Modest gains in health tend to look miraculous in American political theatre. President Barack Obama has every reason to be relieved, at least for the moment. Health care, the poisoned chalice of many a Presidential administration, has not, as yet, polluted his. The jury will be out, and campaigning on this, for some time yet.
The initial targets of Obama’s health care plan are modest. Obama is hoping to provide $940 billion in an effort to cover 32 million Americans. He sealed this part of his efforts where he, effectively, began: Iowa City, where he commenced his drive to reform America’s health system in May 2007. But the White House must have been heaving a sigh of relief when the US House of Representatives approved the Senate version of the bill 219 votes to 212. It passed without the help of the cantankerous Republicans, who opposed it across the aisle with resolute determination.
On Thursday, the Democrats pushed legislation through the Senate hoping that parts that were passed there will be approved off on its return to the House. The bill would amend the new health care regime by closing a gap in coverage for Medicare recipients of drug benefits. Tax subsidies to low-income citizens would also be increased to enable them to afford health care.
The GOP is proving predictable in its tactics and its animosity to these movements. The Republican states are hopping with anger, desperately finding a straw man to blame and a legal weapon to utilise. Many are huddling together in the hope of finding a constitutional basis to scupper Obama’s plans. Even in the Senate, Republicans were keeping vigil over the statute books, striking off two minor provisions of the bill covering Pell grants for low-income students, deeming them violations of congressional budget rules.
Broader legal challenges are being contemplated in the rooms of GOP personalities. Individuals such as Bill McCollum, Florida’s Republican attorney general, was adamant that the moves to impeach the new regime were based on honourable, legal motives. The legal eagles in the Republican states are particularly concerned with the requirement in the bill that people purchase health insurance. State governments are not particularly thrilled with the prospect of having to spend more on health services at the behest of Washington, D.C.
Nonsensical observations abound. The ‘tea party’ representatives are out with banners featuring ‘Destroyer in Chief – Stop Socialism’. Rep. Mike Pence of Indiana suggested a fatuous point: ‘Some say we’re making history. I say we’re breaking history.’ (How one fractures the continuum of time in this manner is a miracle only the House member is privy to.) Senator Charles Grassley (R., Iowa) did not hide his loathing for this assault on American singularity. ‘It’s the Europeanization of America, and that’s not what Americans want’ (Wall Street Journal, Mar 25).
The new law requires most Americans to have health insurance. Not doing so is the new disease – one will pay a fine for not having coverage. A punitive eye is directed against big employers – they are saddled with the task of providing coverage or risk financial penalties. Pre-existing conditions in a person’s health will be no bar to coverage.
Progressives like Dennis J. Kucinich, after being wooed on Air Force One by the President, dropped their opposition, fearing that stonewalling on this would simply sink the plan altogether. Kucinich had made a very public stance against any health plan lacking a public option, finding fault with keeping health reform within the world of hustling profit. But his opposition waned as he meditated at the rotunda beside Lincoln’s statute in Washington, D.C. The hope here is that reform will be incremental, with this bill being a modest measure towards more radical health reform. Some, such as America’s Health Insurance Plans, a consortium of 1,300 member companies, find the bill inadequate in improving the quality of health care in the US or, for that matter, dealing with spiralling costs.
The drawn lines of conflict are now hardening and drying in the dust of battle. Obama is readying himself. ‘They’re [the Republicans] are actually going to run on a platform of repeal in November. And my attitude is: Go for it.’ The mobilised student in Iowa City approved of the President’s message. But will the American electorate? Not all Republicans, as David Sarasohn’s column for The Oregonian (Mar 23) points out, will be hunting for a souvenir gavel for their House leader, John Boehner of Ohio. ‘By deciding to follow Boehner,’ stated a fretful Earl Blumenauer (Rep., D-Ore), ‘talking instead of acting, they empowered every little Democratic faction in the House, every Democratic senator.’
Binoy Kampmark was a Commonwealth Scholar at Selwyn College, Cambridge. He lectures in politics and law at RMIT University, Melbourne. Email: [email protected]