INQUIRER Global Nation

WASHINGTON DC, United States — US President Barack Obama’s top domestic priority is reforming the nation’s health care system by October, and his success or failure could define his presidency.

Obama wants to bring down cost and improve the quality of health care in the country, as well as provide health insurance to an estimated 50 million poor Americans, including children, who have no coverage or are underinsured.

Opponents of the plan say a new health care system would cost $2.5 trillion, which accounts for roughly one-sixth of the economy. White House estimates indicate that Obama’s health plan would require $1 trillion over 10 years, or about $100 billion yearly.

But the president reckons that about 70 percent of the needed funds would be generated simply by realigning existing health programs, like Medicare and Medicaid.

At a recent White House press conference, he stressed that health care reform is not just about the 47 million Americans who don’t have any health insurance at all.

“Reform is about every American who has ever feared that they may lose their coverage, if they become too sick or lose their job or change their job,” he said. “It’s about every small business that has been forced to lay off employees or cut back on their coverage, because it became too expensive.”

He stressed that lack of reform is the “biggest driving force behind our federal deficit” and the skyrocketing cost of Medicare and Medicaid.

“So let me be clear. If we do not control these costs, we will not be able to control our deficit. If we do not reform health care, your premiums and out-of-pocket costs will continue to skyrocket,” Obama pointed out.

He warned that unless the system is reformed, some 14,000 Americans will continue to lose their health insurance every single day.

Being the richest nation on earth, the United States, ironically, has never had a universal health care system. What it has are publicly funded health care programs, namely: Medicare for the elderly and disabled; Veterans Health Administration for those in the military service and their dependents; and Medicaid for the poor.

Moreover, federal law guarantees public access to emergency services regardless of ability to pay.

Democrats and Republicans generally agree that health care changes are needed, but they have a hard time coming to an agreement on the solutions. While it is a very sensitive national issue that voters and their elective officials are passionate about, health care has been a major stumbling block that previous administrations, as early as Truman’s, have tried to fix, but without success.

Among the basic questions being raised from both sides of the political aisle include: (1) Should the health plan include a government-run component to compete with private insurance? (2) Should employers be required to provide coverage for their workers? (3) And to what extent must individuals be asked to pay for their insurance?

Yet, the urgency of reform is perhaps best illustrated by a comparison of US spending on health care with that of neighboring Canada.

In 2006, per-capita spending for health care in the US was $6,714 as against $3,678 in Canada. America spent 15.3 percent of GDP on health care in that year as against Canada’s 10 percent.

The study also found that the quality of Canadian health services was better. Canadians live longer (80.34 years) compared to Americans (78.6 years). And the infant mortality in Canada is lower compared with that of the US.

Obama recognizes the political reality that this year is the best time to get health care reform done. Next year, all members of the House and a third of the Senate will be up for re-election, and election-year pressures would make it doubly hard for lawmakers to cast tough votes on divisive issues. By 2011, moreover, attention will turn to the next presidential race, which will begin to overshadow Obama’s legislative agenda.

Confronted by an onslaught of opposition to health care reform, the White House last week opened a “Reality Check” website to counter online crucial issues from “rationing” to euthanasia.

The site hopes to replicate the success of the Obama campaign’s “Learn the Truth about Barack Obama” site, which covered everything from the birth certificate to William Ayers.

White House aides said the key is to respond to viral rumors with an aggressive, equally viral response.

“We're offering the site and tools to empower individuals across the country to take this content into their own hands and share it among their networks,” said a senior administration official.

The Democratic National Committee is also urging supporters to visit the local offices of their senators and House members and to speak up in favor of health care reforms.

Obama appeals to the nation’s conscience, highlighting the issue as a matter of urgency to families who are losing their life savings trying to pay for medical care and to small businesses burdened by trying to provide coverage to their employees.

Asked by a journalist why the rush to meet his deadline for passage of House and Senate bills, Obama said: “I’m rushed because I get letters every day from families that are being clobbered by health care costs. They ask me, ‘Can you help?’ ”

“This is not about me. I have great insurance, and so does every member of Congress,” he quipped.