Democracy in operation: US Healthcare Reforms

It appears there are some amongst you who are interested to know more about the US healthcare reforms in March 2010, and all the sound and fury that surrounds Obamacare.

Healthcare reforms have been a thorny issue when it comes to American politics; in the 1990s the Clinton administration attempted reform the healthcare system (it was then led by Hillary Clinton, Bill Clinton’s wife, and became known as Hillary-Care) In March 2010, President Obama managed to pass the Patient Protection and Affordable Care Act, a milestone in American healthcare reforms:

The Patient Protection and Affordable Care Act is enacted by President Barack Obama, providing for the phased introduction over four years of a comprehensive system of mandated health insurance with reforms designed to eliminate “some of the worst practices of the insurance companies” — pre-condition screening and premium loadings, policy rescinds on technicalities when illness seems imminent, lifetime and annual coverage caps. It also sets a minimum ratio of direct health care spending to premium income, and creates price competition bolstered by the creation of three standard insurance coverage levels to enable like-for-like comparisons by consumers, and a web based health insurance exchange where consumers can compare prices and purchase plans. The system preserves private insurance and private health care providers and provides more subsidies to enable the poor to buy insurance.

Well-intentioned as it does seem, the Republicans (being Republicans), held a strong opposing stance towards the bill. Not a single Republican in the House or Senate voted in favour of the bill. Their opposition was broadly based on the following objections:

• Rises in taxation, and corollary increases in government spending on affordability subsidies.
• They objected to a new Health Insurance Rate Authority that would determine whether rate increases were “unreasonable” and to enforced rebates or premium reductions, and to any proposal that might have allowed government funds to subsidize abortion
• The opposition declared the law to be a “government takeover of health care” (the Republicans seem to prefer that healthcare be left to the free market instead of having the government control the industry as in a ‘socialist’ setting – a lot of this has to do with political ideology and the general suspicion of big government)
• There are also legal challenges: for instance, the Virginia Health Care Freedom Act prohibits any individual from being required to purchase health insurance. (doesn’t this leave you wondering: who doesn’t want healthcare insurance when it clearly benefits them? But as I mentioned in class Americans are big on freedom of choice is and the general political climate there does not favour infringements on personal liberties even if doing so might make people better off as a whole.)

Not to mention the incessant lobbying that continues to block reform and proposed legislations. America’s health insurance industry has spent hundreds of millions of dollars stalling healthcare reform – for the clear reason that a government take-over – even if it is a partial one-  would undermine the private’s sector profitability (remember the logging case I told you about? the conflicting interests between various interest groups?)

There are six registered health care lobbyists for every member of Congress. The campaign against health care reform has been waged in part through substantial donations to key politicians. The single largest recipient of health industry political donations and chairman of the Senate Committee on Finance that drafted Senate health care legislation is Senator Max Baucus. A single health insurance company, Aetna, has contributed more than $110,000 to one legislator, Senator Joe Lieberman, in 2009

Additional links if you’re interested:

http://www.usnews.com/opinion/blogs/john-farrell/2010/03/19/why-republicans-fear-obamas-healthcare-reform

http://www.straitstimes.com/BreakingNews/World/Story/STIStory_636725.html (on recent developments – how the republicans are choking of funds for democrats)

Now if you compare this to how Singapore passes bills (or make reforms to any of existing policies), you’d realize how our politicians have a much better time. This is not to say that our system is necessarily better though. The full picture is certainly more complicated than all that, but I’ll leave it off here for now, and talk to you guys in class if I have the time to!

Comments welcomed, btw.

Ms Chan 🙂