US health care a test of political gridlock

       In what was being described as a make-or-break moment for United States President Barack Obama, on Wednesday he showed the form that won him the presidency against some pretty long odds less than a year ago with a speech before Congress on healthcare reform. With his reasonable and at times passionate address it looks likely that his Democrat Party will be able to pass a meaningful - though far from perfect reform bill despite the obstruction of such efforts by Republicans and some Democrats who seem to be against all change.
       This bodes well for his presidency and for the US as a whole, and also to a greater degree than might be obvious - for the international community,which needs the US to take a lead role in issues ranging from Middle East peace to climate change.
       That's not to say the US can solve these issues single-handedly, nor is it meant to imply that the US role in them thus far has been exemplary. But clearly it is not a good thing if the world's biggest economy and most powerful nation militarily - not to mention technologically - is hamstrung into confusion and impotence by political haggling. That's exactly what the nation has been on the verge of for a long time, well before Mr Obama came to town, with partisan politics making even routine government business impossible at times.
       If a decent healthcare bill can be passed it is a strong signal that a new coalition is forming that can actually move forward on necessary legislation.
       To his credit Mr Obama has tried to reach out to those on the opposite side of the political fence and compromise and build trust across the political spectrum. This has come at the expense of the support of the progressive base that worked hardest to see him elected.
       For this he has been rewarded with a campaign from the anti-healthcare reform contingent that can only be described as deceitful. Some even went as far as to say his reform bill contained hidden clauses that authorised "death panels" for old people or people with severe disabilities because medical care for them is just too expensive.
       The detractors of healthcare reform speak of the dangers of government involvement in health care, conveniently ignoring the fact that almost every developed nation and most developing nations have socialised medicine to some extent, and that the US' own Medicare programme and Veterans'Administration hospitals are run by the government.
       As noted above, Mr Obama has made compromises, and perhaps too many of them. According to several sources, he agreed to take a single payer plan off the table without a fight.
       Single payer means a government-run organisation would collect all healthcare fees, and pay out all healthcare costs, thus cutting out the need for private insurance companies.
       According to the group Physicians for a National Health Program (PNHP),the US spends twice as much as other industrialised nations on health care,yet the system performs poorly in comparison and still leaves 45.7 million people without health coverage and millions more inadequately covered.
       PNHP says this is because "private insurance bureaucracy and paperwork consume one-third of every healthcare dollar.
       "Streamlining payment through a single nonprofit payer would save more than $400 billion per year, enough to provide comprehensive, highquality coverage for all Americans."
       Mr Obama is on record as being in favour of a single payer plan, but feels it is not politically feasible.
       He is probably right about that.The crucial issue now is whether the public option, a government-run alternative to private insurance, will make it into the final bill.
       Polls have consistently shown that a majority of Americans are in favour of a public option.
       In his speech on Wednesday night Mr Obama came out strongly in favour of a public option, but unfortunately he stopped short of saying the measure is imperative in a final bill.
       The president can't be faulted for making concessions to avoid a political impasse, but now is the time to draw a line and deliver on some of the genuine change he promised when he was campaigning.
       The detractors of healthcare reform in the US speak of the dangers of government involvement in health care, conveniently ignoring the fact that the Medicare programme and Veterans'Administration hospitals are run by the government