Leading article: President Obama makes a decent fist of a thankless job

There are signs of progress on health, but greater challenges remain

Share
Related Topics

The odyssey of American healthcare reform should by now have removed any lingering illusions about the difficulty – some would say, the near impossibility – of legislating complex public policy in a system as hedged by checks and balances as that of the US.

By historical standards, the vote by the House of Representatives late on Saturday night passing a measure that extends coverage to tens of millions of Americans currently without it, and imposes tough new rules on the privately run insurance industry, was a triumph. Not since Lyndon Johnson bulldozed Medicare and Medicaid into law in the 1960s has an effort to overhaul the country's manifestly inadequate healthcare system progressed as far.

It is worth remembering that the last such attempt, by Bill Clinton more than 15 years ago, did not even make it out of committee on Capitol Hill. This time the Senate is finalising a bill, while the House has actually passed one, that would reshape a sector accounting for one-sixth of the entire US economy. Alas, the hard part is yet to come.

The House vote was fraught enough; with almost 40 of Mr Obama's own Democrats defecting, it was approved by a majority of just 220-215, and then thanks only to last-minute horse-trading over the ever-vexed matter of abortion. The Senate will be an even tougher obstacle. A leading Republican there has already pronounced the House measure "dead on arrival", while approval by the Senate of its own bill depends on more deals, not only on abortion, but also on a government-run insurance scheme, the so-called "public option" opposed by many moderate Democrats as well as virtually every Republican.

Whatever legislation emerges must command the support of 60 of the 100 members of the Senate, if it is not to be filibustered to death in a chamber where party discipline is notoriously weak. There are only 58 Democratic Senators, plus a couple of independents. The margin of error for Harry Reid, the majority leader, is precisely zero.

Healthcare reform moreover is only the beginning. Two more measures of massive import, tackling climate change and placing new regulations on the financial markets, are lumbering towards the legislative runway. In the current sour economic climate, both will be a tough sell; they have already prompted criticism that Mr Obama is trying to do too much, too quickly. All of which of course merely underscores the often-forgotten reality of the US system – that while a president has vast discretionary powers in foreign policy, in the domestic arena he is as easily tied down as a sleeping Gulliver.

But foreign policy too threatens to be barely less frustrating and unmanageable. Mr Obama's impending trip to Asia, where he visits China, Japan and Korea and attends the Apec summit in Singapore, offer a let-up in the pressure. But in the Middle East, his push for a breakthrough between Israel and Palestine has collapsed, while his critical decision on whether, and by how much, to increase American troop strength in Afghanistan – a decision made no easier by last week's rampage by a Muslim officer at Fort Hood in Texas, in which 13 people were killed – cannot much longer be delayed.

Mr Obama's greatest asset remains his personal popularity. Americans may have doubts about his policies, but they still seem to like the man himself. However, likeability, intelligence and large majorities in Congress are no guarantee he will succeed, either at home or abroad. Not for the first time, the presidency is on display for what it is: the toughest and most thankless job on earth.

React Now

Latest stories from i100
SPONSORED FEATURES
iJobs Job Widget
iJobs General

Recruitment Genius: Membership Sales Advisor - OTE £10,000 Uncapped - Part Time

£7500 - £10000 per annum: Recruitment Genius: The fastest growing fitness chai...

Recruitment Genius: IT Support Engineer - 2nd & 3rd Line

£25000 per annum: Recruitment Genius: The IT Support Engineer is needed to ass...

Recruitment Genius: Operations Officer

£15000 - £17000 per annum: Recruitment Genius: It's an exciting time for this ...

Recruitment Genius: Junior / Mid Software Developer

£22000 - £30000 per annum: Recruitment Genius: This is an exciting opportunity...

Day In a Page

Read Next
 

Think I'm living the high life on benefits? Here's what being disabled costs me every day

Hannah Buchanan
 

Like many other black men, I grew up with only women around. Now I'm worried the experience has ‘feminised’ me

Tyrell Williams
Refugee crisis: David Cameron lowered the flag for the dead king of Saudi Arabia - will he do the same honour for little Aylan Kurdi?

Cameron lowered the flag for the dead king of Saudi Arabia...

But will he do the same honour for little Aylan Kurdi, asks Robert Fisk
Our leaders lack courage in this refugee crisis. We are shamed by our European neighbours

Our leaders lack courage in this refugee crisis. We are shamed by our European neighbours

Humanity must be at the heart of politics, says Jeremy Corbyn
Joe Biden's 'tease tour': Could the US Vice-President be testing the water for a presidential run?

Joe Biden's 'tease tour'

Could the US Vice-President be testing the water for a presidential run?
Britain's 24-hour culture: With the 'leisured society' a distant dream we're working longer and less regular hours than ever

Britain's 24-hour culture

With the 'leisured society' a distant dream we're working longer and less regular hours than ever
Diplomacy board game: Treachery is the way to win - which makes it just like the real thing

The addictive nature of Diplomacy

Bullying, betrayal, aggression – it may be just a board game, but the family that plays Diplomacy may never look at each other in the same way again
Lady Chatterley's Lover: Racy underwear for fans of DH Lawrence's equally racy tome

Fashion: Ooh, Lady Chatterley!

Take inspiration from DH Lawrence's racy tome with equally racy underwear
8 best children's clocks

Tick-tock: 8 best children's clocks

Whether you’re teaching them to tell the time or putting the finishing touches to a nursery, there’s a ticker for that
Charlie Austin: Queens Park Rangers striker says ‘If the move is not right, I’m not going’

Charlie Austin: ‘If the move is not right, I’m not going’

After hitting 18 goals in the Premier League last season, the QPR striker was the great non-deal of transfer deadline day. But he says he'd preferred another shot at promotion
Isis profits from destruction of antiquities by selling relics to dealers - and then blowing up the buildings they come from to conceal the evidence of looting

How Isis profits from destruction of antiquities

Robert Fisk on the terrorist group's manipulation of the market to increase the price of artefacts
Labour leadership: Andy Burnham urges Jeremy Corbyn voters to think again in last-minute plea

'If we lose touch we’ll end up with two decades of the Tories'

In an exclusive interview, Andy Burnham urges Jeremy Corbyn voters to think again in last-minute plea
Tunisia fears its Arab Spring could be reversed as the new regime becomes as intolerant of dissent as its predecessor

The Arab Spring reversed

Tunisian protesters fear that a new law will whitewash corrupt businessmen and officials, but they are finding that the new regime is becoming as intolerant of dissent as its predecessor
King Arthur: Legendary figure was real and lived most of his life in Strathclyde, academic claims

Academic claims King Arthur was real - and reveals where he lived

Dr Andrew Breeze says the legendary figure did exist – but was a general, not a king
Who is Oliver Bonas and how has he captured middle-class hearts?

Who is Oliver Bonas?

It's the first high-street store to pay its staff the living wage, and it saw out the recession in style
Earth has 'lost more than half its trees' since humans first started cutting them down

Axe-wielding Man fells half the world’s trees – leaving us just 422 each

However, the number of trees may be eight times higher than previously thought
60 years of Scalextric: Model cars are now stuffed with as much tech as real ones

60 years of Scalextric

Model cars are now stuffed with as much tech as real ones