Obama’s early Christmas present….
Despite all the wrangling President Obama’s Healthcare Bill has passed through the Senate. Now the path is clear for negotiations between the Senate and the House of Representatives which has also passed a similar bill. The vote must be something of a relief for Obama whose political reputation is clearly closely tied to the fate of healthcare reform.
No doubt this is at least partially the reason why Republicans have attacked the bill so viciously and ultimately, despite reservations in some quarters, the Democrats have ultimately come on board. The bill brings health insurance companies to heel; insurers can no longer deny coverage because of a person’s medical condition; charge higher premiums because of a person’s sex or health status; and cannot rescind coverage when a person becomes sick or disabled.
For those amoung us who think that the National Health Service with some kind of insurance system there are salutary lessons about how corporations behave when the state leaves the field. Low and middle-income earners as well as vulnerable groups fall through the safety net and are left uninsured and the pursuit of profit is paramount. Profit can only be made in insurance by managing risk and that necessarily means the rejection of high risk groups (precisely those that are most vulnerable).
Corporations and companies can thus never take the place of the state. This is something that is harder for American culture to readily accept with its ingrained cultural suspicion of the government doing anything. No doubt this is something that Republican opponents of the bill will be playing on as;
the resulting product would vastly expand the role and responsibilities of the federal government. It would, as lawmakers said repeatedly in the debate, touch the lives of nearly all Americans.
However, this poses an interesting possibility that if the bill is passed and gradually is accepted then the ramifications in the longer term could be more wide-ranging than simply to give more Americans access to healthcare. The ripples could be felt the world over if the citadel of neo-liberalism adopts a leading role for the state in the provision of healthcare. It will make attempts to undermine the NHS look distinctly outmoded and ironic to say the least. This is a good reason for all of us to be cheered by Obama’s early Christmas present.