it currently stands and its not through yet will leave 17 million uninsured. And in America health insurance is crucial.

  • if you don’t have health insurance and currently 47 million Americans do not, it is very hard or impossible to access healthcare due to costs. Those who are not insured tend to be the working poor.
  • There is a very competitive insurance market in America and these for profit providers compete for the healthier, younger people as they are more profitable.
  • The insurance companies refuse to cover people with pre existing conditions such as asthma, heart disease and diabetes as they drive costs up – which reduces their profit.
  • The CEOs of the five largest insurers are paid on average $8 million a year EACH.

And that’s what Obama was referring to – that the Affordable Healthcare Act “would protect every American from the worst practices of the insurance industry”. But that is exactly it – the bill as proposed would prevent insures form taking on just younger and healthier and excluding certain people depending on health status. But look at the language, he is not saying we will eliminate all bad practice just we will take out the worst.

And in the next sentence he says, the plan “would give all Americans a chance to choose an affordable healthcare plan in a competitive market”. And this is where he really has fallen down.

The original plan proposed that every state would have a federal/public insurance plan that would be cheaper than the private plans which would make it more affordable to people and drive down costs but this has been abandoned in the compromises.

Yet one cannot over estimate what Obama is up against – unbelievable opposition. The republicans have driven a campaign against – they describe Obama as a communist, a socialist, the reforms as unconstitutional, that it a government take over. Republican Jim Demint has said that the healthcare reform will take away freedom.

But we also know that $1/2 billion of US dollars spent by healthcare lobbyist lobbying against it. The republicans are against it wholeheartedly. The private for profit insurance companies are against it and now many democrats are against it because they think Obama has given away too much. The previous six attempts to reform healthcare in America from Roosevelt to Clinton have failed…

So what happens from here?  Some think that this watered down version which will leave 17 million Americans uninsured and drops the public element, will go through. Others say it’s the first step in the right direction, not the perfect bill but we can improve it and it is an important step.

Marcia Angell (well worth looking up and reading), a medic, Harvard lecturer and critic says “It simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges”.

Paul Krugman suggests that Obama’s policy and political judgement is poor and that this is evident in his healthcare plans – that compromise is leading to broader, shallower legislation that could be easily challenged and may not be the best way forward.

Republicans say they will repeal it if it goes through as soon as they are in power.

Scott Brown, the republican who was elected to Ted Kennedy’s seat in Massachusetts last week is a significant shift in power relations. Brown, the pick up boy, won a seat in a state where democrats had a 3 to 1 majority and where there have tried to do what Obama is trying for America – universal coverage and bringing health insurance costs down.

But they have failed as Obama will as in Massachusetts unsatisfied as not everybody is covered (200,000 remain uncovered). AND they continue to have rising health care costs. Why? Because they have failed to cull the dominance of for-profit providers.

America spends more than any other country on healthcare yet it has poorer developing world health outcomes than 40 other countries in the world and fares particularly badly for poor people and African Americans.

But we know why – there are rising healthcare costs in America coz for-profit providers are more interested in profit than healthcare, because for-profit provision lead to poorer health outcomes, because for-profit providers over provide unnecessary health care for the well and do not provide enough for the unwell.

But crucially, Brown’s victory in Massachusetts means the democrats no longer have a 60-40 majority in the Senate so they will have to compromise further on bill.

Scott Brown campaigned very effectively against the healthcare bill – this is the man who is in favour of water boarding….


America’s healthcare coverage is dividing the nation, yet Obama is criticised for being too radical and too compromising, this is an issue that will not go away… More anon.


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