Leading article: A victory that may come to define the Obama presidency

The deal on US healthcare is a compromise, but still hugely significant

Share
Related Topics

American presidents, it is often said, have about a year to make their mark – enact a major piece of legislation that then shapes and defines the rest of their term in office. Failure to choose the right weapons, or the right turf, can be fatal.

Barack Obama has at times struggled to find a cause he can truly make his own. He seemed to take on too many issues at once, from Middle Eastern peace to climate change, without demonstrating that he had a clear strategy to carry them through. With the Senate's passage of his bitterly contested healthcare bill, the clouds have lifted a little. Just in time for the Christmas break, the President can afford to wipe the sweat from his brow and contemplate his holiday with some satisfaction.

Much attention here and in the United States has been focused on what this mammoth undertaking, involving nine months of political haggling, has already cost him politically. To many of the most fervent Obama supporters, the compromises he has had to strike in order to guide the bill through the Senate and the House of Representatives have resulted not in a golden mean but leaden mediocrity. For left-wing Democrats, abandonment of the so-called public option, the direct provision by the state of health insurance for the poor, is a bitter pill.

That is almost certainly a lost cause now, a casualty of a savage Senate battle against resurgent Republicans who closed ranks against Obama's supposedly "socialist" health reforms with frantic and, at times, disconcerting zeal.

Nor is the battle over the trimmed-down health reform package finished, even now. What the Senate agreed to on Christmas Eve was not the same package that the House of Representatives nodded through in the autumn. A joint committee will have to meet, therefore, probably within the next few days, to fuse the two bills into one, which will then go back to both houses. Only then will the bill become law, hopefully before the President delivers the State of the Union address next month.

Nevertheless, we should not lose ourselves in all the details about messy compromises, and so miss the vital significance of what Mr Obama is tantalisingly close to achieving. The President is surely right to assert that most of a loaf is better than no loaf at all, and to describe his health reform package as the most important item of social policy in America since the 1930s.

Tens of millions of poor Americans who have been denied healthcare cover in the past can in all likelihood look forward quite soon to a day when they will be able to face the prospect of illness with a little more equanimity than they do now. Under the new bill, most people who are not currently covered by Medicaid – the existing federal and state-funded insurance scheme for those on low incomes – will either have access to it, or will receive subsidies to obtain health insurance elsewhere. Businesses will be obliged to offer coverage to their employees. The number of potential beneficiaries of these changes is huge, and could affect the lives of more than 30 million people.

Democratic presidents and politicians since the era of Teddy Roosevelt have fought and lost battles to set up a comprehensive national system of health insurance for Americans – a system that would benefit the many, not just the few. The Clintons tried their hand at this and failed. If Mr Obama closes this deal, he has a chance to earn a place in American history as a great reformer.

React Now

Latest stories from i100
iJobs Job Widget
iJobs General

Digital Project Manager/BA

£300 Per Day: Clearwater People Solutions Ltd: An experienced Digital/Ecommerc...

Creative Content Executive (writer, social media, website)

£30000 - £35000 Per Annum + 25 days holiday and bonus: Clearwater People Solut...

SEN Teacher

£100 - £120 per day: Randstad Education Bristol: Supply special educational ne...

Regional ESF Contract Manager

£32500 - £35000 per annum: Randstad Education Birmingham: European Social Fund...

Day In a Page

Read Next
 

August catch-up: Waiting on the telephone, tribute to Norm and my Desert Island Discs

John Rentoul
Jihadist militants leading away captured Iraqi soldiers in Tikrit, Iraq, in June  

Middle East crisis: We know all too much about the cruelty of Isis – but all too little about who they are

Robert Fisk
Middle East crisis: We know all too much about the cruelty of Isis – but all too little about who they are

We know all too much about the cruelty of Isis – but all too little about who they are

Now Obama has seen the next US reporter to be threatened with beheading, will he blink, asks Robert Fisk
Neanderthals lived alongside humans for centuries, latest study shows

Final resting place of our Neanderthal neighbours revealed

Bones dated to 40,000 years ago show species may have died out in Belgium species co-existed
Scottish independence: The new Scots who hold fate of the UK in their hands

The new Scots who hold fate of the UK in their hands

Scotland’s immigrants are as passionate about the future of their adopted nation as anyone else
Britain's ugliest buildings: Which monstrosities should be nominated for the Dead Prize?

Blight club: Britain's ugliest buildings

Following the architect Cameron Sinclair's introduction of the Dead Prize, an award for ugly buildings, John Rentoul reflects on some of the biggest blots on the UK landscape
eBay's enduring appeal: Online auction site is still the UK's most popular e-commerce retailer

eBay's enduring appeal

The online auction site is still the UK's most popular e-commerce site
Culture Minister Ed Vaizey: ‘lack of ethnic minority and black faces on TV is weird’

'Lack of ethnic minority and black faces on TV is weird'

Culture Minister Ed Vaizey calls for immediate action to address the problem
Artist Olafur Eliasson's latest large-scale works are inspired by the paintings of JMW Turner

Magic circles: Artist Olafur Eliasson

Eliasson's works will go alongside a new exhibition of JMW Turner at Tate Britain. He tells Jay Merrick why the paintings of his hero are ripe for reinvention
Josephine Dickinson: 'A cochlear implant helped me to discover a new world of sound'

Josephine Dickinson: 'How I discovered a new world of sound'

After going deaf as a child, musician and poet Josephine Dickinson made do with a hearing aid for five decades. Then she had a cochlear implant - and everything changed
Greggs Google fail: Was the bakery's response to its logo mishap a stroke of marketing genius?

Greggs gives lesson in crisis management

After a mishap with their logo, high street staple Greggs went viral this week. But, as Simon Usborne discovers, their social media response was anything but half baked
Matthew McConaughey has been singing the praises of bumbags (shame he doesn't know how to wear one)

Matthew McConaughey sings the praises of bumbags

Shame he doesn't know how to wear one. Harriet Walker explains the dos and don'ts of fanny packs
7 best quadcopters and drones

Flying fun: 7 best quadcopters and drones

From state of the art devices with stabilised cameras to mini gadgets that can soar around the home, we take some flying objects for a spin
Joey Barton: ‘I’ve been guilty of getting a bit irate’

Joey Barton: ‘I’ve been guilty of getting a bit irate’

The midfielder returned to the Premier League after two years last weekend. The controversial character had much to discuss after his first game back
Andy Murray: I quit while I’m ahead too often

Andy Murray: I quit while I’m ahead too often

British No 1 knows his consistency as well as his fitness needs working on as he prepares for the US Open after a ‘very, very up and down’ year
Ferguson: In the heartlands of America, a descent into madness

A descent into madness in America's heartlands

David Usborne arrived in Ferguson, Missouri to be greeted by a scene more redolent of Gaza and Afghanistan
BBC’s filming of raid at Sir Cliff’s home ‘may be result of corruption’

BBC faces corruption allegation over its Sir Cliff police raid coverage

Reporter’s relationship with police under scrutiny as DG is summoned by MPs to explain extensive live broadcast of swoop on singer’s home