Sunday, March 28, 2010

America's main parties both risk injury in tussle over healt

March 24, 2010

Put aside the procedural shenanigans that will doubtless occupy hours and hours in the US Senate as Democrats nurse through their health-care plan, and Republicans try every possible means to stop them.

Put aside, too, a constitutional challenge by 10 state attorneys-general who fear a massive shift in costs from the federal government due to Obamacare.

And forget, for now, the ranting that America has crossed a Rubicon and this 2500-page bill offering the hope of insurance coverage for about 30 million more Americans actually crimps on the American dream - "fewer freedoms, less opportunity'', as Sarah Palin portrays it.

Certainly, there are issues that will be the subject of ongoing and fierce debate. The passage of the $US940 billion ($A1.03 billion) bill this week was historic, exhilarating even. But more mundane questions remain over its long-term effect on US finances and over some of its finer points that appear to shield drug companies from generic competitors, that could put the squeeze on Medicare for the elderly and could land the middle-classes with higher taxes.

It is complicated legislation. Every day, opponents throw up new objections, claiming to have unearthed ambiguities; every day, media pick at the tapestry and run with a thread that seemingly contradicts the bigger picture.

Little wonder, then, that most Americans seem bewildered about just how the changes will affect them. Which is a moot point for Democrats: after 13 months of bitter political wrangling and three incarnations of the bill, they are still struggling to sell its merits to an electorate deeply suspicious of Big Government and the imposition of any new tax.

So how will it play for the big political parties, and for the President himself? Certainly, the Democrats look to be facing the toughest road to November's mid-term congressional elections. The incumbent majority usually does.

Within weeks, the parties will be in full battle mode, and at a time when Democrats will want to be seen to be pushing hard to get Americans back to work - 20 million have no job or not enough hours to sustain their household - they will face constant sniping from Republicans determined to muddy their healthcare triumph.

It's impossible to predict with any confidence likely Democrat losses. A fresh opinion poll conducted by CNN revealed 59 per cent of respondents opposed the bill, compared with 39 per cent in favour.

Americans have yet to buy, it seems, the narrative being parlayed by Democrats that the reforms are as significant as those of the civil rights era.

And yet the same poll harboured a warning for Republicans, too. Many people who opposed the bill did so because they said it was not liberal enough, having jettisoned an earlier public insurance option. In fact, 52 per cent either support the legislation or think it should be more liberal.

The risk for Republicans is that they have locked themselves into abject opposition. They have pledged to repeal the bill should November deliver them control of Congress. But what if the Democrats' hard-sell gives them traction?

Many of the measures are attractive: they encourage more competition between private insurers that could lead to lower premiums; they allow parents to include children in a family insurance plan until age 26 (up from 22); they prevent insurers from refusing cover to people with pre-existing illnesses; and they scoop up millions of the uninsured with tax breaks that will let them afford basic coverage.

Having voted unanimously against the bill, the Republicans have punted heavily against health-care reform, as William Saletan noted on "If the public hates the program, they'll be rewarded at the polls. But if the public likes it, they're in for trouble."

As for the 44th president, health-care reform might well be the signature item of Obama's political obituary, whenever it is written, but it won't be the only issue that determines the term of his White House occupancy. The President's plate is full enough with issues of state: he meets Israel's Prime Minister in Washington today to try to heal a fissure in US-Israeli relations; he is prosecuting war in Afghanistan while seeking to extract US troops from Iraq; he is pushing hard for nuclear non-proliferation but is struggling to clinch a weapons deal with Russia, while Iran continues a recalcitrant dance with the international community; and he is challenged by China and by America's global economic partners alert to any hint of rising protectionism in the US.

But issues of state are what US presidents typically deal with, and he can expect little thanks from the American people, whose main focus remains local. Few people outside the US fully appreciate the damage the "great recession" is inflicting on local communities, with some shouldering unemployment rates above 20 per cent. Local municipalities in 17 states have opted for four-day school weeks and deep cuts to other services in a bid to balance budgets starved of tax revenue.

On the one hand, Obama has 2½ years to prove himself an alchemist, transforming hope into palpable change. But his dilemma is this: should the Democrats lose control of Congress, his agenda will be stymied and his prospects of a second term diminished.

Simon Mann is The Age's United States correspondent.



Hmmmm interesting to see all the hypocrisy about medicare in the states seeing as how quite a few state governments (including republican ones) and public organizations have resorted to obtaining their drugs for their plan members from Canada where costs are significantly lower due to the evil 'communist' socialists have established an universal healthcare system for all. Yet such an official system is all wrong for the good ol' US of A. . .

Canuck13 - March 24, 2010, 10:31AM

What you don't say is how much of the $US940 billion ($A1.03 billion) were bribes, additional unrelated expenditure, to get it passed.

bloodsportforall | canberra - March 24, 2010, 12:28PM

As weak as it is, the legislation could at least be seen as a step on the path toward universal care. It's relevance to Australia in positive terms is moot, though a vague reference may have been made to all being on the same tram now, given that so many drooling idiots of the Australian right right tend take their cue from the drooling idiots of the Amerikan right. However, this slight positive is now likely to be swamped by a flood of inanity stemming from the likes of the truly mad and bad Palin for instance. Insane rhetoric such as '"fewer freedoms, less opportunity'' - what the hell has this got to do with anything? It is a healthcare debate - incredible. To see programmes where so many yanks have to pile into football stadiums, to get elementary medical and dental treatments that are otherwise beyond them. To have all their pensioners drive up to Canada to get prescriptions - a practise made illegal by yank politicians in the pay of big pharma. Against this, to have this poisonous moron Palin saying "fewer freedoms, less opportunity'' - what the hell is she talking about? Unfortunately, the group of people resident in Oz and known generally as 'Australians who really want to be Amerikans' - being the traitorous and treasonous bunch they are, will take up these extremist and mad rallying calls from the nutcases in Amerika and continue their attempts at undermining our health system.

Leon T | Melbourne - March 24, 2010, 12:35PM

Oh Canada! That bastion of freedom where a conservative commentator cannot even be heard but for the hatred of ideologues who won't tolerate the existence of an alternative view:

If their systen is so good why did one of their provincial governors race off to Amerika last year for a bypass procedure?

@Leon: how easily you dismiss the very foundation on which the American democracy was established, that being a Constitution written in defiance of European monarchies that esposed a mindset that government knows best. You may interpret the erosion of freedoms and opportunity as 'insane rhetoric' but I can assure you they are at the very core of the American experiment. Hall hath no fury like an independent told he must buy health insurance or face a visit from the IRS.

brian - March 24, 2010, 1:51PM

>The passage of the $US940 billion ($A1.03 billion) bill this week was historic

I think you mean $A 1.03 Trillion


Osi | Melbourne, Facing Front. - March 24, 2010, 2:36PM

More fluffy rhetoric brian - lets have a few bars of yankee doodle dandee or something while you are at it. Goons who go all misty like when ever the idea of Amerika is even mentioned are the true cretins of our age. It is you who threaten every freedom. Young kids who cannot get access to medical services, being marginalised in the land of the free and the home of the brave. Yeah - '"fewer freedoms, less opportunity'' - sure d...h...!

Leon T | Melbourne - March 24, 2010, 5:09PM

Big difference between 1.03 billion and 1.03 trillion. quite a slip-up especially since this writer gave a lecture a Melbourne Uni last year on the use of stats and figures in journalism!

Elena | Melbourne - March 26, 2010, 10:36AM
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