Healthcare Reform

For over 75 years now, numerous Democratic Congressmen – and indeed several Presidents – have tried to pass something remotely resembling meaningful healthcare reform. For 75 years, they have failed. Back in 1993, Bill and Hillary Clinton’s failed ‘HillaryCare’ died with a whimper in the Senate and Mrs. Clinton was denied her chance at a second attempt by Mr. Obama in the Democratic primaries. In November of 2008, the election of Barack Hussein Obama signalled a chance to buck the trend. Mr. Obama won, amongst other reasons, for his plans to bring his iconic notion of ‘change’ to a healthcare industry that is as ineffective as it is wildly expensive. Unsurprisingly popular with the young and the needy, these promises bought him a lot of votes. Once well within his seat in the Oval Office, though, Mr. Obama was forced to come to terms with the political realities of Washington. And while it took the far-left just days to begin attacking Mr. Obama for failed promises and ‘empty rhetoric’, the truth is that the decision is not only Mr. Obama’s to make. Indeed, healthcare reform cannot come by way of Executive Order. Enter the United States Congress. While the 2009 healthcare reform bill narrowly passed the House of Representatives last month, it is now in gridlock in the Senate. Whether it passes before or after Christmas (or indeed at all), the bill will require the support of 60 Senators before it reaches Mr. Obama’s desk. With 58 Democrats in the Senate, this means relying on the support of either two independents (Joe Lieberman and Bernie Sanders) or two Republicans (Olympia Snowe and Susan Collins). A mix of the two camps would also work.

In terms of resolving the argument and forming a compromise, we may be getting closer to the finish line. Only last week, the Democratic leader of the Senate, Harry Reid, heralded a landmark compromise between the so-called ‘Gang of Ten’ liberal and conservative Democratic Senators. However in reaching a compromise, these ten most influential Democrats have risked alienating the more liberal wing of the party – and people like Senator Russ Feingold – by eliminating the so called government-run ‘public option’ and replacing it with new scheme of nonprofit insurance plans overseen by an existing federal agency, the Office of Personnel Management. Under the terms of the compromise, and as a nod to the more liberal wing of the party, the Senators also included the provision to expand Medicare, allowing some people between 55 and 64 to purchase coverage early. The deal also includes a ‘trigger’ for a government-run public plan, should the nonprofit plans fail to realize their potential. President Obama was particularly enthusiastic about the breakthrough, suggesting that “critical progress” had been made. Senator Reid himself called it a “broad agreement”. Whether or not this agreement will hold, only time will tell.

No matter how many times you say it, shocking it still remains. As of 2007, over 46 million Americans remain without any form of healthcare insurance whatsoever. In an example of how unfettered free-markets do not always do their job, the U.S. spends more than two and a half times what the UK does on its own government-run healthcare system. Efficient or productive then, the U.S. system certainly isn’t. Even then, the more expensive U.S. system delivers consistently worse outcomes than its government-run competitors across the pond. On infant mortality, for example, the U.S. ranks 30th, behind the likes of South Korea and Malta. On maternal morality, too, the American system fails to live up to its expensive price tag. Even in the few areas where the U.S. system asserts a strong advantage – like prostate cancer – this does little for the millions of American men who have no form of healthcare insurance at all. Moreover, on the issue of prostate cancer, many experts have also warned of the common inaccuracies arising from a direct comparison of the two systems. The U.S. for example, has one of the highest recorded rates of prostate cancer in the world. This is due, at least partially, to their continuing reliance on the PSA blood test. As Cancer Research UK argued in a blog earlier this year, ‘this ‘over diagnosis’ inflates the survival statistics, at the expense of ‘over treating’ men – which is expensive and can cause long-term side effects (which can need further treatment)’.

One of the key arguments always put forward by opponents of healthcare reform is the power of the free market. ‘America has the best healthcare system in the world’, they shout, even though such statements bear absolutely no resemblance to the reality in which millions of Americans exist. Socialize healthcare at the point of delivery, they say and the forces of innovation disappear. The reality, of course, is quite different. Once again, the much derided British system is the perfect model. Here in Britain, and under a system that Republicans love to hate, some of the largest and most successful pharmaceutical companies in the world reside. From GlaxoSmithKline to AstraZenica, these industry giants pour millions into R&D every single day and compete around the world as some of the most successful firms in the sector. They invent lifesaving new drugs and contribute generously to the growth of the wider industry. Even in ‘super-socialist’ France (GOP high command has a particular dislike of our European neighbors), large firms like Sanofi-Aventis boom. In Germany, and Switzerland, too, innovation flows and profits surge. This is then, a manufactured myth. A myth invented by insurance companies and lobbyists and fronted by Republican Congressmen. The truth is that no Democrats – or indeed no sane policy makers per se – are proposing the total elimination of the private sector’s role within the wider healthcare industry. Far from it. This would indeed be innovation suicide. What Democrats and the current President are proposing, however, is placing the lives of millions of Americans above the profits of a handful of insurance companies that do little to directly improve the health of America’s citizens: denying insurance companies the ability to discriminate based on ‘pre-existing conditions’ and ensuring that America’s wounded veterans are given the healthcare options they deserve. Hardly unreasonable for a country that professes to be ‘the shining city on the hill’: the land of hope and liberty – not to mention the wealthiest country on the face of the earth. And while the bill currently up for debate on Capitol Hill represents only the very start of the long-term solution, a start is most certainly better than a continuation of the status quo. Mr. Obama’s Presidency rests on its success.