What will become of Barack Obama’s health reforms? 奥巴马的医疗改革会带来什么？
WHEN Barack Obama signed a sweeping set of health reforms into law on March 23rd 2010, he knew it was a historic moment—and not just because Joe Biden, the vice-president, whispered into his ear that it was a “big fucking deal”. He had successfully ridden the wave of popular support that brought him into office to deliver universal health coverage, a feat that eluded all his predecessors.
But the reality of politics has obstructed that grand dream. Republican leaders in Congress are trying to repeal the law outright. Several federal judges have ruled that one of the central provisions of the new reforms, an “individual mandate” requiring everyone to purchase coverage, is unconstitutional. And a recent poll by the Kaiser Family Foundation (KFF), a non-partisan outfit, revealed that hostility to the laws among politically vital independents has shot up sharply. One year on, how fares Mr Obama’s proudest achievement?
The chief strategy used by the administration to win over sceptics and to undermine legal challenges is to present the new laws as an unstoppable juggernaut. For example, when Kathleen Sebelius, the secretary of health and human services, spoke about the reform to the Senate Finance Committee on March 16th, she pointed to evidence of an “enormous difference it has made in the lives of Americans”.
True, the administration has rushed into force provisions affecting consumers directly, in an effort to win popular support. For example, some forbid insurers from denying coverage to children with pre-existing conditions, or imposing lifetime payout caps on anyone. The new laws also already require insurers to cover children up to 26 on their parents’ policies, which will benefit some 1.2m young people. Nearly 48m people on Medicare, the government health scheme for the elderly, are to get free preventive services such as colonoscopies and mammograms. In 2010 nearly 4m of them got $250 tax-free rebates to help pay for drugs.