What is next for US Healthcare?


Throughout the presidential election campaign, the then Democratic Party nominee Barack Obama kept reiterating the need for healthcare reform and made promises to the country that efforts toward that end would be the cornerstone of his administration. But now that we have seen his functioning style as President over the tenure, there is little reason to believe that the election campaign promises would be met. Since Obama’s inauguration in January 2009, his efforts to reform the healthcare system were met with persistent opposition from the Republicans and a handful of conservative Democrats, both in the House of Representatives and the Senate. With the recent loss of Massachusetts senate seat to Republicans, the task of passing the healthcare reform bill has become more challenging.

The State of Healthcare Today:

But beyond the nitty-gritty of political maneuvering and discussing the merits and demerits of various reform plans, a more fundamental moral question need be answered. The question is, why is the United States, in spite of being the world’s leading economic power, continue to offer no health insurance for a significant section of its population (nearly 50 million citizens) and provide poor quality healthcare for the rest? For example, among all the advanced economies of the Western world, the United States holds the notorious distinction of poor health outcomes and high healthcare costs. Even our northern neighbor Canada has a better healthcare system, with the help of an effective public option (Krugman, 2010).

Practical Impediments to Healthcare Reform:

In the article written by Gail R. Wilensky, there is no effort to address this fundamental ethical question. Moreover, while Wilensky points to the dangers associated with increasing the fiscal deficit. Even with the current estimates on projected Medicare and Medicaid savings, as well as savings from capping deductions for the rich, there is bound to be a “potential shortage of $300 billion to $600 billion of additional revenue because most estimates of 10-year cost of full coverage are in the range of $1.2 billion to $1.5 billion (with some estimates being as high as $2 billion)” (Wilensky, 2009). But we have to remember that a deficit of $300 to $600 billion over a ten year time frame pales in comparison to the $700 billion bailout that was handed to the failed financial institutions of our country. Surely, there is something sinister about our economic system, when privately owned and run banks are given preference over the health and wellbeing of millions of citizens.

Prospects for the Future and Conclusion:

In contrast to Gail Wilensky’s view that partisan politics is thwarting meaningful healthcare reform, the true reason for the prevailing healthcare stalemate is the strong corporate influence over our democratic institutions. This is reflected in the choice of staff members in the executive branch of government, the handpicked appointments to posts in judiciary, the corporate funding of candidates during election campaigns, etc. Again, Wilensky fails to mention the crucial fact that the reason healthcare reform became an election issue last year is because of pressure from large business corporations such as GM and Walmart, to alleviate their expenditure toward employee health insurance (Richmond & Fein, 2007). This suggests that legislative changes take place in our country only when one or other of the corporate groups will the government to make favorable changes. It then begs questions about the nature of our democratic institutions and whether or not we have a functioning democracy in the first place. Such contrasting viewpoints on the reasons for the healthcare inaction are expressed by noted documentary filmmakers such as Michael Moore, as well as prominent left-wing intellectuals like Howard Zinn, Noam Chomsky, Paul Krugman, etc. According to these alternative voices of reason, meaningful progress, in healthcare or in other aspects of society and economy, will not come about, until we address the broader systemic flaws.


Richmond, Julius & Fein, Rashi (2007), The Health Care Mess: How We Got into It and What It Will Take to Get Out, Harvard University Press.
Krugman, Paul (July, 2009), Why markets can’t cure healthcare, Column in New York Times, retrieved from http://krugman.blogs.nytimes.com/2009/07/25/why-markets-cant-cure-healthcare/
Gail R. Wilensky (August, 2009), Healthcare Reform: A Work in Progress, retrieved from http://www.hfma.org/hfm/2009archives/month08/HFM0809EOW.htm>