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Sicko no more – Yea for Obama!

March 23, 2010

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After a yearlong push, president Obama succeeded where many  before him have attempted but failed. In an historical victory on Sunday night, the House of Representatives approved of a comprehensive health care bill – with 219 to 212 votes and not a single republican voting for –, thereby clearing the way for far reaching health care reforms.

The call for an overhaul of the US health care system began as a way to come to the aid of the uninsured. It gained momentum however when middle-class families flooded congress with complaints about their insurance companies, including sky high premiums, denial based on pre-existing conditions and even cancellations when they became ill.

President Obama made the passing of the health care bill – which will provide medical coverage to 32 million uninsured Americans and affect almost everyone who is already covered – the centerpiece of his agenda. The heated political battle that preceded the bill’s approval will likely divide parties for many years to come and be used by republicans as a weapon in this year’s midterm elections.

One American that will likely have celebrated Sunday night is liberal filmmaker and author Michael Moore. His 2007 documentary Sicko investigates the US health care system, focusing on insurance companies and the pharmaceutical industry.

According to Sicko, close to 50 million Americans are uninsured and even those who are covered often become victims of insurance company fraud. In the documentary, former employees reveal initiatives aimed at cutting costs and increasing company profits, including giving out bonuses to physicians who can find reasons to deny necessary treatment for policyholders.

In the new health care bill, insurance companies are barred from denying coverage for pre-existing conditions, canceling coverage for sick people, as well as charging higher premiums based on a person’s gender or medical history.

Cartoon by John Cole

Individuals at the same time are required to purchase coverage for which new subsidies will be provided to families of four with an annual income of up to $88,000 – four times the poverty standard in the US. Tax for Medicare (the US social insurance program for retirees) will be imposed on investment income for individuals making over $200,000 and couples making over $250,000. The plan is projected to cost $940 billion in the first 10 years and to reduce the deficit by $130 billion during that period.

The US health care reform plan is in part modeled after the way universal health care is organized in European countries, including the Netherlands. Interestingly enough, in recent years the Netherlands has looked at the US health care system when it searched for ways to increase patient quality as well as productivity and efficiency in health care.

In 2006 a new system based on regulated competition was introduced. The Dutch model includes a mandatory basic coverage – for which low-income citizens are subsidized – and optional supplemental coverage that can be purchased at an additional premium.

So far, surveys about public satisfaction in the Netherlands provide conflicting findings. However, a 2009 study by Sweden and Brussels based Health Consumer Powerhouse – a private research company co-funded by the European Commission – ranked the Netherlands number 3 of countries where people get ‘the most bang for their buck’ on its Euro Consumer Health Index.

The US health care overhaul will stretch out over the next years, with some legislation – such as access to high-risk pools for people with no insurance because of pre-existing conditions – taking effect almost immediately. Most reforms however will not take place until 2014 so we will have to wait to fully see and feel ‘what change looks like’.

For the moment, I celebrate Obama’s victory and that of the 219 democrats that supported the bill and helped move America in the right direction for all, republicans included.

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