Obama has another go at health

Public health and the availability of healthcare in an affordable and efficient way are top priorities for people in most countries. Governments respond to that by ensuring that they, too, are seen to prioritise healthcare. And yet it is a political graveyard, whatever country you may want to consider. The only politician that I can remember in my lifetime, in any country of which I have knowledge, making some political capital out of the health brief was Charles Haughey, when he was Minister for Health in Ireland in the late 1970s. He somehow managed to side-step the hot issues and dodge the usual bullets, and was admired and lauded; and for what? He offered every member of the population a toothbrush. Smart move.

Every other politician who has tried health has regretted it. Brian Cowen and Mary Harney in Ireland; Frank Dobson and many others in the UK; Hillary Clinton and, now, Barack Obama in the US. The problem is that everyone wants to be protected and cared for, but without big bills when disease or ill health strikes. And nobody knows how to square that circle. The only way to do it securely is through insurance that has been properly assessed on an actuarial basis, but unless there is some ‘risk equalisation’ (meaning that the cost of insurance is not related to the likelihood of illness) it becomes prohibitive; and if there is risk equalisation it becomes unprofitable for insurers. There is no way of winning in this game.

And yet, as civilised countries, we must find a way of addressing this, as we cannot go back to making people live insecurely in fear of the consequences for them and their families of serious illness. So we must continue to try, and more politicians will have to be offered up on this altar.

Let us hope that Barack Obama – whom the world needs to be successful for all sorts of reasons – is not one of these. After a lot of political jousting over the past year on the back of proposals made by his Democratic Party, he has now come forward with his own proposals for health reform. In the United States this is vital not least because of the large numbers who are currently outside any system of healthcare. If I read his plan correctly, he is hoping to achieve progress through compulsory insurance for all in a setting of a regulated industry with capped premiums (so presumably some risk equalisation). Whether this can work remains to be seen. But much more important right now than whether the figures might add up is whether it can work politically. There would be damaging consequences if this plan fails. So I am not thinking too much about whether this is a viable way of managing healthcare, I am just hoping it is accepted and is implemented, so that Americans can get proper cover and so that Obama’s political capital rises again. These are tricky times, and what happens to US healthcare may affect us all in unexpected ways.

Explore posts in the same categories: politics, society

Tags: , , ,

You can comment below, or link to this permanent URL from your own site.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.


%d bloggers like this: