Leading article: President Obama can – and must – win this battle

Reform of the US health system is in the whole country's interest

Related Topics

Barack Obama's presidency will not stand or fall by the fate of his proposed reform of the US health system. Nor is the Senate's postponement of any vote until after the summer recess fatal. The delay is, however, indicative of the almighty battle of wills the President faces, with the US Congress, with his own Democratic Party, and with the massed ranks of special interests ranged around the behemoth that is the healthcare establishment in the United States – the insurance companies, the drug firms, their lawyers and lobbyists.

Together, this makes for a huge, wealthy and powerful coalition. When it also incorporates the majority of Americans who say they are content with their present health provision, there can be no mistaking the magnitude of Mr Obama's task. But, as he said in his latest foray to win over the sceptics, "this debate is not about me – I have great health insurance and so does every member of Congress". It is about the 47 million people who at any one time have no private health insurance, about the 25 million who discover their cover is inadequate, and about the toll this takes on the country as a whole.

Americans can hardly say they had no warning. Mr Obama was voted in on pledges that included tougher regulation of the financial sector, diplomatic re-engagement with the world, withdrawal from Iraq and – right up there with those priorities – reform of the health system to make insurance accessible to all. Nor can the uninsured complain about the quality of his advocacy. Mr Obama has been as categorical and consistent as any scandalised European in his condemnation of the inequalities the US health system exacerbates. Figures for infant mortality and life expectancy lag behind those in much of Europe, while more personal bankruptcies are caused by health costs than any failed business or financial scam.

Yet the longer the debate goes on, the more it seems to resemble the last blighted effort at health reform, the scheme scornfully written into history as Hillary-care. Opponents of reform seem suddenly to be on the front foot again, playing the politics of fear. They are citing waiting lists, gate-keepers and the supposed scourge of "socialised medicine", just as they did 15 years ago. Universal health insurance, they insist, will be bought at the expense of those who now enjoy some of the most comprehensive and advanced treatment in the world.

There are many reasons, however, why Mr Obama can, indeed must, succeed. He can succeed because he has clearly studied and learnt from the mistakes made by Mrs Clinton. Rather than circumvent the insurance companies, he wants to co-opt them. And he has laid out the principles of reform, while leaving the practicalities to Congress. This has created a confusion of plans and contributed to the delays, but it has left Mr Obama free to campaign from the high ground. It has also removed the personalisation that proved so lethal to the Clinton scheme; this time blame for failure will be shared.

And Mr Obama must succeed because, although the present system serves many well, it also leaves too many people out, while devouring an ever-increasing proportion of GDP. With most people insured through their workplace, unemployment rising, and the budget deficit yawning wider, all the assumptions on which the US healthcare edifice rests are looking shaky. With energy, commitment, and even the country's parlous economic figures on his side, the President has every reason to stay in the fight.

React Now

Latest stories from i100
iJobs Job Widget
iJobs General

KS2 Teacher Cornwall

£21500 - £40000 per annum: Randstad Education Plymouth: Randstad Education Ltd...

IT Project Manager

Competitive: Clearwater People Solutions Ltd: Our client based in Chelmsford a...

Business Intelligence Specialist - work from home

£40000 per annum: Ashdown Group: An established and growing IT Consultancy fir...

Business Intelligence Specialist - work from home

£40000 per annum: Ashdown Group: An established and growing IT Consultancy fir...

Day In a Page

Read Next
Nigel Farage has urged supporters to buy Mike Read's Ukip Calypso song and push it up to the No 1 spot  

Mike Read’s Ukip calypso is mesmerisingly atrocious — but it's not racist

Matthew Norman
Shirley Shackleton, wife of late journalist Gregory Shackleton, sits next to the grave of the 'Balibo Five' in Jakarta, in 2010  

Letter from Asia: The battle for the truth behind five journalists’ deaths in Indonesia

Andrew Buncombe
Indiana serial killer? Man arrested for murdering teenage prostitute confesses to six other murders - and police fear there could be many more

A new American serial killer?

Police fear man arrested for murder of teen prostitute could be responsible for killing spree dating back 20 years
Sweetie, the fake 10-year-old girl designed to catch online predators, claims her first scalp

Sting to trap paedophiles may not carry weight in UK courts

Computer image of ‘Sweetie’ represented entrapment, experts say
Fukushima nuclear crisis: Evacuees still stuck in cramped emergency housing three years on - and may never return home

Return to Fukushima – a land they will never call home again

Evacuees still stuck in cramped emergency housing three years on from nuclear disaster
Wildlife Photographer of the Year: Intimate image of resting lions claims top prize

Wildlife Photographer of the Year

Intimate image of resting lions claims top prize
Online petitions: Sign here to change the world

Want to change the world? Just sign here

The proliferation of online petitions allows us to register our protests at the touch of a button. But do they change anything?
Ed Sheeran hits back after being labelled too boring to headline festivals

'You need me, I don’t need you'

Ed Sheeran hits back after being labelled too boring to headline festivals
How to Get Away with Murder: Shonda Rhimes reinvents the legal drama

How to Get Away with Murder

Shonda Rhimes reinvents the legal drama
A cup of tea is every worker's right

Hard to swallow

Three hospitals in Leicester have banned their staff from drinking tea and coffee in public areas. Christopher Hirst explains why he thinks that a cuppa is every worker's right
Which animals are nearly extinct?

Which animals are nearly extinct?

Conservationists in Kenya are in mourning after the death of a white northern rhino, which has left the species with a single male. These are the other species on the brink
12 best children's shoes

Perfect for leaf-kicking: 12 best children's shoes

Find footwear perfect to keep kids' feet protected this autumn
Anderlecht vs Arsenal: Gunners' ray of light Aaron Ramsey shines again

Arsenal’s ray of light ready to shine again

Aaron Ramsey’s injury record has prompted a club investigation. For now, the midfielder is just happy to be fit to face Anderlecht in the Champions League
Comment: David Moyes' show of sensitivity thrown back in his face by former Manchester United manager Sir Alex Ferguson

Moyes’ show of sensitivity thrown back in his face... by Ferguson

Manchester United legend tramples on successor who resisted criticising his inheritance
Two super-sized ships have cruised into British waters, but how big can these behemoths get?

Super-sized ships: How big can they get?

Two of the largest vessels in the world cruised into UK waters last week
British doctors on brink of 'cure' for paralysis with spinal cord treatment

British doctors on brink of cure for paralysis

Sufferers can now be offered the possibility of cure thanks to a revolutionary implant of regenerative cells
Ranked seventh in world’s best tourist cities - not London, or Edinburgh, but Salisbury

Lonely Planet’s Best in Travel 2015

UK city beats Vienna, Paris and New York to be ranked seventh in world’s best tourist destinations - but it's not London