A new chapter in the history of healthcare reform

By Dr. Ananya Mandal, MDMar 22 2010

Making of History

The US house of Representatives has voted narrowly to pass a landmark reform that has been on the agenda for quite some time now. The bill passed by 219 votes to 212, with no Republican backing after strong debate. This bill will extend insurance coverage to 32 million more Americans, and marks the biggest change to the US healthcare system in decades.

"We proved that we are still a people capable of doing big things," President Obama said in his remarks after the vote. "This legislation will not fix everything that ails our health care system, but it moves us decisively in the right direction," he said. He said he would expect to sign the legislation into law soon.

The Vote

When the vote count hit the magic number of 216 - the minimum needed to pass the bill - Democrats hugged and cheered in celebration and chanted: "Yes we can!" Under the legislation, health insurance will be extended to nearly all Americans, imposes new taxes on the wealthy, and bars restrictive insurance practices such as refusing to cover people with pre-existing medical conditions. Speaking moments before the vote, House Speaker Nancy Pelosi said the health care reform honored the nation's traditions. "We will be joining those who established Social Security, Medicare and now, tonight, healthcare for all Americans," she said, referring to the government's pension program and health insurance for the elderly established nearly 50 years ago.

The Republicans however have vowed to continue resisting it. They say the measures are unaffordable and represent a government takeover of the health industry. "We have failed to listen to America," said Republican party leader John Boehner.

Sceptics & queries

“In the short term Obama will get a boost, because the narrative is that he came back from the dead and got done what no president has managed to do in 70 years,” said Peter Wehner, who was a political adviser to President Bush. “But once people discover that their Medicare taxes are going up, that there are deeper cuts in Medicare Advantage, that there are court challenges to many provisions, and that the process of getting it passed created a portrait of corruption, it won’t sit well.”

President Obama countered this feeling by saying that three-quarters of a century of American history is largely on his side. In 1966, celebrating the creation of the first Medicare rolls that covered 20 million Americans, President Johnson recalled the complaints three decades earlier that Social Security “would destroy this country,” and noted “there is not one out of 100 who would think of repealing it.”

Amidst protests and doubts regarding anti-abortion moves, President Obama on Sunday also announced plans to issue an executive order assuring that healthcare reform will not change the restrictions barring federal money for abortion.

Where do we go next?

According to the Congressional Budget Office, the final version of the Democrats' healthcare plan will cut the federal deficit by $138bn (£92bn) over 10 years.

These reforms will increase insurance coverage through tax credits for the middle class and expansion of the Medicaid programme for the poor. They represent the biggest change in the US healthcare system since the creation in the 1960s of Medicare, the government-run scheme for Americans aged 65 or over.

What happens in the future and whether the Republicans are true in their predictions is anybody’s guess but for now credit goes to the young President to have achieved what others failed to.