U.S. health care reform, seen from abroad
COMMENTARY | July 29, 2009
The overseas press: As in the U.S., reports focus on the need for universal health care, cost control, and the high political stakes for Obama.
By Lauren Drablier
JAKARTA--Internationally, some news and opinion stories see the U.S. getting close to establishing needed health care reform—but others see major obstacles. All in all, in this sampling, the views from abroad seem much like those at home.
A column in Scotland’s Sunday Herald says reform is a must in that the U.S. spends more on health care but gets lower ratings in the most basic criteria than any other developed nation:
“So many presidents have been frustrated in their attempts to introduce universal healthcare that when Barack Obama declared it would be the signature legislative achievement of his first year in office, it was tempting to accuse him of hubris. But after a tough week of negotiations in the Senate and the House of Representatives, the most significant change in US social policy for decades is finally within reach.
“So far this year, insurers, hospitals and drug companies have spent $1.4 million (£857,220) a day on lobbyists. A Washington Post investigation found that 350 former government employees or members of Congress have been hired to influence the debate. This is nothing new, of course. The medical lobby has been adept at framing the discussion, despite damning statistical evidence that the profit motive has corroded America's healthcare system.
“According to the latest data, the US spends an average of $6402 per person on healthcare each year. That is around twice as much as Britain, France, Germany or Japan, yet by the most basic criteria, such as life expectancy or infant mortality, America gets the worst results of any developed nation.
“This does not stop Fox News relating National Health Service horror stories or tracking down disgruntled Canadians, upset at the level of care they receive for their tax dollars. A Wall Street Editorial predicted that ‘the real victims of government healthcare will be American patients’.
“To conservatives, the public plan is merely a precursor to a complete takeover of the system.
“Congress has killed universal healthcare before. Obama must hope that this time will be different.”
A July 25th column inThe Australian outlines obstacles blocking the path to universal health care and states that Obama “risks being branded a failure” if health reform legislation is not passed:
“Barack Obama is discovering the downside to being portrayed as a miracle worker. For almost six months in the White House, the US President rode high on his remarkable popularity. He used public support for his message of hope, change and renewal that inspired voters during the election campaign to assert his authority and win early backing for measures to combat the US recession.
“But the bubble had to burst some time and Obama must wish it hadn't been so soon as he is yet to tackle the big policy challenges of his first term. Opinion polls have started to slide as American voters wonder whether their saviour after George W. Bush is all he was cracked up to be.
“Most worrying to the White House must be the dramatic tumble in support for the way Obama is handling the economy, the budget deficit, health and unemployment. Voters may like Obama, as [White House senior adviser David] Axelrod claims, but a majority has now lost confidence in his handling of these issues.
“After starting out saying he wanted a bipartisan approach to policy, stern resistance from Republican congressional leaders has left Obama with no choice but to revert to partisan support.
“…the first African-American US President risks being branded a failure after expectations were raised so high…
“Countries such as Australia, Britain and Canada had these debates years ago but Obama is fighting a battle that trails back to Harry Truman's failed attempt in 1948. He could end up being forced to accept another layer of a health program grafted on top of the existing regime of private health for the employed and a patchwork of subsidies.
“‘I think the President had a terrific vision and grand plans on where to go with health and climate change, and if we were not left with this budget deficit and the recession was not as deep, it might have worked out,’ Charlie Cook (respected commentator and author of online newsletter The Cook Political Report) tells The Weekend Australian.
“‘Obama cannot escape the realities of the US economy. But if his health and climate change policies don't work, he may have to tread that well-worn path of US presidents whose domestic fortunes wane: concentrate on foreign policy and hope for peace in the Middle East.’”
A column in Germany’s Spiegel Online calls the reformation of the health care system in the US Obama’s personal “crusade” and argues that changing the healthcare system in the US will ultimately change US culture:
“In the cradle of capitalism, the president is arguing for more solidarity. Because up until now, being sick in America has been a private matter; and as a result, 47 million Americans have no health insurance today. So Obama wants America to become less American.
“Every day during the economic crisis, another estimated 14,000 people lose their jobs, and therefore their health insurance. Additionally, the World Health Organization (WHO) reports that thousands of Americans die each year because they are denied the most basic health care. For America, a superpower that likes to set an example to the rest of the world, that is a damning indictment.
“Obama may have inherited a lot of problems from his predecessor, but the reorganization of the American health care system is a crusade he has chosen. If he succeeds, that alone will see him go down in history as a notable leader. If he fails, though, it will be his first serious defeat. At the moment, the situation isn't looking very good for him.
“The plan is as bold as it is overdue. The American health care system is expensive, ineffective and socially inequitable -- and it comes at an annual per capita cost of $7,500 -- twice as high as in Germany. Since 2000, doctors, hospitals and the pharmaceutical industry have managed to achieve a 70-percent increase in earnings, which Obama calls "health inflation."
“The renowned Institute of Medicine even estimates that almost one-third of all medical care in the US -- or about $700 billion worth -- is "pure waste." This figure is one-and-a-half times the German federal budget and even exceeds the US military budget.
“The magnitude of the problems has always been overshadowed by the size of the anti-reform coalition. Once again, the Republicans are intent on launching a battle of the cultures. Because while the debate revolves around party tactics, it also touches on some fundamental issues about American culture. How American should America be in the 21st century?”
France 24, in a news article after Obama’s July 23rd press conference on health care, sees Obama trying to regain the initiative:
“With his presidency nearing the six-month point, the healthcare stalemate is seen as a test of Obama’s ability to move forward on a pressing domestic priority and to fulfill the promises of change that carried him to a decisive victory in last November’s election.
“Healthcare reform has been a thorn in the side of many US presidents, including Bill Clinton who tried, and very publicly failed, to change the system.
“This latest attempt has been hampered by the price tag of the reform (a projected $1 trillion in the next ten years), Republican resistance to Obama’s proposals, and a complex web of competing interests, including those of private insurers, hospitals, and drug companies.
“One sticking point being currently debated in Congress is the income surtax on high earners that Obama mentioned as a way of financing the overhaul.
“Throughout his remarks, Obama warned that a prolonged stalemate would only lead to soaring insurance fees and more uninsured Americans.”
In Washington Commentary: The Options – Healing the Sick or ‘Breaking’ Obama, Thailand’s Asian Tribune highlights all of the angles that Obama is taking in order to push for reform, paralleled with those taken by his opponents:
“America’s ‘Great Health Care Debate, 2009,’ is being carried out at a high decibel level. Partisans on all sides of the discussions keep increasing their stridence on whatever issues particularly attract or repel them, often exuding heat and sound but not shedding light.
“Obama approaches the health care debate from three directions. First, there is the profoundly human side to it, with close to 50 million people in the Affluent Society without any health insurance at all. Like numerous others, he finds this form of gross inequity intolerable, and is determined to change it.
“Second, he sees the current health care system as not serving most of the insured adequately, because of (a) steadily increasing costs and also because (b) many crucial decisions are taken not by doctors but by insurance companies. The latter fact is glossed over by critics of health care reform who argue that a “public option” would take the power of choice away from doctors.
“Actually, in many cases it would take that power away from medically untutored insurance staff. Meanwhile, insurance premiums are doubling every nine years, rising faster than wages and causing great hardship to many of those who are fully insured.
“Third, he is convinced that ballooning health care costs are a major driver of the federal deficit. Health care costs account for almost 18 percent of GDP thereby affecting the health of the economy.
“Meanwhile, doctors, nurses, professional institutions, and the American Association of Retired Persons have come out in strong support of reform. Public attitudes, as measured by polls, are sharply divided. Both the insured and the uninsured want reform. The insured do not want anything less than what they now have. Neither group wants reform to involve escalating costs down the years
“Then there are the exponents of “Nobama-Obama” politics. They have thrown all kinds of dirt at him – including the discredited allegation that he is not a natural-born US citizen – expecting some of the dirt to stick to him. They forget, of course, that dirt adheres to those who do the throwing. Their purpose, having failed to prevent him from gaining the presidency through the people’s vote, is to prevent him from winning a second term. They appear confident that they can exploit health care reform to bring about his eventual downfall.”
In Obama, Health reform cannot wait, Italy’s AGI stresses the need for health care reform in the US, noting, however, that opposition is tough:
“The reform of the US health system is "central" to the US economy and Congress must approve it by the end of the year.
“But the measure must deal with opposition in both parties: the conservative democrats who maintain that the stalemate is due to a lack of information on how the government will save money or pay for the new healthcare system; the liberal democrats concerned that the project will not be sufficient and the Republicans who have attacked the plan saying that it has exorbitant costs.”
China’s Xinhua discusses how health care reform will affect Asian Americans in Asian Americans call for full, inclusive health reform:
“…while the legislative proposals mention health disparities among ethnic groups, the bills fail to cover the many immigrants and legal permanent residents who live and work in the U.S., but for whom the cost of health insurance is too often out of reach.
“‘It's critical that Congress not be divided by distractions and focus on improving health care for all communities,’ said Sonal Ambegaokar, health policy attorney for the National Immigration Law Center.
“She said many immigrants paid the same taxes as U.S. citizens, but many legal immigrants were not able to obtain or were made to wait years to get affordable health care programs that were paid for by their taxes.
“‘Asian Pacific Islanders and other immigrant communities must take action in order to be included in any reform proposal,’ said Scott Chan, community advocate for the Asian Pacific American Legal Center.”
Lauren Drablier, based in Paris, has a masters degree in nternational affairs from Sciences Po Paris.
Editorial Team, NewsTrust
08/01/2009, 09:59 PM
This is a fantastic roundup thank you! I've submitted it, and all the links to NewsTrust (disclosure: I work there) to get all of this information to the community there which is engrossed in health care, but doesn't often look at international sources. Thank you!