cancel2 2022
Canceled
Here is an article for today's Daily Express looking at the healthcare reforms from a British perspective.
OBAMA'S REFORMS ON HEALTHCARE WILL NOT CREATE AN NHS (Source)
GEORGE Bernard Shaw described Britain and the US as “two countries divided by a common language”.
Had he been around to witness Barack obama winning a victory for his plans on healthcare reform on Sunday night he might instead have concluded that Britain and the US are impossibly divided over their attitude towards healthcare.
In Britain it is hard to imagine any party winning an election without pleading its dying devotion to the NHS. The battle to establish America’s first nationwide healthcare scheme, by contrast, has nearly broken Obama’s presidency.
His ratings have plummeted. Many Democrats fear healthcare reforms will lead to heavy defeat for the party in the mid-term elections this November, possibly leading to the loss of both houses, the Senate and the House of representatives.
Barack Obama managed to get his bill through only after months of horse-trading, culminating in his offer to reinforce an existing ban on using federal government funds for elective abortions – those where there is no medical need.
Even so, Sunday’s victory was itself far from comfortable. The House of representatives – the US equivalent to the House of Commons – passed Obama’s bill by 219 to 212 votes. No Republicans voted in favour and 34 Democrats voted against.
It is an astonishing come-down for a president inaugurated little more than a year ago on a huge tide of good-will and with a strong mandate to lead America away from the path of the unpopular Bush administration. How can the noble aim of bringing affordable healthcare to the 32 million Americans who currently lack health insurance cause such a change in sentiment?
To begin to understand the healthcare issue in the US you could do worse than start with the words of Republican Congressman Devin Nunes who on Sunday implored his colleagues to reject the Obama bill and “say no to totalitarianism”. To outsiders, this is an incomprehensible description of what has been proposed.
The Obama bill will not create a vast state monolith like the NHS. Instead, Obama promises a more effective market in private health insurance, which all Americans will be forced to buy. Thirty-two million Americans who currently lack insurance will be offered subsidies in order to bring insurance within their reach.
Healthcare companies will be banned from refusing insurance to people with pre-existing health problems and from cutting off cover when people become ill. In fact, the Obama reforms could be argued to represent a move away from state provision.
Contrary to the image of the US healthcare system as a preserve of free enterprise, half of Americans are at present reliant on state-funded care, either though Medicare, which serves the elderly, Medicaid, which serves the poor, or other schemes for children. Under the new system, much of this cover would be transferred to private insurance companies.
Many Americans have a deep distrust of big government and high state spending. They see the battle against universal, state-backed healthcare as symbolic of a much bigger, long-term struggle against socialism. In their view, Western European economies are a halfway house between US-style free enterprise and former Soviet communism, and they will resist anything which they see as moving the US economy in the direction of Europe.
The battle did not begin with Obama: a branch of the Democrat party has been trying to establish a healthcare system for 50 years. The last to try and fail was Hillary Clinton, given the job by husband Bill when he became president in 1992.
Many are fearful over the cost. Like Britain, the US has a huge public sector deficit – caused by years of tax cuts combined with spending rises and made worse by the recession. The Obama reforms, it is estimated, will cost $940billion over 10 years. Obama counters that this sum will be dwarfed by the savings it will make. He estimates that the transfer of services from Medicare and Medicaid to more efficient private providers will save $1.3trillion – although this is over 20 years, meaning that the US taxpayer will be out of pocket in the short term.
Few, though, would contend that the US healthcare system does not require some reform. It is ruinously expensive and – taken as a whole – very poor value for money. In 2007 the US spent $7,290 per head on healthcare (taking into account private as well as public spending). This is half as much again as the next country on the list – Norway – which spent $4,763 per head.
The equivalent figure for France was $3,601, Germany $3,588 and Britain $2,902. It is far from clear, however, what Americans get for this huge extra spending. While the US scores highly in treatment of heart disease and cancer survival rates, its performance on infant mortality is a cause of national shame. In the US 6.4 babies out of every 1,000 live births die before their first birthday.
In Britain the corresponding figure is 5.0. There are many reasons to admire the American belief in free markets and enterprise. Even after the economic crisis – for which US banks bear heavy blame – the US economy has been impressive in its resilience. But it is hard to see the current US healthcare system as a triumph of capitalism – and hard to see how the Obama reforms will do much to bring down the cost.
Much as we moan about the NHS we can all be pleased we don’t have to foot the healthcare bills faced by Americans.
OBAMA'S REFORMS ON HEALTHCARE WILL NOT CREATE AN NHS (Source)
GEORGE Bernard Shaw described Britain and the US as “two countries divided by a common language”.
Had he been around to witness Barack obama winning a victory for his plans on healthcare reform on Sunday night he might instead have concluded that Britain and the US are impossibly divided over their attitude towards healthcare.
In Britain it is hard to imagine any party winning an election without pleading its dying devotion to the NHS. The battle to establish America’s first nationwide healthcare scheme, by contrast, has nearly broken Obama’s presidency.
His ratings have plummeted. Many Democrats fear healthcare reforms will lead to heavy defeat for the party in the mid-term elections this November, possibly leading to the loss of both houses, the Senate and the House of representatives.
Barack Obama managed to get his bill through only after months of horse-trading, culminating in his offer to reinforce an existing ban on using federal government funds for elective abortions – those where there is no medical need.
Even so, Sunday’s victory was itself far from comfortable. The House of representatives – the US equivalent to the House of Commons – passed Obama’s bill by 219 to 212 votes. No Republicans voted in favour and 34 Democrats voted against.
It is an astonishing come-down for a president inaugurated little more than a year ago on a huge tide of good-will and with a strong mandate to lead America away from the path of the unpopular Bush administration. How can the noble aim of bringing affordable healthcare to the 32 million Americans who currently lack health insurance cause such a change in sentiment?
To begin to understand the healthcare issue in the US you could do worse than start with the words of Republican Congressman Devin Nunes who on Sunday implored his colleagues to reject the Obama bill and “say no to totalitarianism”. To outsiders, this is an incomprehensible description of what has been proposed.
The Obama bill will not create a vast state monolith like the NHS. Instead, Obama promises a more effective market in private health insurance, which all Americans will be forced to buy. Thirty-two million Americans who currently lack insurance will be offered subsidies in order to bring insurance within their reach.
Healthcare companies will be banned from refusing insurance to people with pre-existing health problems and from cutting off cover when people become ill. In fact, the Obama reforms could be argued to represent a move away from state provision.
Contrary to the image of the US healthcare system as a preserve of free enterprise, half of Americans are at present reliant on state-funded care, either though Medicare, which serves the elderly, Medicaid, which serves the poor, or other schemes for children. Under the new system, much of this cover would be transferred to private insurance companies.
Many Americans have a deep distrust of big government and high state spending. They see the battle against universal, state-backed healthcare as symbolic of a much bigger, long-term struggle against socialism. In their view, Western European economies are a halfway house between US-style free enterprise and former Soviet communism, and they will resist anything which they see as moving the US economy in the direction of Europe.
The battle did not begin with Obama: a branch of the Democrat party has been trying to establish a healthcare system for 50 years. The last to try and fail was Hillary Clinton, given the job by husband Bill when he became president in 1992.
Many are fearful over the cost. Like Britain, the US has a huge public sector deficit – caused by years of tax cuts combined with spending rises and made worse by the recession. The Obama reforms, it is estimated, will cost $940billion over 10 years. Obama counters that this sum will be dwarfed by the savings it will make. He estimates that the transfer of services from Medicare and Medicaid to more efficient private providers will save $1.3trillion – although this is over 20 years, meaning that the US taxpayer will be out of pocket in the short term.
Few, though, would contend that the US healthcare system does not require some reform. It is ruinously expensive and – taken as a whole – very poor value for money. In 2007 the US spent $7,290 per head on healthcare (taking into account private as well as public spending). This is half as much again as the next country on the list – Norway – which spent $4,763 per head.
The equivalent figure for France was $3,601, Germany $3,588 and Britain $2,902. It is far from clear, however, what Americans get for this huge extra spending. While the US scores highly in treatment of heart disease and cancer survival rates, its performance on infant mortality is a cause of national shame. In the US 6.4 babies out of every 1,000 live births die before their first birthday.
In Britain the corresponding figure is 5.0. There are many reasons to admire the American belief in free markets and enterprise. Even after the economic crisis – for which US banks bear heavy blame – the US economy has been impressive in its resilience. But it is hard to see the current US healthcare system as a triumph of capitalism – and hard to see how the Obama reforms will do much to bring down the cost.
Much as we moan about the NHS we can all be pleased we don’t have to foot the healthcare bills faced by Americans.
