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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"We repealed, then forgot": the long shadow of Section 28 homophobia

Why are deeply conservative views about the "promotion" of homosexuality still being reiterated to Scottish school pupils? 

Grim stories of LGBTI children being bullied in school are all too common. But one which emerged over the weekend garnered particular attention - because of the echoes of the infamous Section 28, nearly two decades after it was scrapped.

A 16-year-old pupil of a West Lothian school, who does not wish to be named, told Pink News that staff asked him to remove his small rainbow pride badge because, though they had "no problem" with his sexuality, it was not appropriate to "promote it" in school. It's a blast from the past - the rules against "promoting" homosexuality were repealed in 2000 in Scotland, but the long legacy of Section 28 seems hard to shake off. 

The local authority responsible said in a statement that non-school related badges are not permitted on uniforms, and says it is "committed to equal rights for LGBT people". 

The small badge depicted a rainbow-striped heart, which the pupil said he had brought back from the Edinburgh Pride march the previous weekend. He reportedly "no longer feels comfortable going to school", and said homophobia from staff members felt "much more scar[y] than when I encountered the same from other pupils". 

At a time when four Scottish party leaders are gay, and the new Westminster parliament included a record number of LGBTQ MPs, the political world is making progress in promoting equality. But education, it seems, has not kept up. According to research from LGBT rights campaigners Stonewall, 40 per cent of LGBT pupils across the UK reported being taught nothing about LGBT issues at school. Among trans students, 44 per cent said school staff didn’t know what "trans" even means.

The need for teacher training and curriculum reform is at the top of campaigners' agendas. "We're disappointed but not surprised by this example," says Jordan Daly, the co-founder of Time for Inclusive Education [TIE]. His grassroots campaign focuses on making politicians and wider society aware of the reality LGBTI school students in Scotland face. "We're in schools on a monthly basis, so we know this is by no means an isolated incident." 

Studies have repeatedly shown a startling level of self-harm and mental illness reported by LGBTI school students. Trans students are particularly at risk. In 2015, Daly and colleagues began a tour of schools. Shocking stories included one in which a teacher singled out a trans pupils for ridicule in front of the class. More commonly, though, staff told them the same story: we just don't know what we're allowed to say about gay relationships. 

This is the point, according to Daly - retraining, or rather the lack of it. For some of those teachers trained during the 1980s and 1990s, when Section 28 prevented local authorities from "promoting homosexuality", confusion still reigns about what they can and cannot teach - or even mention in front of their pupils. 

The infamous clause was specific in its homophobia: the "acceptability of homosexuality as a pretended family relationship" could not be mentioned in schools. But it's been 17 years since the clause was repealed in Scotland - indeed, it was one of the very first acts of the new Scottish Parliament (the rest of the UK followed suit three years later). Why are we still hearing this archaic language? 

"We repealed, we clapped and cheered, and then we just forgot," Daly says. After the bitter campaign in Scotland, in which an alliance of churches led by millionaire businessman Brian Souter poured money into "Keeping the Clause", the government was pleased with its victory, which seemed to establish Holyrood as a progressive political space early on in the life of the parliament. But without updating the curriculum or retraining teaching staff, Daly argues, it left a "massive vacuum" of uncertainty. 

The Stonewall research suggests a similar confusion is likely across the UK. Daly doesn't believe the situation in Scotland is notably worse than in England, and disputes the oft-cited allegation that the issue is somehow worse in Scotland's denominational schools. Homophobia may be "wrapped up in the language of religious belief" in certain schools, he says, but it's "just as much of a problem elsewhere. The TIE campaign doesn't have different strategies for different schools." 

After initial disappointments - their thousands-strong petition to change the curriculum was thrown out by parliament in 2016 - the campaign has won the support of leaders such as Nicola Sturgeon and Kezia Dugdale, and recently, the backing of a majority of MSPs. The Scottish government has set up a working group, and promised a national strategy. 

But for Daly, who himself struggled at a young age with his sexuality and society's failure to accept it, the matter remains an urgent one.  At just 21, he can reel off countless painful stories of young LGBTI students - some of which end in tragedy. One of the saddest elements of the story from St Kentigern's is that the pupil claimed his school was the safest place he had to express his identity, because he was not out at home. Perhaps for a gay pupil in ten years time, that will be a guarantee. 

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