Why sickly US health bill affects us all

Republican resentment bodes ill for yet-to-be-passed bills

So the picture on Capitol Hill may now be one of grinning Democrat faces -- but for how much longer? Early today, health-care reforms backed by President Barack Obama finally scraped past the crucial Senate hurdle, with the Democrats getting the required 60 votes to move the bill to a final vote by Christmas Eve.

Yet this Democratic victory has bred deep resentment in the Republican caucus. Reports from Washington suggest that a new era of partisanship is about to begin, boding ill for yet-to-be-passed bills still tied up in the Senate.

The key concern is that Republicans will choose to play politics, causing domestic intransigence to weigh down on globally important issues such as climate change and nuclear weapons proliferation.

Climate change legislation, which Senate Democratic leaders aim to bring to the floor by next spring, has been hotly opposed by Republican senators, particularly those from the manufacturing states. The failure of the bill to pass through the Senate before the recently ended Copenhagen summit was blamed as one of the reasons for the world's subsequent inability to agree on a legally binding treaty, demonstrating how America's domestic problems have impeded global co-operation.

Similarly, Obama wants the Senate to ratify the Comprehensive Test Ban Treaty, a legally binding agreement that calls for a world halt to nuclear weapons testing which the US Senate declined to ratify in 1999. To date, the treaty has been signed by 182 countries, but has yet to come into force because the US and eight other countries have yet to give it their approval.

Both bills require a 60-40 majority to pass, making a show of bipartisanship all but crucial for any hoped-for success: with exactly 60 Democratic senators there is no room for manoeuvre. And, remember, Obama's stated goal was to achieve a bipartisan health bill -- a forgotten hope.

Republicans are convinced that the Democrats are heading towards an "historic mistake" and intend to force a series of six procedural showdowns to keep Senate in session right through Christmas Eve -- a tactic designed to drag the final vote out until after the Democrats' self-imposed deadline. If successful, this would further delay attempts to work out a compromise between the House's and the Senate's health-care legislation.

Moreover, the Democrats' hard-fought win still hangs in the balance -- the absence of a single member of the Democratic caucus could derail the bill's progress.

"What the American people should pray is that somebody can't make the vote," Senator Tom Coburn of Oklahoma, a leading Republican opponent of the health bill, was quoted as saying.

The Senate bill, as it now stands, will significantly transform the US health-care system, mandating almost all Americans to buy insurance, with those from lower-income groups receiving subsidies to do so. It would mean 94 per cent of Americans under the age of 65 would have medical coverage by 2019.

But compromises had to be made in order to win the necessary votes.

The option of a new government-run insurance plan to compete with private insurers was dropped, while support had to be given to revised language on abortion in order to win the crucial 60th vote from Senator Ben Nelson from Nebraska -- one of the most conservative Democrats. The bill now says that states can opt out of insurance plans that cover abortions, and state "insurance exchanges" will have to offer at least one plan that does not fund abortions.

Nelson's support for the bill was also given on condition that the federal government will permanently fund Nebraska's bill for Medicaid, the insurance plan for the poor.

Such wrangling for votes has attracted fierce criticism that the concessions made to Nebraska are akin to bribery and corruption. Senator John Cornyn, a Texas Republican, described the effort to get the 60 votes as "basically a pay-to-play approach . . . and it's just repulsive".

However, this does not mean that the haggling is over. The bill will have to be merged with the House's version, which still restrains the government option and places stricter limits on abortion funding, before going back to both houses for another vote.

 

Follow the New Statesman team on Twitter

 

Getty
Show Hide image

Arsène Wenger: how can an intelligent manager preside over such a hollowed-out team?

The Arsenal manager faces a frustrating legacy.

Sport is obviously not all about winning, but it is about justified hope. That ­distinction has provided, until recently, a serious defence of Arsène Wenger’s Act II – the losing part. Arsenal haven’t won anything big for 13 years. But they have been close enough (and this is a personal view) to sustain the experience of investing emotionally in the story. Hope turning to disappointment is fine. It’s when the hope goes, that’s the problem.

Defeat takes many forms. In both 2010 and 2011, Arsenal lost over two legs to Barcelona in the Champions League. Yet these were rich and rewarding sporting experiences. In the two London fixtures of those ties, Arsenal drew 2-2 and won 2-1 against the most dazzling team in the world. Those nights reinvigorated my pride in sport. The Emirates Stadium had the best show in town. Defeat, when it arrived in Barcelona, was softened by gratitude. We’d been entertained, more than entertained.

Arsenal’s 5-1 surrender to Bayern Munich on 15 February was very different. In this capitulation by instalments, the fascination was macabre rather than dramatic. Having long given up on discerning signs of life, we began the post-mortem mid-match. As we pored over the entrails, the curiosity lay in the extent of the malady that had brought down the body. The same question, over and over: how could such an intelligent, deep-thinking manager preside over a hollowed-out team? How could failings so obvious to outsiders, the absence of steel and resilience, evade the judgement of the boss?

There is a saying in rugby union that forwards (the hard men) determine who wins, and the backs (the glamour boys) decide by how much. Here is a footballing equivalent: midfielders define matches, attacking players adorn them and defenders get the blame. Yet Arsenal’s players as good as vacated the midfield. It is hard to judge how well Bayern’s playmakers performed because they were operating in a vacuum; it looked like a morale-boosting training-ground drill, free from the annoying presence of opponents.

I have always been suspicious of the ­default English critique which posits that mentally fragile teams can be turned around by licensed on-field violence – a good kicking, basically. Sporting “character” takes many forms; physical assertiveness is only one dimension.

Still, it remains baffling, Wenger’s blind spot. He indulges artistry, especially the mercurial Mesut Özil, beyond the point where it serves the player. Yet he won’t protect the magicians by surrounding them with effective but down-to-earth talents. It has become a diet of collapsing soufflés.

What held back Wenger from buying the linchpin midfielder he has lacked for many years? Money is only part of the explanation. All added up, Arsenal do spend: their collective wage bill is the fourth-highest in the League. But Wenger has always been reluctant to lavish cash on a single star player, let alone a steely one. Rather two nice players than one great one.

The power of habit has become debilitating. Like a wealthy but conservative shopper who keeps going back to the same clothes shop, Wenger habituates the same strata of the transfer market. When he can’t get what he needs, he’s happy to come back home with something he’s already got, ­usually an elegant midfielder, tidy passer, gets bounced in big games, prone to going missing. Another button-down blue shirt for a drawer that is well stuffed.

It is almost universally accepted that, as a business, Arsenal are England’s leading club. Where their rivals rely on bailouts from oligarchs or highly leveraged debt, Arsenal took tough choices early and now appear financially secure – helped by their manager’s ability to engineer qualification for the Champions League every season while avoiding excessive transfer costs. Does that count for anything?

After the financial crisis, I had a revealing conversation with the owner of a private bank that had sailed through the turmoil. Being cautious and Swiss, he explained, he had always kept more capital reserves than the norm. As a result, the bank had made less money in boom years. “If I’d been a normal chief executive, I’d have been fired by the board,” he said. Instead, when the economic winds turned, he was much better placed than more bullish rivals. As a competitive strategy, his winning hand was only laid bare by the arrival of harder times.

In football, however, the crash never came. We all wrote that football’s insane spending couldn’t go on but the pace has only quickened. Even the Premier League’s bosses confessed to being surprised by the last extravagant round of television deals – the cash that eventually flows into the hands of managers and then the pockets of players and their agents.

By refusing to splash out on the players he needed, whatever the cost, Wenger was hedged for a downturn that never arrived.

What an irony it would be if football’s bust comes after he has departed. Imagine the scenario. The oligarchs move on, finding fresh ways of achieving fame, respectability and the protection achieved by entering the English establishment. The clubs loaded with debt are forced to cut their spending. Arsenal, benefiting from their solid business model, sail into an outright lead, mopping up star talent and trophies all round.

It’s often said that Wenger – early to invest in data analytics and worldwide scouts; a pioneer of player fitness and lifestyle – was overtaken by imitators. There is a second dimension to the question of time and circumstance. He helped to create and build Arsenal’s off-field robustness, even though football’s crazy economics haven’t yet proved its underlying value.

If the wind turns, Arsène Wenger may face a frustrating legacy: yesterday’s man and yet twice ahead of his time. 

Ed Smith is a journalist and author, most recently of Luck. He is a former professional cricketer and played for both Middlesex and England.

This article first appeared in the 24 February 2017 issue of the New Statesman, The world after Brexit