The Obama Health Plan and the Republican onslaught

When President Barack Obama pushed through Congress a health reform law, which is giving more than 30 million Americans access to healthcare, which they never had before, the Republicans - and the right wing Tea Party - never forgave him. Indeed, the losses that the Democratic Party had in the recent mid-term elections were partly due to the heartland of the Republican Party and the Tea Party expressing anger over the health plan.What is now even more revealing is that the opponents of the health plan have moved from seeking redress in the people’s court — the Congress — to fighting a rear guard war through the judicial system by filing various cases in the courts.A federal judge in Virginia ruled on Monday that the keystone provision in the Obama healthcare law is unconstitutional. This is the provision that requires most Americans to obtain insurance — either from the public or private sector — to be protected against paying enormous medical bills when they fall sick.President George Bush, a Republican, appointed this federal judge to office.Two other district court judges have in the recent past supported the health plan in their rulings. But it is to be noted that these are judges appointed to their positions by Democratic presidents. Hence the battle in the courts is really a political battle couched under the principle of constitutional interpretation of a congressional law meant to influence the lives of ordinary Americans in a certain direction.Medicine is very expensive in the US, so is hospitalisation. When the poor, who do not have insurance cover, fall sick, they either die or seek solace in public healthcare amenities, which somebody pay for. This includes Medicare, a public funded health insurance scheme to which the poor resort for some limited insurance coverage. But conservatives have attacked even this as a scheme that offers "a free ride to the indolent and lazy".The current annual World Health Report by the World Health Organisation (WHO) is focused on ‘Health Financing: Towards Universal Health Coverage’. It argues, with facts and figures across the globe, why access to quality, adequate and affordable health care is so crucial to everyone. It provides data of nations, which have done well in development as being those, which have put premium on the health of their people.Whether one is talking about Great Britain – just coming out of the Second World War in 1946; of Cuba – following the Revolution of 1958; of Brazil – after the devastating military regimes that were ended by the constitutional reform of 1988; or even of Rwanda – following the genocide of 1994; the attention given to universal healthcare is key to overall development of the country.There is really no correlation between how rich a country is and how well it gives its people healthcare. Many developing countries today have come up with very imaginative health financing systems, which quickly steer them successfully towards universal coverage. Usually these are done through health insurance schemes that combine private and government funding. The aim, however, is one: Reducing out-of-pocket expenditure and minimising or even abolishing user charges. In this regard, the poor are not left out to be perpetual victims of underdevelopment and lack of access to healthcare.The report goes further to point out that it is inconceivable for any government to commit itself to achieving the Millennium Development Goals without, at the same time, having a time action plan for achieving universal health insurance coverage by the year 2015.At the recent global conference on Health Financing in Berlin at which this report was launched as countries gave their reports on universal health coverage, Kenya was expected to be at the forefront as one of the few countries, which had a National Health Insurance Scheme by 1966. Indeed, countries like Malaysia, Singapore and Philippine did borrow from the Kenyan model when they were starting their own, but they are now way ahead of Kenya.There are two things to remember about universal healthcare: One, no matter how poor or rich one is, one never knows when one is going to fall sick, and with what type of illness.Two, even if one is insured for all types of illnesses and at whatever time or age, one never knows when any of one’s relatives, friends, workmate, employee or an accident victim one comes across on the highway will fall sick, and need care even when they are not insured.The whole point about universal healthcare coverage is that we all pool our resources together to minimise the risks any one of us may run into in terms of seeking healthcare when we don’t have money, are too old to earn money, or are faced with an ailment too costly to treat from our meagre resources.It is the Government that has the capacity to mobilise resources and bring in all players to put together a scheme of healthcare financing and insurance, which can take care of all the citizens.In the US, the Obama administration has come up with the Affordable Care Act, which, among other things, compels every American to take up health insurance so that in the event of illness they are not a burden either to themselves, their neighbours, or the state. The Government is putting at the disposal of such people an affordable government-funded health insurance scheme, which, for all intents and purposes, is a subsidised scheme.Kenyans, being rational people, should support such a policy rather than be compelled to attend harambees every now and again raising money for kidney, heart, lung, brain, liver, colon ailment of a patient held up at the Kenyatta National Hospital or being flown to India for urgent organ transplant or other forms of treatment.

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