Triumph for President who dared to dream
Sydney Morning Herald
Tuesday March 23, 2010
BARACK OBAMA has hailed a historic vote on healthcare reform in the US Congress, saying the $US940 billion ($1.03 trillion) revamp represented "another stone firmly laid in the foundation of the American dream".The President, triumphant after hard-fought weeks promoting the changes, said they ensured for American families and workers that "neither illness nor accident should endanger the dreams they've worked a lifetime to achieve".The measures, which are expected to extend health insurance to an extra 32 million people and for the first time oblige Americans to take out some cover, are the biggest makeover for the US healthcare system since the introduction in the mid-1960s of government-funded Medicare for those aged over 65.Mr Obama saluted the House of Representatives after an exhaustive 12-hour special Sunday sitting which toiled through rancorous debate and points of order before approving the bill by 219 votes to 212. In the end, 34 Democrats voted against the bill. There were suggestions that some of them, representing conservative constituencies, had been given the OK to vote no by Democrat heavyweights confident of a majority and with one eye on November's midterm elections.It will now go to Mr Obama to be signed into law.The house also passed by 220 to 211 a package of amendments in a so-called "reconciliation" bill that will go directly to the Senate for approval."At a time when the pundits said it was no longer possible, we rose above the weight of our politics," Mr Obama, side-by-side with the Vice-President, Joe Biden, said in a televised address from the White House just before midnight. "We pushed back on the undue influence of special interests. We didn't give in to mistrust or to cynicism or to fear. Instead, we proved that we are still a people capable of doing big things and tackling our biggest challenges."We proved that this government - a government of the people and by the people - still works for the people."This isn't radical reform, but it is major reform."This is what change looks like," he said in reference to his campaign slogan. It could also have been a rebuff to Republicans, including Sarah Palin, who goaded Democrats last month by asking, "How's all that hopey, changey stuff workin' for ya?".Victory in the year-long push for healthcare reform was delivered finally by a bloc of about half-a-dozen anti-abortion Democrats who agreed to support the bill on receiving assurances from Mr Obama that a ban on taxpayer funds being used for abortion would stay.The first bill - essentially, the Senate's version of healthcare reform passed on Christmas Eve - may have allowed the channelling of some federal subsidies into abortion services. But the Michigan Democrat Bart Stupak, speaking on behalf of the bloc, said the President's promise of an executive order reaffirming the existing ban on federal funds supporting abortions, had clinched the deal.Republicans argued that an executive order did not carry the force of law and could be overturned. They later goaded Mr Stupak, some shouting "baby killer" across the chamber, after he rejected eleventh-hour efforts to reopen debate on the bill.The victory would immediately enhance Mr Obama's presidency, commentators argued, after months of near-constant criticism that he was aloof and too cerebral for Americans, and probably overburdened by pressing issues, not least the sluggish economic recovery.In recent weeks, however, the President has found renewed voice in his push to win backing for healthcare reform, a key plank of his election platform that promised change.Other measures among the reforms, which preliminary analysis suggests could slice more than $US143 billion off the budget deficit over 10 years, include the creation of a consumer exchange where individuals and small businesses can shop for insurance policies. It also provides for penalties if people do not buy some cover or if a business evades its responsibilities to its workers.Introduction of the measures will be gradual, taking three to four years. Some tax imposts on wealthy Americans are not scheduled to kick in until 2018.The House Speaker, Nancy Pelosi, marked the historic moment in Congress by describing the reform as "an American proposal that honours the traditions of our country".She cited the late Edward Kennedy, as a longtime driving force, for his role in the triumph.Shortly before his death last August, Senator Kennedy had written to Mr Obama saying that "access to healthcare was the great unfinished business of [American] society"."Until today," Mrs Pelosi added.Lamenting what he said was a compromised bill and the fact that polls revealed a deeply divided nation over healthcare reform, the Republican leader, John Boehner, said the chamber had "failed to listen to America, and we have failed to reflect the will of our constituents"."Shame on each and every one of you who substitutes your will and your desires above those of your fellow countrymen," the House Minority Leader said.WHAT€™S IN THE BILL ... AND WHEN IT WOULD TAKE EFFECT$250 rebate to Medicare prescription drug beneficiaries who reach the coverage gap called the €śdoughnut hole€ť Within a yearProvide immediate access to high-risk pools for people with no insurance because of pre-existing conditions 90 days after enactmentBar insurers from:€ Denying people coverage when they get sick€ Denying coverage to children with pre-existing conditions€ Imposing lifetime caps on coverageRequire insurers to allow young people to stay on their parents€™ policies until they turn 26 6 months after enactmentRequire individual and small group market plans to spent 80 percent of premium dollars on medical services; large group plans would have to spend at least 85 percent January 1, 2011Increase the Medicare payroll tax and expand to dividend, interest and other unearned income for singles earning more than $200,000 and joint filers making more than $250,000 2013Provide subsidies for families earning up to 400 percent of poverty level, currently about $88,000 a yearRequire most employers to provide coverage or face penaltiesRequire most people to obtain coverage or face penalties 2014Impose 40% excise tax on high-end insurance policies 2018Expand health insurance coverage to 32 million people 20191915 Progressive campaign in eight states for compulsory health insurance fails.American Medical Association initially supports the idea, then rejects it.1932 Study finds that millions of Americans cannot afford healthcare.recommends group insurance. AMA and other critics denounce ideas as €śsocialist€ť.1933 Democrat President Franklin Roosevelt (left) supports national health reformduring his 12 years in office but is unable to overcome congressional opposition.1944 Wagner-Murray- Dingell bill provides for universal health insurance; billreintroduced twice but never gains traction.1945 Democrat President Harry Truman (left) calls for a single universal system.The AMA, other critics warn of €śsocialised medicine€ť.1962 Democrat President John Kennedy (left) addresses the nation to talk about Medicare; AMA issues televised rebuttal. 1965 Medicare and Medicaid, health programs for the elderly and the poor, become law.1976 Democrat Jimmy Carter€™s (left) campaign for national insurance fails. 1993 Democrat President Bill Clinton effort at reform, including universal coverage, meets with fierce opposition.2008 Healthcare reform is major issue of presidential campaign; both candidatesannounce comprehensive proposals.Feb 2010 Obama holds bipartisan health care summit, White House releases detailedhealthcare plan. March Bipartisan analysis says Senate bill with Obama revisions willreduce deficit, spending. Big push to find 216 votes to pass bill in House. All GOP, some Democrats oppose.
© 2010 Sydney Morning Herald