The battle over the future of the US healthcare industry moved to the airwaves yesterday as Americans got their first glimpse of advertisements in support of President Barack Obama's vision of change featuring ordinary citizens bewailing a system that has let them down.
Even as the 30-second spots began airing, Mr Obama was again in his bully pulpit giving interviews on the network news broadcasts and making one more press appearance on the lawn of the White House Rose Garden. The aim was to push members of Congress to accelerate passage of a plan to guarantee health insurance coverage for everyone.
But the road to that goal still seems a very long one. Only this weekend, successive members of Congress, including several key Democrats, warned that an August deadline for passing versions of a new healthcare bill in the Senate and the House of Representatives was almost certain to be missed, potentially dooming the whole effort.
However, there was some good news for the President yesterday when a key Senate committee finally settled on a final proposal for legislation. The plan they adopted suggests creating a public insurance plan that consumers could opt for in preference to private policies.
The Obama TV ads offer plainly told stories from five Americans whose lives have been turned upside down by illness and the problems they faced in getting (and paying for) care. It was to be shown in Washington DC and in several states which have members of Congress who could be critical in helping passage of the reform, including Florida, Indiana and Maine. Almost 50 million people in America are without any kind of health insurance.
When Bill and Hillary Clinton proposed reform in 1993, they were thwarted in part because of the infamous "Harry and Louise" series of television advertisements. They were financed by industry lobbyists opposed to reform and featured two actors at a kitchen table speculating about the horror of government-run medicine.
This time, the White House clearly has no intention of leaving the airwaves to its opponents. But it will certainly have to share them. Moreover, the storm of competing advertisements and videos will break not just on TV but also on the internet. And unlike 16 years ago, the bulk of these propaganda campaigns are likely to involve not actors but real people. Already on YouTube is a clip from Conservatives for Patients' Rights, which opposes reform, with testimony from a British woman, Katie Brickell. She laments the National Health Service, which, she says, refused to give her the pap smear that might have prevented her cervical cancer. "In all likelihood, I only have a couple of years," Ms Brickell says in the clip. "I feel the National Health Service has let me down."
Mr Obama is not seeking a single-payer system, however. Even in its most pristine form, the reform will leave a system that still relies primarily on a hodge-podge of private insurance plans coupled with new subsidies to consumers to help them pay for policies. The mix will also include mandates on businesses to oblige them to offer coverage.
Certain to also hit headwinds are plans detailed in committees in the House of Representatives this week to finance the changes in part with new surtaxes on the richest Americans.
"During a deep economic recession, it is criminal malpractice for Democrats to push a government takeover of healthcare and a new small-business tax that will destroy more jobs," House Minority Leader John Boehner, a Republican, insisted.
In his Rose Garden yesterday, Mr Obama was flanked by leaders of the American Nurses Association offering their support for reform. "I really like nurses," he said, recalling the care given by nurses when his youngest daughter Sasha caught meningitis as an infant.
The President acknowledged the success of the Senate health committee in reaching agreement. "This progress should make us hopeful – but it shouldn't make us complacent."
Case study: Left to pick up $165,000 bill
Greg Douglas of Maine was out of luck when he flipped his pick-up truck and his flying tool box broke his collar bone and several ribs.
As he was rushed to hospital – where he would remain for nearly a month – he thought the insurance his wife had through her waitressing job would see them through. It didn't.It turned out that the restaurant group that employs his wife, Pam Douglas, had weeks before switched insurers and the new firm baulked at paying the costs of the hospital stay, leaving the family to pay $165,000. Neighbours did their best to help, raising $3,000. "The town put on this benefit," said Mrs Douglas. "Nobody had ever seen so many people. I cried the whole time." It has helped, but not much.Reuse content