Healthcare reform: a victory for democracy

The Senate voted Thursday 24 December the bill to overhaul the US health care system and to guarantee access to health insurance for tens of millions of Americans. If the bill becomes law, it would be a milestone in the history of US social policy, comparable to the creation of Social Security in 1935 and Medicare in 1965. It is a historic achievement - after several attempts by Roosevelt, Kennedy and Clinton- putting an end to an iniquitous system where healthcare is mostly controlled by private insurance companies which provide coverage only to the healthy and those which can afford the high costs of the premium. The significance of the reform is that health is not a market good but a right, something which cannot be left to market forces for people most in need. Incidentally, the USA has one of the lowest life expectancy index among the wealthiest capitalist economies.

The reform should cover 95% of the population giving access to health insurance through public subsidies. The Congressional Budget office estimates that the bill would provide coverage to 31 million uninsured people, but still leave 23 million uninsured in 2019. One-third of those remaining uninsured would be illegal immigrants.

It is not meant to be a national health system like in most European countries. The funding mechanism is, however, complicated and expensive. The bill would require most Americans to have health insurance, would add 15 million people to the Medicaid and would subsidize private coverage for low- and middle-income people, at a cost to the government of $871 billion over 10 years.

The strong opposition of the republicans and right wing ideologists show how this reform is far reaching and limits the power of the health insurance companies. It is a victory for democracy and human rights.