When you’re the newly-installed leader of the most powerful nation in the world and you inherit two of the biggest issues facing the country and the world, there are many ways to skin the cat. The woeful state of the economy aside, healthcare is the next main concern for Americans.
Roughly 45·7 million Americans—15% of the country’s population—lack health insurance. Both wealthy and poorer states have almost a quarter of residents between the ages of 18 years and 64 years uninsured. The US Congressional Budget Office predicts that, nationwide, the number of uninsured people will rise by 10 million in the next decade. And this in a country where health-care expenditure alone is estimated to exceed US$2·5 trillion this year (17% of the GDP).
How did this situation arise? Well, largely because there has never been a national policy of healthcare; healthcare services were private-sector driven and subjected to market forces. Only the elderly (Medicare), the poor (Medicaid) and the military (Veterans Health Admin) were provided with some sort of cover, and this too was limited. Not that there were no attempts by previous Presidents to redress the issue. The Clinton (Hilary, not Bill) healthcare plan was mooted in 1993 to provide universal healthcare for all Americans but fell by the wayside – largely because it was formulated behind closed doors and eventually attacked by its own party members.
Enter President Obama. Realising Clinton’s mistake of not getting public consensus first before planning, one of his first tasks was to call for a White House Forum on Health Reform summit in the East Room which was held on 5th March 2009 and attended by 150 representatives, including legislators from both parties and representatives of interest groups such as drug companies, health professionals and labour unions.
Lesson No 2 – engage the people across the country. Via the internet, 9000 community discussions were held throughout the country from December 2008 and 3,000 reports filed in to the forum.
Even at the Summit, it was clear that the President wasn’t going to get his way as exemplified by his campaign promises on healthcare reform (covered by my posting here “Obama vs McCain on Healthcare”). But there was room for compromise and consensus..lesson no 3.
Although the path is long and expensive and the solutions far from apparent, the President concluded that there was “a clear consensus” over the need for reform, promising a “transparent and inclusive” process.
Initiating a national healthcare financing plan is an arduous challenge for any country in the world, but the lessons from Obama so far show a practicable and feasible way of tackling the problem, no matter how enormous it is. Perhaps, other countries (like Malaysia, where they have been vacillating a national insurance plan for decades) can benefit from these lessons on the way to go forward.