America’s healthcare victory

Late on Sunday night Washington time, politicians in the US House of Representatives (Congress) passed an historic bill to change America’s troubled healthcare system.

For over 100 years Democrats having been trying to make healthcare coverage compulsory for all its citizens – since President Theodore Roosevelt first declared it.

Now the bill will go to the Senate for final approval (predicted to be a formality) and then onto President Obama’s desk for signing into law.

In the midst of a lot of legal complexities, it has several key elements.

Firstly it bans insurance companies from denying coverage to people with pre-existing conditions (like cancer or shoulder injuries), or from putting caps on how much they will pay out each year (crucial for those with serious illnesses).

It also requires insurers to offer preventative care and to allow children up to 26 to be under their families’ policies.

A special committee will ensure insurance premiums don’t rise beyond an unreasonable level and that older people aren’t charged over three times more than younger people.

The government will subsidise the poor and small businesses to help with their coverage.

To pay for it all there will be a tax increase for the wealthy in certain areas, a tax on medical equipment and tanning beds, and cuts to wastage in government-run healthcare programs.

Most importantly, the bill makes insurance compulsory and will extend healthcare coverage to 32 million Americans who currently have none.

The icing on the cake is that according to the Congressional Budget Office, a neutral agency that calculates the cost of legislation, the changes will save the government US$143 billion over 10 years.

However, Obama and his Democrats didn’t get everything. A lot of their proposed changes had to be scrapped in order to get the bill passed with the necessary 216 votes.

Lawmakers had removed a government-run insurance scheme, a national insurance exchange to compare and buy policies, and a ban on insurer price-fixing.

In terms of adjustments to the current bill, a tax on high-end policies has been scaled-back and delayed, and payouts on government programs have increased.

And finally the clincher – on Sunday morning Obama secured the votes of six Democrats by removing funding for abortions. That got them to 219 votes.

Reports suggested that Obama and even Bill Clinton (who had previously tried such healthcare reform and failed) had been relentlessly on the phone to various Democrats urging them to vote for the bill.

Obama even delivered his televised speech last week in the Ohio district of an undecided congressman in order to seal his vote.

The reason for all the negotiating is because unlike many modern countries, US politicians don’t have to vote in line with their party. Instead, they vote on a law depending on what people in their district would want.

With congressional elections coming up in September, a number of Democrats opposed the bill for fear of not being re-elected in their districts.

But solidarity was not a problem for the Republicans. Not a single one of them voted for the bill.

They argue it is a government-takeover of healthcare, it will do little to slow spiralling medical costs, and will increase healthcare premiums and taxes for the middle class.

Democrats contend that Republicans merely represent the interests of the insurance companies, although they agree more needs to be done with regards to curbing costs.

They believe economically this is the right move and that Americans will realise they are better off once they see the effects of the new laws.

So even though President Obama didn’t get some of the big changes he’d hoped for, it’s still a big victory.

Many analysts believe that had the vote failed, Obama wouldn’t have been re-elected to a second term as president in 2012. This is because it would have cast doubt in people’s minds as to his ability to get things done.

He dismissed such political speculation after the vote saying this wasn’t a victory for him, his administration or the Democrats, but for people to whom the system had been failing.

So moving forward, things remain pretty much as normal. Some laws kick in within the first year while others don’t come in until 2014 or even 2018.

Obama will hope that the success of these healthcare changes will encourage Americans to give him a second term and support further changes before his time is up.

But for now, he can bask in the satisfaction of bringing the biggest change to America’s inefficient healthcare system in 40 years, and finally delivering on a century-old promise.

By The Casual Truth

Photo – President Obama with House of Representatives Speaker Nancy Pelosi