Obamacare, Romneycare and the race for President

As approval of Obamacare and Romneycare falls, healthcare remains one of the most prominent issues o

There will be one glaring issue in the upcoming 2012 presidential election: healthcare reform. According to the latest Real Clear Politics poll - and almost every other poll out there - Mitt Romney will be the one to take on Obama come November 2012, and there couldn't be a more fitting match for such a prevalent issue.

In 2006 Romney achieved the passage of his bill for universal health coverage in Massachusetts while serving as governor. His plan - commonly referred to as Romneycare - included subsidies, an exchange, and a mandate, in its most basic form. Subsidies would be given to the poor and uninsured to enable them to become insured; an exchange would be created to help individuals buy insurance apart from companies and groups; and an individual mandate that everyone buy insurance as a part of their personal responsibility as a citizen of the state was instated.

"It's a Republican way of reforming the market," Romney said after signing his healthcare bill on 12 April 2006. "Because, let me tell you, having 30 million people in this country without health insurance and having those people show up when they get sick, and expect someone else to pay, that's a Democratic approach. That's the wrong way. The Republican approach is to say, 'You know what? Everybody should have insurance. They should pay what they can afford to pay. If they need help, we will be there to help them, but no more free rides.'"

Obama came into office in 2008 with healthcare reform at the top of his agenda. He immediately put his plan into action, working with several of the Democrats from Romney's team, and using the 2006 healthcare bill as a model for the national system.

What was once Romney's most outstanding accomplishment has now become a source of shame to many in the Republican party. To think a Republican's bill laid the blueprints for what has become Obamacare is many conservatives' worst nightmare.

While the bills are similar, there are some fundamental differences. Romney's plan is funded by revenue from the federal government and funds that were being used to reimburse hospitals for giving free care to the uninsured while Obama's will be funded by new taxes and savings from Medicare cuts. Romney's bill is 70 pages and Obama's is 2,000. There have to be a few other things in that extra 1,930 pages.

The biggest - and perhaps the most overlooked - difference is the fact that Romney's plan is for a single state and Obama's includes an entire nation.As Kathleen Parker, a columnist for the Washington Post, put it:

"Just because something works well on the state level doesn't necessarily mean it will work on the federal level. A family of three has different requirements than a family of 300. Or 3,000. Or 3 million. You get the picture."

Romney has defended his bill using the same argument, arguing:

"Our plan was a state solution to a state problem, and [Obama's health law] is a power grab by the federal government to put in a one-size-fits-all plan across the nation."

Scott W. Atlas, a professor at Stanford University Medical Center, gave Real Clear Politics six reasons why this plan for healthcare wouldn't work on the national level. Atlas says Obamacare will result in less access to timely health care, less access to state-of-the-art drugs proven to cure serious diseases, less access to modern medical technology, less choice of doctor and treatment, less choice in health insurance coverage, and less access to leading innovators in health care.

Some of these problems are already surfacing in Massachusetts. A recent Boston Globe article revealed that patients in Massachusetts are facing up to 48 day waits to see a doctor for a "non-urgent medical issue." They also reported that many doctors are no longer accepting new patients. Many believe this is a reflection of the inaccessibility to come on the national level with Obamacare.

According to a recent poll of Massachusetts registered voters conducted by Suffolk University in Boston, Mass., 49 per cent answered "no" when asked if they thought healthcare in Massachusetts was working. When asked if they thought Romney's role in healthcare would help or hurt his presidential campaign, 54 per cent answered "hurt."

Approval for Obamacare is falling as well. According to the latest Rasmussen Reports national telephone survey, 54 per cent of likely US voters favour repeal of Obamacare, while only 35 per cent want it to stay. 46 per cent are confidence that the law will be repealed, while 63 per cent of US citizens consider this issue to be "very important" in their voting decision.

As the election draws closer, platforms may change. Will Obama offer concessions to anti-Obamacare voters, or will repeal only come from the election of a new president? Will Romney continue to defend his state reform while condemning it at the national level, or will he be forced to renounce both in an effort to keep himself in the running for the presidency? Someone will have to step up and address the concerns of the majority. Which of American's two biggest healthcare reformers will it be?

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In the 1980s, I went to a rally where Labour Party speakers shared the stage with men in balaclavas

The links between the Labour left and Irish republicanism are worth investigating.

A spat between Jeremy Corbyn’s henchfolk and Conor McGinn, the MP for St Helens North, caught my ear the other evening. McGinn was a guest on BBC Radio 4’s Westminster Hour, and he obligingly revisited the brouhaha for the listeners at home. Apparently, following an interview in May, in which McGinn called for Corbyn to “reach out beyond his comfort zone”, he was first threatened obliquely with the sack, then asked for a retraction (which he refused to give) and finally learned – from someone in the whips’ office – that his party leader was considering phoning up McGinn’s father to whip the errant whipper-in into line. On the programme, McGinn said: “The modus operandi that he [Corbyn] and the people around him were trying to do [sic], involving my family, was to isolate and ostracise me from them and from the community I am very proud to come from – which is an Irish nationalist community in south Armagh.”

Needless to say, the Labour leader’s office has continued to deny any such thing, but while we may nurture some suspicions about his behaviour, McGinn was also indulging in a little airbrushing when he described south Armagh as an “Irish ­nationalist community”. In the most recent elections, Newry and Armagh returned three Sinn Fein members to the Northern Ireland Assembly (as against one Social Democratic and Labour Party member) and one Sinn Fein MP to Westminster. When I last looked, Sinn Fein was still a republican, rather than a nationalist, party – something that McGinn should only be too well aware of, as the paternal hand that was putatively to have been lain on him belongs to Pat McGinn, the former Sinn Fein mayor of Newry and Armagh.

According to the Irish News, a “close friend” of the McGinns poured this cold water on the mini-conflagration: “Anybody who knows the McGinn family knows that Pat is very proud of Conor and that they remain very close.” The friend went on to opine: “He [Pat McGinn] found the whole notion of Corbyn phoning him totally ridiculous – as if Pat is going to criticise his son to save Jeremy Corbyn’s face. They would laugh about it were it not so sinister.”

“Sinister” does seem the mot juste. McGinn, Jr grew up in Bessbrook during the Troubles. I visited the village in the early 1990s on assignment. The skies were full of the chattering of British army Chinooks, and there were fake road signs in the hedgerows bearing pictograms of rifles and captioned: “Sniper at work”. South Armagh had been known for years as “bandit country”. There were army watchtowers standing sentinel in the dinky, green fields and checkpoints everywhere, manned by some of the thousands of the troops who had been deployed to fight what was, in effect, a low-level counter-insurgency war. Nationalist community, my foot.

What lies beneath the Corbyn-McGinn spat is the queered problematics of the ­relationship between the far left wing of the Labour Party and physical-force Irish republicanism. I also recall, during the hunger strikes of the early 1980s, going to a “Smash the H-Blocks” rally in Kilburn, north London, at which Labour Party speakers shared the stage with representatives from Sinn Fein, some of whom wore balaclavas and dark glasses to evade the telephoto lenses of the Met’s anti-terrorist squad.

The shape-shifting relationship between the “political wing” of the IRA and the men with sniper rifles in the south Armagh bocage was always of the essence of the conflict, allowing both sides a convenient fiction around which to posture publicly and privately negotiate. In choosing to appear on platforms with people who might or might not be terrorists, Labour leftists also sprinkled a little of their stardust on themselves: the “stardust” being the implication that they, too, under the right circumstances, might be capable of violence in pursuit of their political ends.

On the far right of British politics, Her Majesty’s Government and its apparatus are referred to derisively as “state”. There were various attempts in the 1970s and 1980s by far-right groupuscules to link up with the Ulster Freedom Fighters and other loyalist paramilitary organisations in their battle against “state”. All foundered on the obvious incompetence of the fascists. The situation on the far left was different. The socialist credentials of Sinn Fein/IRA were too threadbare for genuine expressions of solidarity, but there was a sort of tacit confidence-and-supply arrangement between these factions. The Labour far left provided the republicans with the confidence that, should an appropriately radical government be elected to Westminster, “state” would withdraw from Northern Ireland. What the republicans did for the mainland militants was to cloak them in their penumbra of darkness: without needing to call down on themselves the armed might of “state”, they could imply that they were willing to take it on, should the opportunity arise.

I don’t for a second believe that Corbyn was summoning up these ghosts of the insurrectionary dead when he either did or did not threaten to phone McGinn, Sr. But his supporters need to ask themselves what they’re getting into. Their leader, if he was to have remained true to the positions that he has espoused over many years, should have refused to sit as privy counsellor upon assuming his party office, and refused all the other mummery associated with the monarchical “state”. That he didn’t do so was surely a strategic decision. Such a position would make him utterly unelectable.

The snipers may not be at work in south Armagh just now – but there are rifles out there that could yet be dug up. I wouldn’t be surprised if some in Sinn Fein knew where they are, but one thing’s for certain: Corbyn hasn’t got a clue, bloody or otherwise. 

Will Self is an author and journalist. His books include Umbrella, Shark, The Book of Dave and The Butt. He writes the Madness of Crowds and Real Meals columns for the New Statesman.

This article first appeared in the 25 August 2016 issue of the New Statesman, Cameron: the legacy of a loser