Obamacare: Listening to the Scottish View Of American Politics

It is interesting how much attention the Obamacare debate is receiving here in Scotland and throughout the UK.  The papers are filled with stories and it is all over the television news.  In today’s Independent, the big story was the Stupack Amendment and abortion.  From”Abortion Hijacks the US Healthcare Debate”:

While the US Supreme Court returned to women the right to seek an abortion in the landmark 1973 Roe vs Wade ruling, Congress subsequently instituted a rule barring the use of federal funds for abortions. But access to abortion, particularly for poorer women, would be narrowed further under the amendment introduced to the legislation by Congressman Bart Stupak last weekend.

The Stupak amendment aims indeed to ensure that abortions will not be available under the new system to women with health coverage subsidised by Government dollars. Additionally, however, it bars insurers from including abortions in their coverage plans if they participate in proposed health insurance exchanges designed to make it easier for lower-income people and small business owners to get insurance.

It didn’t take long for defenders of abortion rights to understand that this represents a change of the rules for women because the effect of the amendment would be to make it impossible for some women to obtain coverage for abortions even when they are ready to pay for it with their own money. “There’s going to be a firestorm,” warned Diana DeGette, a Democrat who opposed the amendment. “Women are going to realise that a Democratic-controlled House has passed legislation that would prohibit women paying for abortions with their own funds... we’re not going to let this into law.”

So much for the fiction that Obamacare would not ever have covered abortions. Indeed, it still might.

But back to the point: People and media here seem most intrigued by two issues. First, and foremost—because Britain is bleeding—what Obama will do in Afghanistan, beyond our purview here. Next, is Obamacare, which they hope will succeed, in part because they believe our health system is worse than it actually is, and because they know a loss will hurt Obama politically and hurt him badly.

In this regard, they worry that recent NHS difficulties have harmed the cause for Obamacare, and are upset when I confirm that opposition to NICE-style rationing has been one of opponents’ most potent weapons. Not that they don’t bemoan the current state of the NHS and admit that national health care in the UK has real problems.  But when they learn that the bloom has somewhat gone off the Obama rose, and this in large part due to Obamacare, they become quite concerned.

And yet: When they learn that the thing has bloated up to 2000 pages, they are shocked.  When they discover it seeks to encompass far more than merely bringing the uncovered into greater health security, they shake their heads.  Those I have spoken with—again anecdotal—think it is a huge mistake to try and remake everything at once and to put so much coverage into health care that it becomes unaffordable for society to carry—a mistake, they say, that has badly damaged the NHS.

Still, great affection remains here for the NHS.  Much of it is a yearning for the way it was before the wheels started coming off.  And in this, I think there is a warning: As one of my dinner conversationalists said—a woman emotionally supportive of our President—it is unwise to rely completely on the state for health care.  Once one becomes too dependent, rehabilitation back into a greater and necessary self reliance can be very painful.