ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Obama's Was a False Promise

Why is single-payer national health insurance not on the agenda?

The Republicans, posturing as saviours of the “free market”, rail against – what they dub – government takeover of the healthcare system, while the Democrats, posing as champions of the “public interest”, pass a bill that serves the interests of the private insurance industry which drives the dysfunctional healthcare system in the United States (us). The liberals then applaud from the sidelines. Democracy as stagecraft is, we must admit, so perfectly choreographed/orchestrated/engineered over there. The Patient Protection and Affordable Care (PPAC) Bill – passed by the US Senate on 24 December last year – was cleared by the House of Representatives on 21 March by a vote of 219-212. Not a single Republican in either the Senate or the House voted for the bill. President Barack Obama signed it into law on 23 March, claiming to have fulfilled his healthcare reform agenda.

The PPAC Act will make it mandatory for the millions of Americans, who have not already done so, to buy the healthcare from the private insurance industry. The Act will in a very limited fashion address major gaps in the current healthcare system. Employers will be fined if they do not provide health insurance, the insurance companies can no longer deny healthcare if there are pre-existing conditions, there will be no lifetime limits in serious illnesses, subsidies will be provided to an estimated 16 million low-income Americans to help pay for insurance and discounts will be provided to those on Medicare to support payment of drugs. However, even after implementation there will still be 23 million Americans uninsured in 2019. Whatever good there is in the bill could have been enacted on a stand-alone basis – for instance, additional funding for community health centres, or the expansion of Medicaid (for the poor). Anyway, a number of the major provisions of the bill will be effective only by 2014, and some, only by 2018.

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