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Parties do battle on US healthcare reforms

Democrats and Republicans go head-to-head as lawmakers from both parties gauge public opinion of planned healthcare reforms

As Republicans prepare to meet and outline a strategy that will derail President Barak Obama's radical reform agenda, Democrats have taken the fight to the opposition, vowing to push changes to the US healthcare system through the Senate, with or without Republican backing.

Both parties are planning to mobilise campaigns aimed at gaining public support using all channels available to them, as the insurance industry hatches its own strategy to scupper the proposed reforms. Democrat lawmakers and the president will use town hall-style meetings, grassroots lobbying and an extensive TV advertising campaign to tell the American people that the sweeping changes will revamp healthcare provision and protect them by ending unfair insurance company practices, including refusing to cover people with pre-existing conditions. Republicans are also planning a swathe of public meetings, and a large number of radio and television appearances.

The coming weeks will be crucial in shaping public opinion, as lawmakers from both parties head across country to gauge constituents' reaction to the planned reforms. Republicans plan to undermine the initiative as a costly exercise, leveraging figures from polls that suggest Americans are uneasy about what lies ahead. Representative Mike Pence of Indiana, chairman of the Republican Conference has issued materials to colleagues, urging them to change opinion by telling people that proposals would lead to 'more than $800bn in new tax hikes' and cuts to Medicare that could lead to millions of US senior citizens losing their health insurance.

Democrats are taking a different tack; they plan to tell those already insured what's in it for them, quashing concerns of increased out of pocket costs, as policies are made available to those with modest incomes. "We understand the future of health reform could hinge on how the conversation with the American people goes in the next six weeks," Representative Chris Van Hollen, Democrat of Maryland, told the New York Times.  

Dissension in the ranks
Although Obama has set the tone and overall goal for the reform agenda, the details of expanding healthcare coverage and increased cost control have been left to the Democratic-controlled House and Senate. As a result Democrats have been bickering about the merits of the proposals. While four congressional committees, one in the Senate and three in the House of Representatives, have approved reforms without the support of a single Republican, a number of conservative Democrats had to be drafted in at the risk of some more liberal votes.

The outline of the $1trn healthcare overhaul has been criticised by members of both parties but there are signs of consensus that would result in more Americans gaining access to health insurance. Both parties recognise the pressing need to rein in spiralling healthcare costs, nevertheless there is still division on the rigour of such measures, with the Senate Finance Committee struggling to find a compromise that would win over Republicans.

Democrats and Republicans alike appear to agree proposals to ban underwriting practices that prevent millions of Americans accessing affordable healthcare cover. However, for some this is just another conflict in a long-fought battle: 75 years ago Democrats first tabled the idea of a comprehensive national health insurance programme. In 1993-94 similar proposals bombed under Bill Clinton thanks to opposition from the insurance industry.

However with Karen Ignagni, president of America's Health Insurance Plans claiming that the industry supports reform and both parties united on plans to provide federal subsidies to make health insurance affordable for people on modest incomes, it is possible that a deal can be struck by the early September deadline.

4th August 2009

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