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.

 

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In focusing on the famous few, we risk doing a disservice to all victims of child sexual abuse

There is a danger that we make it harder, not easier, for victims to come forward in future. 

Back in the 1970s when relations between journalists and police were somewhat different to today a simple ritual would be carried out around the country at various times throughout the week.

Reporters, eager for information for their regional newspaper, would take a trip to the local station and there would be met by a desk sergeant who would helpfully skim through details in the crime Incident Book.

Among the entries about petty thefts, burglaries and road accidents there would occasionally be a reference to an allegation of incest. And at this point the sergeant and journalist might well screw-up their faces, shake their heads and swiftly move on to the next log. The subject was basically taboo, seen as something ‘a bit mucky,’ not what was wanted in a family newspaper.

And that’s really the way things stayed until 1986 when ChildLine was set up by Dame Esther Rantzen in the wake of a BBC programme about child abuse. For the first time children felt able to speak out about being sexually assaulted by the very adults whose role in life was to protect them.

And for the first time the picture became clear about what incest really meant in many cases. It wasn’t simply a low level crime to be swept under the carpet in case it scratched people’s sensitivities. It frequently involved children being abused by members of their close family, repeatedly, over many years.

Slowly but surely as the years rolled on the NSPCC continued to press the message about the prevalence of child sexual abuse, while encouraging victims to come forward. During this time the corrosive effects of this most insidious crime have been painfully detailed by many of those whose lives have been derailed by it. And of course the details of the hundreds of opportunistic sexual assaults committed by Jimmy Savile have been indelibly branded onto the nation’s consciousness.

It’s been a long road - particularly for those who were raped or otherwise abused as children and are now well into their later years - to bring society around to accepting that this is not to be treated as a dark secret that we really don’t want to expose to daylight. Many of those who called our helpline during the early days of the Savile investigation had never told anyone about the traumatic events of their childhoods despite the fact they had reached retirement age.

So, having buried the taboo, we seem to be in danger of giving it the kiss of life with the way some cases of alleged abuse are now being perceived.

It’s quite right that all claims of sexual assault should be investigated, tested and, where there is a case, pursued through the judicial system. No one is above the law, whether a ‘celebrity’ or a lord.

But we seem to have lost a sense of perspective when it comes to these crimes with vast resources being allocated to a handful of cases while many thousands of reported incidents are virtually on hold.

The police should never have to apologise for investigating crimes and following leads. However, if allegations are false or cannot be substantiated they should say so. This would be a strength not a weakness.

It is, of course, difficult that in many of the high-profile cases of recent times the identities of those under investigation have not been officially released by the police but have come to light through other means. Yet we have to deal with the world as it is not as we wish it would be and once names are common knowledge the results of the investigations centring on them should be made public.

When it emerges that someone in the public eye is being investigated for non-recent child abuse it obviously stirs the interest of the media whose appetite can be insatiable. This puts pressure on the police who don’t want to repeat the mistakes of the past by allowing offenders to slip through their hands.  And so there is a danger, as has been seen in recent cases, that officers lack confidence in declaring there is a lack of evidence or the allegations are not true. 

The disproportionate weight of media attention given to say, Sir Edward Heath, as opposed to the Bradford grooming gang sentenced this week, shows there is a danger the pendulum is swinging too far the other way. This threatens the painstaking work invested in ensuring the public and our institutions recognise child abuse as a very real danger. 

Whilst high profile cases have helped the cause there is now a real risk that the all-encompassing focus on them does both victims of abuse and those advocating on their behalf a fundamental disservice.

As the public watches high -profile cases collapsing amidst a media fanfare genuine convictions made across the country week in week out go virtually unannounced. If this trend continues they may start to believe that child sexual abuse isn’t the prolific problem we know it to be.

So, while detectives peer into the mists of time, searching for long lost clues, we have to face the unpalatable possibility that offences being committed today will in turn become historical investigations because there is not the manpower to deal with them right now.

So, now the Goddard Inquiry is in full swing, taking evidence about allegations of child sex crimes involving ‘well known people’ as well as institutional abuse, how do we ensure we don’t fail today’s victims?

If they start to think their stories are going to be diminished by the continuing furore over how some senior public figures have been treated by the police they will stay silent. Therefore we have to continue to encourage them to come forward, to give them the confidence of knowing they will be listened to.

If we don’t we will find ourselves back in those incestuous days where people conspired to say and do nothing to prevent child abuse.

Peter Wanless is Chief Executive of the NSPCC.