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Obama's next health-care challenge

The president must now convince a sceptical US public of the benefits of reform.

Barack Obama has won the most significant victory of his presidency to date. By securing the passage of a bill giving the US near-universal health coverage, he has achieved what eluded every one of his liberal predecessors and has finally dispelled the myth that he is little more than an accomplished orator.

The Republicans (every one of whom voted against the bill) are consoling themselves with the prospect of significant gains in this year's midterm elections. With the polls still showing most Americans against health-care reform, the White House will launch an intensive effort to convince people of the benefits of reform.

The shift in attitudes towards Medicare, which provides health coverage for retired Americans, offers a happy precedent. When the programme was introduced by Lyndon B Johnson in 1965, it was denounced by Republicans such as Ronald Reagan (play this recording) as a measure that would destroy American freedom.

The future president warned that unless the bill was blocked, "One of these days you and I are going to spend our sunset years telling our children, and our children's children, what it once was like in America when men were free."

But in a sign of how times have changed, Republican members yesterday cited alleged cuts to Medicare as part of their assault on the bill. They have reached the sort of accommodation with Medicare that Obama is hoping today's right will eventually reach with universal care.

As Ezra Klein of the Washington Post points out:

The GOP's embrace of the programme that Ronald Reagan fought, and that Newt Gingrich sought to let "wither on the vine", is based on the lived experience seniors have had with the bill: It has made them more, rather than less, free.

But for those Republicans hoping to win back control of Congress and repeal the bill, David Frum has a refreshing message -- forget it.

Frum, a former speechwriter to George W Bush, writes:

No illusions, please: This bill will not be repealed. Even if Republicans scored a 1994-style landslide in November, how many votes could we muster to reopen the "doughnut hole" and charge seniors more for prescription drugs? How many votes to reallow insurers to rescind policies when they discover a pre-existing condition? How many votes to banish 25-year-olds from their parents' insurance coverage? And even if the votes were there -- would President Obama sign such a repeal?

We followed the most radical voices in the party and the movement, and they led us to abject and irreversible defeat.

It's an extremely cogent piece on how the hard right captured the Republican Party and led it to its own Waterloo. Read it all here.

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