US health care – divided by a common language

Nothing apart from guns for all makes the US seem quite so foreign as the Great Health Insurance debate. The holy grail of universal health cover is far from a done deal. Having narrowly passed the House, it starts all over again the Senate. The Murdoch-owned Wall St Journal’s (still free) coverage gives us the true fruit of the right wing vine. First, on costs it sounds a lament for the rich the reader is expected to sympathise with.

“The House bill would impose a tax of 5.4% on individuals with annual modified adjusted gross income exceeding $500,000 or for couples with $1 million a year, effective from January 2011. The surcharge is projected to raise about $461 billion in revenue, almost half of the cost of the measure passed by the House Saturday. The bill would spend slightly more than $1 trillion over a decade to provide health insurance to an additional 36 million Americans by 2013.”
Mind blowing figures. But rather than draw the obvious conclusion that the US should look seriously at value for money for the first time, they prefer to raise moralising fears – horrors – that abortion just might be covered. (BTW, “roil” means, disturb, muddy the waters – I had to look it up.)

Finally another topsy-turvy argument, that anything approaching universal entitlement means not better health care for the poor but rationing under government diktat for the rich. Abortion is exposed as an entry point to the right wing argument.
“However, as subsidized costs soar, government will have no choice but to ration medical care, starting with the aged and grievously ill… The real importance of the abortion uproar is as preview of the politics that will dominate every medical coverage issue if ObamaCare becomes law. Every decision of what to insure or not—when an MRI can be used, or whether a stage-four breast cancer patient can get Avastin or some future expensive drug—will become subject to political intervention over moral disputes or budget constraints. Heretofore, these decisions have largely been made between a doctor and patient. This is the real “right to life” issue.”
Rationing is of course a universal fear, but we would agree that it should not be governed by ability to pay, wouldn’t we?

Brian Walker

Former BBC journalist and manager in Belfast, Manchester and London, Editor Spolight; Political Editor BBC NI; Current Affairs Commissioning editor BBC Radio 4; Editor Political and Parliamentary Programmes, BBC Westminster; former London Editor Belfast Telegraph. Hon Senior Research Fellow, The Constitution Unit, Univ Coll. London