Obama's Health Care Reform: Is It Really That?

Despite some advantages, the bill is so watered down that it barely lives up to its name.

Like many Canadians, I was pleased when Barack Obama was elected president. Obama's campaign speechifying was uplifting and his proposed vision for America was encouraging, especially after eight years of inept and foolish governance. But a fair and prudent judgment of his skills would have to wait until he began to enact policy. On March 21, the bitterly fought and long-awaited healthcare reform bill was passed, and two days later, Obama signed the bill into law.

The Republicans, holding fast to their ultra-right, paleoconservative ideology, have vowed to continue the fight. But on many fronts, they have already won. Not only did they wear the American people down with their pernicious lies and evidence-free "debates,” they also took on the Democrats with such skill and vehemence that some Dems folded faster than Superman on laundry day. The current health care reform bill is but an emaciated shadow of its former promise.

Remember the public option? Health care insurance provided by the state and not by private corporations was a key component of the plan envisioned by Obama. The public option would spend vastly less money on administrative costs than is the case with private insurance. Indeed, it was held up as a cost-saving measure, reducing costs in the range of $25-$110 billion. And as Nobel-winning economist Paul Krugman stated, the public option – despite being supported by a majority of Americans – could drive private insurers out of business, leading to a single-payer system, which is cheaper and more efficient. Add to that the fact that so many in Congress have ties to the health insurance industry, and it was only a matter of time before the public option was withdrawn.

This bill also does not offer universal health care, keeping the U.S. in the unenviable position of being the only industrialized nation in the world without universal coverage.

Health care costs may not be lower for Americans. For example, annual premiums will likely not go down, and insurance companies are not prevented from hiking rates.

It’s also unlikely that this bill will prevent medical-related bankruptcies. In 2009, 62 per cent of personal bankruptcies were medical-related, and of those who went bankrupt because of health care bills, 75 per cent had health insurance. It's the out-of-pocket costs that can lead to financial ruin.

The health insurance companies are ecstatic because not only does this bill mirror many elements of insurance company association America's Health Insurance Plans' 2009 plan, but also because the uninsured must purchase insurance from private companies. For those who refuse, the IRS can garnish two per cent of their annual incomes in penalties.

Yes, more Americans are covered. Yes, lower-income Americans will receive subsidies. These are good things, and they take the U.S. further ahead. But is this really health care reform, or could it be another bag of money handed over to a powerful insurance lobby – the same entity that spent millions to pillory Hillary Clinton when she attempted reform in the early 1990s?

Obama and the Democrats have shown that the progressive voice in America has no political power. The right was never interested in reform, faithfully adhering to its "me first, screw you" conservatism, and Obama, despite his many overtures to the right, was never going to get them onside. The rest of America, many of whom are likely disappointed with a watered-down bill, are broken and tired; a case of emotional attrition due to seemingly endless fighting, promises lost, and commitments squandered.

America, besieged by fanatical tea-baggers, Republican fear-mongering, and Democratic reluctance, is left with expectations set so low for reform that any bill, even when it fails on many of its initial promises, is lauded as a victory.

Once again, middle and lower-income Americans lose, while the health insurance industry in America chomps on a cigar, grins, and declares another victory.