ICU Management & Practice, ICU Volume 9 - Issue 2 - Summer 2009

Is the US Ready for Obama

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It has been described as the beginning of a new era in the US; one of change with a push towards equality and balance among citizens. Critics of the new President and his proposed platform have even gone so far as to call it a "socialist agenda" (Daily Herald – Utah; November 1, 2008). Given this pretence, are we to expect the birth of universal healthcare on American soil within the new administration's first term in office? In the current economic climate, all clues should point to no, but the rhetoric that is coming from the White House and the new Health Secretary Kathleen Sebelius seems to be on message with the President's campaign platform – healthcare reform is a priority and it must start sooner rather than later.

The current healthcare system has been called a "system in crisis" by critics inside the country and dire from those outside (The Sunday Times –UK; March 29, 2009). One out of three Americans under 65 went without health insurance at some point during 2007 and 2008, according to a report recently released by the consumer advocacy group Families USA. An estimated 46 million Americans currently lack health insurance. For those who are covered, their employer-sponsored health insurance premiums have doubled in the last 9 years, a rate 6 times faster than cumulative wage increases. The average cost of family healthcare coverage more than doubled from 1999 to 2008, from $1,543 to $3,354, according to a report by the Institute on Medicine release.

"The cost of healthcare now causes a bankruptcy in America every 30 seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes," Obama said.

The United States spent approximately $2.2 trillion on healthcare in 2007, or $7,421 per person – nearly twice the average of other developed nations. Americans spend more on healthcare than on housing or food. Obama made healthcare reform a central theme of his presidential campaign and promised not only to achieve universal healthcare in his first term, but also to cut the average family's healthcare costs by $2,500.

Since his inauguration at the end of January, the White House has noted the first key steps in the President Obama's healthcare reform:
• The Children's Health Insurance Reauthorisation Act (signed on February 4, 2009), provides quality healthcare to 11 million kids – 4 million who were previously uninsured.
• The American Recovery and Reinvestment Act (Signed into law on February 17): Helps 7 million unemployed Americans keep their COBRA coverage for an additional nine months with a 65 percent subsidy;
• The Recovery Act also invests $19 billion in computerised medical records that will help to reduce costs and improve quality while ensuring patients' privacy;
• The Recovery Act also provides: $1 billion for prevention and wellness to improve America's health and help to reduce healthcare costs; $1.1 billion for comparative effectiveness research that will give doctors objective information about which treatments work and which do not; and $500 million for health workforce to help train the next generation of doctors and nurses.

Among other things, Obama is seeking to set aside $634 billion in a healthcare reserve fund over the next 10 years to help move the country closer to the goal of universal coverage. He also would require senior citizens making more than $170,000 annually to pay a greater share of their prescription drug costs under Medicare.

Public support seems, for the most part to be with President Obama and his planned initiatives. In fact, upwards of seventy-two percent of Americans favour an increase in government influence over the healthcare system to help lower costs and expand coverage, according to a February CNN/Opinion Research Corp. poll.

A visit to the government's health website leaves little doubt that "Reform"- as the site is so titled, is in the cards. The information available highlights recent studies, which show that certain populations are suffering under the current system and links to media articles on healthcare issues. Whether wide scale changes are indeed made or initiated in his first year in The White House still remains to be seen, but the "foundations" of change (a key phrase used extensively by President Obama in recent weeks) are certainly being set.

"I suffer no illusions that this will be an easy process. It will be hard. But I also know that nearly a century after Teddy Roosevelt first called for reform, the cost of our healthcare has weighed down our economy and the conscience of our nation long enough. So let there be no doubt: healthcare reform cannot wait, it must not wait, and it will not wait another year." 
- President Barack Obama, February 24, 2009

It has been described as the beginning of a new era in the US; one of change with a push towards equality and balance among citizens. Critics of the new P

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