Regering og opposition om sundhedsreformen i USA

Tidl. guvernør og republikansk vicepræsidentkandidat Sarah Palin havde et indlæg i WSJ (8/9) om sundhedsreformen, som Obama administrationen arbejder på at få gennemført. Hun citerer tidl. præsident Ronald Reagan for at sige, at "no one in this country should be denied medical care because of a lack of funds". Heri er Palin og republikanerne enige, så debatten står mellem to veje for udviklingen af sundhedsvæsenet: a) Større indblanding fra forbundsregeringen i sundhedssektoren, i alt fra finansiering, forsikringsordninger og rationering, som foreslået af præsident Barack Obama eller b) Markedsorientering af sundhedsvæsenet:

"such policies include giving all individuals the same tax benefits received by those who get coverage through their employers; providing Medicare recipients with vouchers that allow them to purchase their own coverage; reforming tort laws to potentially save billions each year in wasteful spending; and changing costly state regulations to allow people to buy insurance across state lines. Rather than another top-down government plan, let's give Americans control over their own health care."

Palin henviser til en artiklen til et indlæg i NYT af Obama, som blev bragt i sidste måned (16/8). Heri præsenterede Obama nogle af elementerne i en kommende reform, som indebærer større regeringsindblanding i sundhedsvæsenet:

"First, if you don’t have health insurance, you will have a choice of high-quality, affordable coverage for yourself and your family — coverage that will stay with you whether you move, change your job or lose your job.

Second, reform will finally bring skyrocketing health care costs under control, which will mean real savings for families, businesses and our government. We’ll cut hundreds of billions of dollars in waste and inefficiency in federal health programs like Medicare and Medicaid and in unwarranted subsidies to insurance companies
that do nothing to improve care and everything to improve their profits.

Third, by making Medicare more efficient, we’ll be able to ensure that more tax dollars go directly to caring for seniors instead of enriching insurance companies. This will not only help provide today’s seniors with the benefits they’ve been promised; it will also ensure the long-term health of Medicare for tomorrow’s seniors. And our reforms will also reduce the amount our seniors pay for their prescription drugs.

Lastly, reform will provide every American with some basic consumer protections that will finally hold insurance companies accountable. A 2007 national survey actually shows that insurance companies discriminated against more than 12 million Americans in the previous three years because they had a pre-existing illness or condition. The companies either refused to cover the person, refused to cover a specific illness or condition or charged a higher premium."

Men det er stadig ikke mere konkret end det. Obama, der i nat dansk tid holder en tale til Kongressen om sundhedsreformen, vil først fremlægge et lovforslag i næste uge, hvorefter de konkrete forslag så kommer på bordet, men der bliver ikke tid til længere debat, da præsidenten og demokraterne ifølge CNN tilsyneladende vil have lovforslaget til afstemning efter 1 uge. Dermed gentager Obama og demokraterne forløbet om stimuerlingspakken til næsten 800 mia. USD fra foråret, hvori et lovforslag på 1.300 sider blev strikket sammen på en aften og sendt til afstemning dagen efter med håndskrevne rettelser uden mulighed for lovgiverne og interesseorganisationerne til at læse, kritisere eller debattere loven.