By Chris Cermak, DPA,
Washington : The prospects for President Barack Obama’s signature domestic issue, overhauling a costly US healthcare system, have taken a dangerous and nasty turn this month.
Lawmakers are spending August outside of Washington, criss-crossing their home states and districts. The spectacle of senators being shouted down by angry opponents at townhall meetings has become regular fodder for television news channels.
Pennsylvania Senator Arlen Specter, a Republican-turned Democrat, was warned by one outraged voter this week that “one day God will stand before you and judge you” for his role in the health debate.
It is a ferocious argument that could make or break Obama’s young presidency. Many health reform efforts have collapsed over the last decades and it could well fail again under Obama’s watch.
Interest groups and political groups on both sides have already spent millions of dollars on competing advertising campaigns. Some of the debate has come to mirror the 2008 election campaign, with many broadening the argument to the wider role of government in society.
“There are people who want to expand the conflict and make it messy and noisy and bloody, and think that’s going to undercut change,” Bruce Oppenheimer, professor of political science at Vanderbilt University, told DPA.
Congress will continue the search for compromises when lawmakers return from recess Sep 8. Obama wants a bill by the end of the year.
A failure to pass significant health reforms could sap Obama of the political capital he needs to push through other key reforms on issues like climate change, financial regulation and closing the prison for terrorist suspects at Guantanamo Bay.
One Republican senator, Jim DeMint, last month said health care could be Obama’s “Waterloo”, less than a year into his first term in office.
Such talk is a far cry from Obama’s hopeful inauguration in January and contrasts to his continuing popularity abroad. An average of polls compiled by realclearpolitics.com showed his approval ratings have slipped from above 60 percent in June to around 53 percent this week.
A USA Today/Gallup poll found that 49 percent of Americans disapproved of Obama’s handling of healthcare. Only 43 percent approved.
The White House is struggling to control the message. Obama was forced to defend a charge by Republican Senator Chuck Grassley that the proposed overhaul could allow government bureaucrats to decide when to “pull the plug on grandma”.
One-time Republican vice presidential candidate Sarah Palin said the legislation would create “death panels” that could judge who can and cannot receive care, an idea she called “downright evil”.
The attacks centred on a proposed provision that would offer senior citizens the chance to have a government-funded consultation with their doctor on how to manage their end-of-life care. The consultation would be voluntary.
The top two Democrats in the House of Representatives, Nancy Pelosi and Steny Hoyer, sparked their own controversy when they described angry opponents at townhall meetings as “un-American” in a USA Today editorial.
Healthcare has long aroused passions on both sides of the political aisle. President Theodore Roosevelt, a Republican, launched a failed reform bid back in 1912. The last significant change came with the creation of public plans Medicare (for seniors) and Medicaid (for the poor) in 1965.
The current system is largely private and extremely costly. The US spends about $2,500 more per individual on healthcare than the next highest industrialised country, according to the Organisation for Economic Cooperation and Development. The health industry gobbles up about 16 percent of economic output.
About 46 million people are uninsured, also a far higher number than any other industrialised country. Obama argues health costs pose the biggest threat to the country’s long-term federal deficit.
The debate largely centres around whether to create a public insurance option, and a requirement to take health insurance. Conservatives fear any more government involvement will sharply reduce quality.
Many Americans are extremely skeptical about the proposed changes, partly because about 80 percent say they are happy enough with the quality of their care, despite its high cost.
The debate is complex and many of the details are still up in the air. Five different congressional committees are working on separate bills. Some lawmakers have also proposed separate versions, one of which has the bipartisan support of 15 senators.
Obama has drawn some criticism for not weighing into the debate himself more closely. The White House has laid out the broad parameters, but the crafting of the legislation has been left mostly to Congress.
“I don’t think (Obama) wants to put his feet in cement,” Oppenheimer said. “He wants to maintain some flexibility.”
That reticence could change as the legislation nears a vote in the Autumn months.