The historic nature of Obama health reform bill

One thing about this bill is that it brings universal medical insurance across states in the US to the same level with federal government insurance programs. The bill also provides options to private health insurance schemes while, overall, it brings medical insurance coverage up from 85% to 95%. This translates into 32 million people; they were people who could not afford medical insurance earlier on. The bill makes it unlawful for insurance companies to fail to give insurance to people based on previous medical history. It also boosts insurance premiums which increase on a yearly basis. Children can use their parents’ insurance until they are 26 years of age under its provisions. There is control of Insurance costs as well. And the cost of all these?  Nine hundred and forty billion dollars to be spent in the next one decade.

Critics say this is expensive. Republicans fought against the bill based on this and other arguments. But observers say the reform will save America money in the end.  American healthcare system is one of the best in the world; in fact, the existing system has proved enduring. But it also has some unique problems for advanced countries such as the US.  The system, for instance, denies many who need healthcare in several ways, and it has been described as discriminatory, immersed in indifference to the plight of many who need it. In summary, some 45 million Americans have had no access to medical care at all. These are part of the problems President Obama overcame by this bill.

The reform in this bill is groundbreaking and historic for America, though it is not anything like what obtains in the EU countries whose healthcare provisions are perceived as ‘socialist’ in nature by Americans. Yet it is important considering that medicine  in the US has a turnover equal to the British or French economy. Also, what is achieved now has been dreamt of by Americans for decades, but never carried through. The battle that saw this bill come to life is, by inference, not a mean one. Knowing the risk they stand back in their constituencies with voters, lobbies and sponsors, some Democrats voted with the Republicans; not a single Republican lawmaker supported the bill from the beginning, and none voted in its favour in the end. That way, any hope of getting support for subsequent bills in a bipartisan Congress is eroded. President Obama’s chance of having two-third majority in support of any major issue for the rest of his presidency has become thin following this bitter fight. Yet he saw it through.

There are two identifiable risks President Obama took by this. For one, failure at this stage – getting bills that would be policy thrust of a new administration through – had been the undoing of some past democratic party administrations. Former President Jimmy Carter, was an example. His administration had limped to the finishing line thereafter. Former President Bill Clinton got shot in the foot too. He had tried to reform healthcare in 1994, but the Democrats lost control over Congress at mid-term election, and he lost it. Clinton was re-elected for a second term, but nothing great came out of it for his bill. Had Obama lost on this count, his legislative program would be hamstrung, his administration would have begun to limp, long before it could crawl.

On another note, President Obama has put his political future at risk by ramming the bill through. White, Republican President, Theodore Roosevelt, backed off from a major health reform in 1912. Now, 98 years to its centenary, an African-American Democrat had what he wanted; and that in the face of stiff opposition. Already, voters have given a Democrat’s safe seat, one that belonged to late Senator Edward Kennedy, to a Republican in the January election. This fact had once made some Democrats throw up their hands, almost giving up on the health bill. Some other presidents might think of next November’s mid-term election to Congress and back off. And there is Obama’s re-election bid in 2012 to think of, even though he said the passing of the bill by the Congress was the right decision.

There is something that should be noted about a president who saw risks to himself but went ahead with his plan; an Obama who had health reform issues on top of his presidential campaign agenda and, in spite of all he went through, delivered on his promise. Yes, the risk this poses to his political fortune is apparent. But there is a lesson for leadership here, especially in Africa where leaders deliberately circumvent the system, working against what is necessary to better the lives of their citizens. President Obama may gain when he is thought to have lost grounds. For Americans, after those who sent him to the White House for his audacity of hope and the change he promised have a better understanding of the bills’ positive provisions, may yet rise in his support when the time comes.    

Ajibade, a Consultant Writer, lives in Abuja, [email protected]