Financial Times Editorial Comment: Hurdles ahead for US health reform

Financial Times Editorial Comment: Hurdles ahead for US health reform
Copyright The Financial Times Limited 2009
Published: October 14 2009 22:02 | Last updated: October 14 2009 22:02
http://www.ft.com/cms/s/0/150c0872-b8f3-11de-98ee-00144feab49a.html


The Senate finance committee, a crucial player in US healthcare reform, at last voted through its bill on the subject this week. It is likely to form the core of any eventual law. Barack Obama called the committee’s vote a milestone, but cautioned that “we’re not there yet”. He was right on both counts.

In spite of the many compromises already struck, and the countless (often needless) complications already introduced, the bill is indeed a bold and comprehensive measure. After months of to and fro, one should recognise that fact.

The plan, for the first time, would require every American to have health insurance – a provision that is decades overdue. It would make this mandate effective by expanding the Medicaid programme for the poor, subsidising private insurance for millions of other Americans, and telling insurance companies to stop denying coverage to the sick. It would meet the minimum standards of health-care already taken for granted in every other rich country.

The system the plan would create is not perfect. No country has devised such a system. The costs remain a pressing concern. Critics could legitimately hope to improve the bill before final passage. But to oppose this proposal, or something like it, as a step backward is wrong. The system reformed along these lines would require a lot more work in future, to be sure. But repairing the biggest gap in the US social safety net should be regarded as an overriding priority.

Disappointingly, no consensus has formed around that basic goal. The US public is suspicious, and who can blame it? A lack of direction and the administration’s lassitude in making its case have engendered scepticism and resistance. Success is not assured.

The committee passed its bill with just one Republican vote. The Republican party sees a political opportunity: reasoning that it can stop the project and blame the White House for recklessness and over-reaching, it has been implacably negative. The committee’s Democratic majority dropped the “public option” – a new government-run plan to compete alongside private plans, much desired by most Democrats – and compromised with centrist opinion on other points as well, to no avail.

It is deplorable that Republicans are being so obstructive. They complain the bill’s good points will be ground down before it passes. If so, the time to object would be when that happens. Meanwhile, their intransigence has increased the risk that the bill will get worse not better, if it passes at all.