Thursday, 24 December 2009

Universal healthcare is still a long way off for America

From CNN we learn that, after much drawn-out political wrangling and hysteria, "the Senate has passed an $871 billion health care reform bill." Senator Max baucus, a Democrat from Montana, was among those declaring that "today is a victory ... for American families." For his part, President Obama was happy to claim "a Christmas Eve victory on his top domestic priority," whilst the Republicans have unanimously agreed that the bill is a "monstrosity" and promised that "this fight isn't over."

Indeed, whilst the Senate have passed thier final version of the bill, much work remains to be done. As the BBC explain,"the process of reconciling the two bills [the House of Representatives bill and the Senate bill] is expected to begin in January and will require further tough negotiations." Only once that has been done can Obama sign the bill into law, but "the process could still be derailed by last-minute changes of heart among senators." Both liberals and conservatives will have to wait for any final declaration of victory.

However, even if it is premature (and naive) to say that the vote will "define President Barack Obama's legacy and usher in near-universal medical coverage for the first time in US history," it is still worth reflecting on what the reality of this bill is for the American public.

It doesn't take much examination to find that the claims of Republicans and "free" marketeers, predicting everything from "the denial of care to millions who would be judged not fit to live, just as in Nazi Germany" to the rise of US "Communism," are erroneous nonsense. At best. But what of the claims by the White House that this bill "will provide more security and stability to those who have health insurance, coverage for those who don’t, and will lower the cost of health care for our families, our businesses, and our government?"

In October, I said that the bill represents "a sop towards social democracy," with "only as much reform as the power-centric political spectrum will allow." With today's passing in the Senate, the bill thus far appears to live up to those words. The "public option," the government insurance scheme, has disappeared from the Senate version of the bill, along with the national insurance exchange. Both versions of the bill increase nsurance coverage, by 36 and 31 million people respectively, but in both cases over 18 million people will remain without coverage. Meanwhile, in the absence of a public option, the individual mandate that penalises those without coverage only serves to increase the revenue of health insurance companies at the barrel of a gun and punish those who still can't afford insurance.

The bill does offer a slim level of reform. The increased number with coverage, and the extension of both Medicaid and Medicare are indeed welcome. But this bill does not represent anything approaching universal health care, thanks to astroturf uprisings and backroom wranglings as much as to extensive insurance company lobbying. It will not represent such a thing as long as responsibility for creating such a system is left in the hands of politicians who receive more money from private interests than the public they supposedly represent.

If Americans are ever to see the "real, meaningful health insurance reform that will bring additional security and stability to the American people" of Obama's rhetoric, then an active and outspoken frassroots campaign is neccesary. Otherwise the professed intentions of the president and congessional Democrats, real or feigned as they may be, will not stop the private health industry from "doom[ing] another generation of Americans to soaring costs and eroding coverage and exploding deficits."