BBC BLOGS - Have Your Say
« Previous | Main | Next »

What next for Obama's healthcare reform plan?

11:22 UK time, Friday, 26 February 2010

President Barack Obama's healthcare reform plan has suffered its latest setback, after a day-long televised summit on the issue ended without a deal to break the deadlock between parties. What next for the proposals?

Hosting the cross-party talks, Mr Obama outlined his reform plan but Republicans said it was not acceptable and called for a fresh start.

Mr Obama wants to expand healthcare coverage to include millions of uninsured Americans, but Republicans say that the country cannot afford the plans and they want him to start again from scratch.

What next for Mr Obama's health plan? Do you think it should progress as it is or do you think, as proposed by Republicans, that it should be scrapped and reworked? Would you benefit from new healthcare legislation in the US or should it stay as it is?

This debate has now been closed. Thank you for your comments.


Page 1 of 6

  • Comment number 1.

    There is no way the Republicans, drug companies or other vested interests are going to make the US the land of free ANYTHING. It's a democracy in name only.

  • Comment number 2.

    Once again, Republicanism guarantees profits for insurance companies and ignores the needs of the citizens of the USA.

    I feel sorry for Obama having to go up against such pig-headed, ignorant stupidity.

  • Comment number 3.

    Ahh the powers of a democratic country to watch the poor die of disease or send them to fight for the rich! so the privileged can live in laa laa land free from the ails of the poor and blind to the ails of the rest of the world which is starving/suffering to protect their over usage of world resources! now thats what i call a democracy!

  • Comment number 4.

    I think the bill will not pass. A lot of big pharmaceutical companies/medical offices/doctors and medical personnel will be affected. The base of the republican party is the bigwigs and they would not allow this bill to pass and most republicans are connected to drug/insurance companies. The US is the richest country in the world and is the one of the countries that does not provide free health care for its citizens.

  • Comment number 5.

    Its a shame that in the supposed land of the free, that health care is seen as a commodity like buying a tin of baked beans.
    The attitudes of the Republican Party are a total disgrace for calling other countries health care system (such as the NHS) as being "socialist".
    It just goes to show that if the US has 46 million people unable to access health care, that it is a 3rd World country and should be treated as such.
    The Republicans are nothing more than dinosaurs and happy to see people die purely because they are on low incomes.
    Shame on the USA and long live the NHS. It may not be perfect, but I would hate to live on the US if I was poor.

  • Comment number 6.

    Chris - don't forget all the Progressives & liberals special interests. Land of FREE does not mean everything is free.

    The congress needs to address COSTS issue first. Current proposals will increase cost faster. Why - No incentives to save, greater demand on system where supply is lacking (ex: primary care docs), no tort reform, no competition, & waivers for all politicians special interest groups. They have not address the load on system from 10-20m illegal immigrants - 50% of unfunded costs in some areas. This proposal only forces everyone to get insurance - since 50% get afford the complete cost, makes the other 50% paid for it.
    US has too many other underfunded programs (Medicare/Medicaid, Social Security, WARS, FANNIE/FREDDIE, etc), don't add another.

  • Comment number 7.

    A perspective from the East Side of the Pond:

    I know of no one who would not wish eveyone
    to have decent and adequate health care. That
    being said, the current (3) health care bills/
    approaches have significant issues.

    The projected costs are out of line with the
    benefit. It has been projected that some 30%
    of Americans have no health care insurance.
    Also, only the top 50% of Americans pay federal
    income taxes. The costs of the "offerings"
    have estimated to approach/exceed one trillion

    The "American way" does not lend itself to
    government control of basically anything excluding
    defense (see our Constitution). We do not
    desire to have our medical information "shared"
    nor adjudicated by government officials.

    The bills were written "behind closed doors" with
    little (if no) coordination with those who may
    have different/better ideas.

    The latest surveys indicate that a significant
    majority of Americans do not want government
    controlled health care. Seems to me that the
    "majority" should not be shuffled off to the side.

    Americans have large issues with "special deals"
    being offered to secure votes on the issue; Unions
    being exempted from certain taxes, 300 million
    US dollars being offered to ONE state to secure
    ONE vote - the list is long.

    As the federal government has not been able to
    demonstrate fiscal responsibility on anything,
    to relinquish 17% of our economy to the control
    of the federal government seems a bit unreasonable.

    Enough for now - you, I believe, can get the point.

  • Comment number 8.

    Re "There is no way the Republicans, drug companies or other vested interests are going to make the US the land of free ANYTHING. It's a democracy in name only."

    That's correct. United States is not democracy; it's a REPUBLIC.

    Which will be defended "against all its enemies: foreign AND domestic".

  • Comment number 9.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 10.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 11.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 12.

    In my opinion and not being a mind-reader, there was never any intention of brokering a deal between Democrats & Republicans. The television exposure was all about appearance, public relations: Just look how hard Obama was trying to compromise: There was actually sweat on his brow, or maybe the sweat was just a reaction from his intense efforts to control body language. Did you notice the body language: the glance into the air, the vacant stair, the placing of his hands palm-down upon the table as in “Oh God, I want to be anywhere but here! What a total waste of my time.”
    Obamacare will move through Congress and the Senate as an item of budgetary reconciliation (funny term for this particular situation); budget reconciliation doesn’t need a supermajority, just a simple one-vote majority. Imagine if Obama couldn’t come up with a one-vote majority: Now that would be a set-back!
    Obama­care needs at least a trillion dollars to succeed, which it will (supposedly) raise through taxation, fines, penalties, and cost savings.
    Two problems that I can see (I'm short-sighted):
    1. Medicaid.
    Obamacare factors transfering money from Medicaid – but Mediciad is going bankrupt, facing terminal RED in about 7 years.
    For Medicaid, the states contribute as much as 50%, but Medicaid is already bankrupting some states, and these states, unlike the Federal Government, can’t just print more money. So, forget transfering money from Medicaid. Here come the higher state taxes: Get ready middle class Americans.
    2. (I particularly love this next one! Call it my sick sense of humor.)
    Health reform will “save lots of money” by keeping seriously & chronically ill patients from being readmitted to hospitals too frequently; this is a major source of Medicare expenditure. Obamacare would have us believe that a single hospital admission will cure what ails you. Patients (no matter how bad they may be degenerating) will be patched, tuned up and sent home. They better be well and stay that way because reimbursement to doctors and hospitals with higher readmission rates, will be labelled poor performers and reassessed accordingly.

    I could go on and on, but let me just conclude:
    God bless America because it will not be blessed with feasible and sound universal healthcare.

  • Comment number 13.

    This is just another example of economic apartheid. When will the people of the world realise that basic human rights should include free education, access to justice that doesn't depend on your wealth and free access to healthcare. Surely a civilised country should afford those things fiscally and morally.

  • Comment number 14.

    More than time people stopped, particularly the pro Democrat BBC stopped trying to tell the USA how to do their social systems!

    If they can stop this healthcare then it is their concern not ours. They only have to look at our NHS to see what a vast financial drain it can become.

    With yet more revelations of the latest hospital disaster case here recently, blandly recommending the USA go down the same route does not look good!

  • Comment number 15.


    I lived in the UK and paid UK taxes. When Iwas informed I needed to have a heart procedure done, the NHS gave me 12-18 months wait. I called my Doctor back in Texas...and had the procedure done in 2 weeks.

    While it is not perfect, do not be confused with this bill Obama is trying to pass. It does not have to do with health care, but with controlling the health industry and regualtion by big government.

    There are portions of the bill that will have you fined/or jailed if you don't have insurance. So...if you have no money to buy will you pay the fine?

    ALso..please note...universal health care does NOT equal universal access. See the Canadian minister who had heart surgery in FLorida rather than the fine Canadian Health system.

    We do need reform...but this bill is a power grab at 1/6 of the US economy.

  • Comment number 16.

    I applaud the President for not backing down. The Republicans and special interests are desperately hoping this issue will go away. The longer it stays in the public eye the more obvious it will be that the Republicans are driven only by ideology and not reason. They have nothing constructive to offer and are only good at stating what they don't want. In the end we will have Universal Health Care. It's just a matter of time. Full Speed Ahead !!! (with or without the Republicans).

  • Comment number 17.

    You can't just blame the Republicans for this, there are plenty of Democrats in Congress and the Senate who take just as much money from the pharma and medical lobbies as their Republican counterparts and this bill is being held up by dissenting Democrats as much as dissenting Republicans.

    There are vested interests on all sides in this debate and none of them want to upset their paymasters, especially over something as trivial as providing a decent level of healthcare to all American citizens by allowing all citizens the right to choose a publicly funded option when it comes to their healthcare. After all, poor people choose to be poor and should be punished for their laziness and lack of ambition whereas rich people are all hard working, decent people who deserve everything they have and shouldn't have to give any of it away to help look after those lazy poor people.

    Who cares if you have to sell your home to pay your medical bills ?
    Who cares if you can't afford that life saving operation ?
    Who cares if you're denied care because of a pre-existing condition ?
    Who cares if your hospital dumps you on skid row because you don't have the right type of insurance ?
    Who cares if American's have a higher infant mortality rate than some developing nations ?
    Who cares if Americans have one of the lowest life expectancies in the developed world ?
    Who cares if Americans are charged $20+ for a medical prescription that can be bought for a couple of cents across the border ?

    Not American politicians, that's for sure !

    They're all far too busy ensuring that no evil Socialist programs are ever enacted in their nation, except for the armed forces, post office, police department, fire department, public school system, freeway system, public libraries...

  • Comment number 18.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 19.

    As Mr Obama is well aware, the GOP has one main goal: to get back into the WH. To do this they have to demonstrate that Dems are incapable of passing legislation ("see? We told you ... gvrnmt is in need of repair, so elect us!...") --and this explains why they can't permit significant legislation to pass, and it explains how they've become the "Party of 'No!'".

    (This GOP strategy dates from Clinton admin)

    Mr Obama could produce bread from rocks and provide lunch from it but the GOP would deny that it happened.

    "Let's begin from scratch" is GOP-ese for "let the GOP write it".

  • Comment number 20.

    I wonder if this plan, has been to big and to much for Mr Obama and his administration. The reason being that he has given his opponents the weapons to fight back. They have been able to point to the idea that the Obama admin, are attempting to push a form of socialism onto the American people. It may be well, that some of the plans will benefit more people. However it is to big achange in just a short amount of time.

  • Comment number 21.

    It is an American battle of intelligence. Will the people accept socialism and incompetence? Or will the people demand that our chosen leaders respect the constitution.

  • Comment number 22.

    America needs to return to greatness and to do that we need to rebuild our infrastructure which includes decent affordable health care for everyone. Decent health care in a country as wealthy as America is not a privilege but a right.

    Perhaps we have to make it about success. The top 5% of this country hold much of the nation's wealth but without a healthy educated workforce where on earth would they be. Perhaps if we make it about the top 5% retaining their status by keeping the nation's workforce healthy it might finally sink in to the powers that be.

  • Comment number 23.

    Too many vested interests in keeping the status quo and the huge profits to be made from private healthcare, USA has one of the unfairest healthcare systems in the world. If you want to know just how unfair, get a copy of Michael Moores 'Sicko' documentary.

  • Comment number 24.

    American drug companies will never allow a universal heath care program. They will loose to much profits, their number one priority.

    Also, once again, this new format really sucks....

    Volker Sellmann

  • Comment number 25.

    The bill will fail. It has all sorts of issues but at least it would have started a change. This country (which I fought for btw) is a plutocracy. Everything is about money. Everything. Our value system is tragically flawed. If healthcare premiums keep doubling as they have in the past, average people will reach a breaking point. What happens then is anybody's guess. Why do Congressman make three times the national median income? Why do our tax dollars pay for their healthcare but not ours? Why is there no such thing as a preexisting condition on THEIR policies? It's our money after all. Why can't we use it to do something that benefits all of us? It's sickening and saps the spirit.

  • Comment number 26.

    There is obviously something wrong with a system like the US', which costs a lot, and leaves people highly vulnerable when they need health care.

    That being said, we in the UK have no right to criticise. Our NHS is utterly lousy, despite lavish funding.

    Also, there is growing resentment of tax money being used to fund healthcare for our own feckless welfare dependent, and for immigrants, legal or otherwise.

    Basically, I suspect the US system, with a few tweaks, might be quite popular if applied in the UK.

  • Comment number 27.

    From the sound of it the neocons have persuaded the American population that health care reform is Stalinist communism so expect to continue to see the richest country on earth continue to murder their poor sick people.

  • Comment number 28.

    I think the Americans should be thankful that they are not introducing the economic cancer of the NHS into the American economy, just as finally the British public are facing up to reality that it is unaffordable and can no longer be allowed to sap the life blood out of British economy.

  • Comment number 29.

    They could afford it if they didn't spend so much on war! That's the sad truth - the US government spend too much money killing people abroad, and not enough taking care of their own citizens!

    God bless America!

  • Comment number 30.

    Obamas problem is that he considers himself to be a new monarch and wants to tell all the states what to do. That is not the basis of the US constitution. Each state is a separate sovereign entity and collectively they have ceded some common interests to a Federal Government. It is becoming increasingly obvious that the people do not like Obamas approach on a wide range of matters. He needs to put his self given crown back in the closet and listen to the people. If he does not the democrats are going to be wiped out in the November elections and the US will have a lame duck President for the next two years. Something does need to be done however that, good or bad, should be what the people want not the personal ideal of a not too successful social worker who just happens to have the gift of the gab.

  • Comment number 31.

    And I'll say the obvious.... Isn't it the purpose of government to represent the average citizen and protect and preserve their welfare? None of that in the USA-too busy protecting big business (ie. their second income) and their guaranteed pension plans....
    I wonder if the US federal government was wiped out today and the EU government the next day, how long would it take for any regular Joe on main street to notice? I'm betting most folks would say OMG today, forget by tomorrow, and 10 yrs later noone would see any difference except a significant increase in each country's GDP and prosperity, not to mention health and happiness.... what does that say about the "importance" let alone "functionality" of government today???
    Wake up, governments everywhere, all you're contributing is overhead - "legal" dictatorships legislating against citizens' stupidity and preventing the people you claim to "represent" from improving their lives.... if you don't fix this yourselves and soon, you will drive your nations into the third world all over again... and I don't want my college-educated kids to have to rummage through other peoples garbage for food in 20 years you?

  • Comment number 32.

    It now seems that Obama, who was loved by all and easily won the Presidency race has realised that it is not going to be such an easy ride after all. He`s banging his head against a republican brick wall, and that wall is determined to keep him in his place.

  • Comment number 33.

    A health care bill with some added tort reform provisions will finally pass within the next month. Unfortunately, it will probably not have a public plan as an option but even that has been watered down so much and limited to so few, that it would be of little help to most Americans.

    Obama clearly spelled out the problems with the Republicans' ideas regarding reforms that would: Cover only 3 million more; use problematic high risk pools; continue to allow insurance companies to deny coverage because of pre-existing conditions; and promote the use of health savings accounts, which we know are a viable option only for the super-wealthy or the low-risk, healthy--the young, under-40 population.

    We need to contain costs now. We all know that if we do nothing, or try the GOP's baby steps, Medicare will be unsustainable. We all know that we, or our loved ones may be the next victims of the insurance companies' greed. Most of those who voted for Obama and dems in 2008 did so with hopes of achieving comprehensive health care reform. It's time to get it done. If the Republicans want to undo it, they'll simply have to wait until they retake Washington.

  • Comment number 34.

    I watched the entire seven hours (yes, I was housebound by a blizzard) on the Sunlight Labs website, which broadcast the summit live and had the added feature of a sidebar showing the major contributors of every speaker during the debate. It was disheartening and pathetic. Nearly every single Republican had received major donations from the US health insurance industry, the hospital industry, and the pharmaceutical industry. How are the American people supposed to get healthcare reform when half of our politicians are bankrolled by the very industry that needs reforming?

    In the meantime, Republicans and the lobbies that support them are doing a bang-up job continuing to spread disinformation about what a national healthcare system is, to the point where even well-educated, well-travelled Americans think of it as a medical version of a Soviet-era bread line. As an American who has lived in the UK and experienced the NHS firsthand, the shocked reactions that I get when I tell people here about my experience are astounding. Yes, I had a procedure done, no, I didn't have to wait at all, yes, the level of care I received was absolutely comparable to the level of care I'd receive in the US, no, I didn't pay a penny out of pocket, and the clincher is that I pay LESS in taxes in the UK than I do in the US. Most Americans are also completely unaware that in the UK you have a choice between private and public health, and that the existence of the NHS keeps private care costs down (especially compared to the cost of care in the US).

    My family (myself, my husband and one child) are currently paying $1200 a MONTH for basic healthcare. We have to pay an additional $2500 out of pocket before the insurance company will pay for anything. And we're considered lucky to have insurance. The healthcare reform bill is nowhere near perfect, but we desperately need some kind of reform, and it's a start. Healthcare is a basic human right, not a privilege.

  • Comment number 35.

    To all the "entitlement junkies" on this forum. We don't want European socialism here in the USA. The healthcare issue has been highjacked by Obama and his far left administration to fundamentally change the relationship between the government and the US people. It's got nothing to do with healthcare and everything to do with destroying the capitalist system. That is why Obama is spending us into bankruptcy. It's calculated, deliberate and soon we will vote them all out of office. Perhaps Obama can then get a cushy job in Brussels with the rest of the "one world government" crowd.

  • Comment number 36.

    Sick of Health

    Forgive the pun, but I’m sick of watching and listening to the ideological bigotry being used by both sides in the current debate over healthcare reform. Even the fallacy that the debate could possibly be encapsulated by “two sides” makes me angry. The very idea that being able to shout louder than someone else or that a few words written on a placard contributes anything to a debate on such an important issue is asinine in the extreme. Such behavior, including mindless chanting of simplistic slogans, effectively halts all objective discussion and obscures the real issues.
    So, stop mouthing off, stop quoting extreme anecdotal examples and stop using prefabricated, emotive labels designed to perpetuate already polarized thinking.
    This maybe a revolutionary idea, but why don’t we start looking at factual evidence backed up by legitimate research. Yes I know this a new concept, but just bear with me for a while, you never know, we might then draw some reasoned and sensible conclusions.
    Here is an initial, outrageous idea to open up your thinking:
    Starting in 2010, schooling for our children will no longer be funded or provided by either state or federal government. All parents and children will be expected to pay in full for their academic education which will be provided by private institutions. Emergency treatment for difficult math problems and long words will be available at certain schools but waiting times might be quite long.
    This policy will be introduced on the overall premise that nobody ever died as a direct result of not being educated. However, people do die as a direct result of health issues. In view of this, all funding currently provided by every level of government to education will be reallocated to healthcare.
    Silly idea because that’s not the way we do things – and imagine the increased incidence of illiteracy…Oh, wait a second…
    Now that you are smiling broadly and are instantly ready take on new and radical ideas, here are some facts:
    • The United States of America does not have the best health system in the world
    • The United States of America does not have the worst health system in the world
    • The United States of America has some of most advanced healthcare expertise in the world
    • The United States of America’s delivery of overall healthcare and its health outcomes do not compare well to most other industrialized countries
    • The United States of America has the capability to offer expert treatment to patients of all ages
    • The United States of America has an illogically high incidence of infant mortality and avoidable death rates

    Okay, that smile has lessened somewhat, so here are some factual statements and observations:
    • I don’t know which country does have the best health system in the world - but neither does anyone else reading this
    • The United States of America spends more (per capita) on administering the bureaucracy of its healthcare than any other country in the world. Sometimes by a factor of three or four over countries with effective universal systems.
    • There is no particular reason why employers should continue to be responsible for providing healthcare. It is an invidious practice that can be extremely detrimental to both employee and employer interests. The practice has its origins in the pay freezes of World War II, yet now seems entrenched in the American working life. Why should your employer decide what health cover you get? Your family physician doesn’t tell you where you should work!
    • There is no reason why a national, universal health plan should increase individual or government healthcare costs. Individual tax costs will increase but, if a scheme is implemented effectively, there will be no health insurance premiums to pay. Employers should no longer have to pay their portion to the insurers and there should be no co-pay. In case you missed that – NO CO-PAY! Your employer may even pass his or her savings on to you as a wage increase.
    • Effective preventative healthcare makes an enormous contribution to the quality of life and the longevity of that life. In the current situation prevailing in the United States of America, there is little incentive for health insurers to finance preventative care. The premise is that, as people change jobs and healthcare insurers, the financial benefits of preventative medicine might be enjoyed by organizations other than those that originally funded it.
    • Viewed from afar, the citizens of the United States of America are hypochondriacs obsessed by illness. This hypochondria is fueled by a constant barrage of television commercials for prescription drugs containing information that should only really be evaluated by competent medical professionals. Trendy acronyms only exacerbate the obsession – why not become obsessed by health and wellness instead?
    • Market forces and human nature are generally inappropriate in healthcare. Physicians are encouraged to treat where treatment is perhaps unnecessary. Pharmaceutical companies need a steady stream of new illnesses, gullible or mercenary physicians and new drugs to keep them in business. Health insurers need to be able to promise nurturing care from cradle to grave and yet be able to deny treatment on all possible occasions.
    Now that the smile has been replace by a scowl and you’re thinking about shouting or painting a placard, here are some comparisons that will restore your faith in man’s inhumanity to man
    • Universal schemes can only provide the greatest good for the greatest number and will spend any and all amounts of money provided
    • Private schemes will drop you if it looks as though you might get a long-term illness
    • Universal schemes will always treat acute cases first and will generally do these well. less urgent cases may well wait some time for treatment
    • Private schemes will treat your acute or less urgent conditions entirely in respect of financial considerations, but will have you back in your car about the same time the anesthesia wears off, often causing you to come back again (with another co-pay) in a couple of days
    • Universal schemes often provide unintentional long-term accommodation for the homeless
    • Private schemes always use the latest and most expensive treatments irrespective of whether they are superior to proven treatments.
    • Universal schemes are often unwilling to adopt new procedures until cost and/or patient benefits have been established
    Here is a dirty word:
    Actually it’s two words, but you get the drift. Most universal or national health schemes operate this policy. Supporters of the status quo in United States health policies consider it blasphemy. It is a prime example of the emotive labeling so apparent in current healthcare discussions.
    Single-payer simply means that payment for medicines and treatment comes from a single source. That single source is the organization that operates the health service - almost invariably the government. Pharmaceutical companies and medical practitioners abhor this policy because they are unable to play numerous payers (with differing priorities) off against each other. Instead they have to deal with a single body that has the single objective of balancing cost and patient benefit – more simply known as value for money. The VA health system bureaucracy “sorta-kinda” operates in a similar way to single-payer.
    This does mean that many medical practitioners will get less for the work that they do. Pharmaceutical companies will undoubtedly claim that they will be unable to research new treatments. Personally, I can live with this because the physicians that earn substantially less will only be those who have been financially focused in their practices. Pharmaceutical companies will continue to research and develop because that is what they have to do to exist. Maybe these new pressures will force them to be more focused on effective remedies? Am I the only person who wonders whether drug companies develop new products and then look for an illness to treat with it? The objective of a healthcare system is to look after the receivers of that healthcare – not to make a few professionals obscenely wealthy.
    The bottom line is that the current healthcare systems (in terms of delivery and outcomes) in the United States of America are ineffectual and probably irreparable in their current form. Federal and state politicians are scared to death of the pharmaceutical lobby and failure to be re-elected (but then I repeat myself). The AMA represents the interests solely of the medical profession and has stood four-square in the way of any proposed initiatives that benefit patients at the expense of their members. I don’t think insurance companies care one way or the other because they think they will still get a large slice of the cake whatever happens. When it dawns on them that single-payer may become a reality, they will get the rest of the politicians that the pharmaceutical companies missed.
    It should not (and cannot) be beyond the wit of the US Government to take the time to investigate the healthcare schemes that are the most successfully operated in other industrialized countries. Surely, somewhere in this nation, we have officials with the ability to judge and evaluate the best of those and surely we have the expertise to implement such a scheme here.
    According to the Organization for Economic Co-operation and Development (OEDC), in 2003/2004, per capita health expenditure in the United States of America was $6,120 (15.3% of GDP), life expectancy was 77.5 years and infant deaths, per thousand, were 6.9. During the same period in Japan, per capita health expenditure was $2,249 (8% of GDP), life expectancy was 81.8 years and infant deaths, per thousand, were 2.8.
    Here are some final kickers. How can the country that considers itself the most advanced economy in the world, allow its citizens to be denied preventative healthcare because of corporate avarice? How can it allow around 700,000 families each year to bankrupt themselves seeking healthcare? How can it let people die for lack of healthcare?
    For those that say government cannot afford universal healthcare, consider this: in 2003 (according to the World Health Organization) the United States government spent more, per capita, on healthcare than each of the governments of the United Kingdom and Sweden. Two countries that each have universal healthcare, the citizens of these countries did not have co-pays and both countries achieve generally better health results than the United States of America can boast.
    Personal net expenditure on healthcare would drop significantly under a properly implemented universal scheme and a single payer scheme would have the potential to cut billions of wasted dollars out of administrative costs.
    Finally, President Obama’s scheme will not work because it does not address the fundamental underlying problems. The supporters of the status quo will gladly watch the percentage of GDP spent on healthcare rise to 20% in the unreasoned belief that the marketplace will deliver effective healthcare and that we already have (of course) the best healthcare in the world. Basically we’re screwed!

  • Comment number 37.

    The level of analysis here in the US is shocking, but it is what we hear from our media. To the people who moan about the crippling cost of universal health care: all the other industrialized countries pay about HALF as much per person as we do. And they have lower infant mortality and less suffering from disease in old age. The US is throwing health care money away on insurance companies instead of medicine.

    The second point is that Obama's plan costs a trillion dollars over ten years to cover an extra two or three million people, expand coverage with very high personal payments to another ten or twenty million, and takes abortion coverage away from all women, even those with private insurance because of the rules required for the public component by our right wing.

    That thing is not health care reform, which this country desperately needs. It's the Health Insurance Profit Protection Act.

  • Comment number 38.

    Well, the way I see US politics, there are bold differences that cannot be merged together which resulted into these parties.
    So I think mr Obama should focus on how to pass the bill without GOP support, they want to start afresh, but behind that they want all their ideas to be embraced which contradicts with what Democratic party believe in or want.
    Go ahead Mr president, I believe your faith is to serve also those who do not have or have very little but who are working very hard day in day out to meet their needs.

  • Comment number 39.

    The Democrats had a year to push this socialist bill through with a super-majority in both Houses and they couldn't do it. There is no way the Republicans could have stopped this from happening. Even now, the Democrats can push it through with a majority vote and then face the wrath of the majority of the American people who are against it in the November elections. So, why don't you leftists stop blaming the Republicans? There is no way they can stop this from becoming law if the Democrats want to push it down our throats.

  • Comment number 40.

    I doubt the so-called "public option" (universal healthcare) will be included in the final bill. There is simply too much opposition and distrust to do that. An effective misinformation campaign launched by the insurance and pharmaceutical industries, enthusiastic support from political opportunists, greed, ideology and the erroneous perception that socialized medicine in European countries and Canada is a failure have convinced most Americans that our flawed and expensive system is the best in the world and can not be improved.

  • Comment number 41.

    In the sense of costs, it only makes sense that we put bombs, guns and artillery in front of the needs of the citizen (capitalism). We're taught from grade school that our government is to serve it's citizens first, but our system has lost it's sense of checks and balances in this day and age. Revolution will come soon, anyone can see that.

  • Comment number 42.

    This stream of consciousness style is not a "debate". I'd rather use other more pertinent comment boards if this is the best the BBC can do. THe HYS has lost its appeal. And this does not truly express the weight of opinion either. You get lost in a maze of random thoughts. Are more people critical of US healthcare? Do most people want the power with the individual or increase the power of government? Who the heck knows?

  • Comment number 43.

    If Obama tries to skirt the Senate through this "budgetary procedure" or whatever he wants to call it, he is deliberately violating the Constitution and should be prosecuted appropriately for treason.

  • Comment number 44.

    The U.S. can't be the only western country without a general healt plan for it citisens,the republicans do not understand how the averages american live (45% live for less than any EU citicen gets in retirements pay)and have no insurance. If one looks at the retirements pay for a person serving in congress, as well as there healtcare plan for life, one can see how out of tuch they are. The difrence between a Oxford Dictionary and a U.S. is, the word corruption exits in the Oxford edition it has been replaced in the U.S. with "Special Interest". And we want the world to look at our great Democracy and so called freedom. The greates problem in American politick's is the two party system, which do not favor the rights of the American people. Who ever is in power undo what the other party put into place, so no way of going forward.

  • Comment number 45.

    1. At 12:05pm on 26 Feb 2010, chris wrote:

    There is no way the Republicans, drug companies or other vested interests are going to make the US the land of free ANYTHING. It's a democracy in name only.

    We are not a democracy we are a Republic - big difference look it up. As an ex-brit I know the NHS and now our US system - our hospitals and staff are the best and all you need for full access is get a job (or if you are genuinely unable government programs here in Tennessee). For me the American system, although expensive at times, is FAR superior - and who knows if 'We the People' get changes WE want (not Obamas socialism) it'll be even better!

  • Comment number 46.

    For an entire year the Democratic Senate Majority would not pass Obama's health care bill. They never needed one Republican vote to pass it. Obama could pass this bill with 51 votes in the Senate even today...his party has turned their backs on him and his 'Plan'.

    Instead of pushing the government to take over health care, he should focus on a few laws to force insurance companies to not drop people with high cost medical problems and cap the amount of yearly increase on policy's. He could also increase the resource pool of doctors by giving more college grants to students studying medicine.

  • Comment number 47.

    "CAN WE HAVE A DEBATE ON THIS NEW WEB SITE AS I DON'T LIKE IT ONE LITTLE BIT. SCRAP IT AND RETURN TO THE ORIGINAL FORMAT." may be progress but it's entirely in the wrong direction. For me HYS has lost much of it's appeal - makes it no better then so many other "also ran" bloggs.

  • Comment number 48.

    As an American, my ancesters came from all over the world. They worked hard and never ask for a hand out from the government. They fought in wars and will continue to fight for FREEDOM AND LIBERTY. In today's world, money rules instead of HUMAN RIGHTS. It was proven in 2008-2009 with Wall Street and all over the world. We have become numbers in a computer. Health Care is our right as a HUMANS. Why should an INSURANCE company dictate who lives and who dies. Why should the rich prevail with Health Insurance Coverage and the unemployed suffer because of the Rich Companies that destroy their lifes?

  • Comment number 49.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 50.

    ps New format sucks but thanks for all the BBC does anyway.

  • Comment number 51.

    America needs to grow up, we are mismanaged. We have bad schools funded based upon income within the local area, such poor funding for tomorrows children, not good for managed future. We have poor health coverage based upon what you can afford, poor management. As humans and workers we deserve basic services, and taxed to pay for it.
    Flat tax, nationalize health, nationalize education, join the EU as a member, wake up america.

  • Comment number 52.

    We seem to be stuck in the same party posturing that we say we are frustrated with in the first place. Personally, I feel that we could improve the services offered to the poor without nationalizing the entire system. Nor do I believe the US will ever embrace a system perceived as socialist in nature. I do wonder why we are so focused on expanding government coverage and not addressing healthy living and preventative care. Oh wait, Mrs. Obama is tackling that one with her focus on childhood obesity. Oddly, she was so concerned with political correctness in the interview I watched that she would not characterize these children with the use of the phrase 'your child is obese' or use the descriptor 'fat'. Here is a revelation- Americans, in general, do not exercise enough, eat too much fatty food, and do not engage in the basic preventative measures to avoid need health insurance in the form of 'disaster coverage'. Okay, I have to go- this temporarily employed American, with no health insurance needs to go for a walk.

  • Comment number 53.

    I am quite impressed with the way Obama is handling it (The Healthcare issue). Beyond a point the leaders have to ram it through (Reconciliation). While doing it they have to give full chance to the other side to be flexible, listen to their view point and allow them to come On Board. So has he done.
    The sumit is history now. It is time for action. When push comes to shove the Leader has to be decisive. He cannot leave things in a limbo. He could be right, he could be wrong. That time will tell.
    Big thumbs up to Obama as far as I am concerned. And Buddy ! Do not hesitate even if it means Reconciliation.

  • Comment number 54.

    I love our President. Mr. Obama is doing his best for the American citizens. His opponents are enemies of America.

  • Comment number 55.

    every body agrees that the heath system is broke, yet both parties can't seem to get it righ. the people have lost trust in the government and this is the blow back. its a loose loose situation. if the bill is pushed through and does not benefit the system but crash it , democrats are screwed if it don't go through, well things will just get worse America has dug it self a hole it might find really difficault to get out of, and given how the world is so globally interconnected a domino effect is coming and there is no escape

  • Comment number 56.

    " 1. At 12:05pm on 26 Feb 2010, chris wrote:

    There is no way the Republicans, drug companies or other vested interests are going to make the US the land of free ANYTHING. It's a democracy in name only."

    Ignoring the fact that the US is a republic, not a democracy why would the drug companies object if Obama uses government money to provide their drugs to the 40M americans who don't currently have insurance. Do you think the NHS in Britain or the social healthcare programmes in Europe force the drug companies to give their drugs away for free?

    Incidentally the worlds biggest pharmaceutical company is Glaxo-SmithKline. They're British.

  • Comment number 57.

    I hope the Democrats do go ahead and force this legislation into law against the will of the majority of the American people. That way, it will insure that the Democrats lose their majorities in Congress in the November election.

  • Comment number 58.

    If Mr. Obama and his party elect to carry through their threat to pass this bill by reconciliation, then he should be impeached as the congress and senate representatives should be recalled. This bill is not the will of the people. Yes there is a need for reform, but if what you proposed is not good enough for all, inclusive of those whom are passing it, then it's time to reconsider. No special deals, no favoritism, no lobbyists, just represent the people as you were elected to do. If this bill is passed by reconciliation, then that is dictatorship by the Democrats, not a government of the people.

  • Comment number 59.

    If you want an honest, unbiased view of what is wrong with the USA's healthcare system, and why our NHS is a million times better, then just watch Michael Moores film 'Sicko'.

    One quote from the film that stands out '75% of people who have paid for medical insurance, and then find they have become ill AFTER they took out the insurance, end up bankrupt'.

  • Comment number 60.

    This format is appallingly bad.

    Whoever thought/designed this should be sent back into the basement where they belong.

  • Comment number 61.

    The American people need a health plan that benefits the whole country but politics and party lines are a major stumblling block to an idea that might give everyone equal chance at the doctors office not just the rich. Obama has the right idea but the interestes of the powerful medical labatories and insurance companies will do anything to make sure their profits are still getting higher. shame on anyone that denies health care from its people especially in a country that promotes Human Rights because the health care it is a Human Right voliation

  • Comment number 62.

    "This proposal only forces everyone to get insurance - since 50% get afford the complete cost, makes the other 50% paid for it"

    Liberty, taking liberties with the English language, doesn't seem to understand the basics of public health insurance i.e. where the majority pays large sums of money to stop the poor spreading diseases. Flu, TB, measles, polio; you name it, could be eradicated if everyone got vaccinated. If you are struggling already you don't pay for vaccination and everyone gets what you got! Bacteria are free but the vaccines cost money so what do you want, sickness or health?

  • Comment number 63.

    Obama is not going to give up on this health care reform. The Republicans can fight as hard and as long as they want. Obama has the interests of the entire country in mind as he fights for this; the Republicans have the interests of corporate leaders in mind. The Democrats will win this one.

  • Comment number 64.

    Obama has spent his time with logical rational arguments. The audience are trained to TV ads that yell, “Buy this because we tell you!” Thinking is hard, changing and giving is hard! Lose the intellectual approach, sound bite and punchy ads will win – this is about the minds of the people. They supported the war because GW promised to “whoop anyone who messes with USA”, not the need to prevent radicalisation of the youth and women’s rights!

  • Comment number 65.

    Obama should press ahead and pass health care reform without delay! The republican call to start all over again or do it piecemeal effectively amounts to having no reform at all even though they too agreed that something urgently needs to be done about health care in America! Even worse, if the two parties' positions on the issue were reversed today, those hypocritical republicans will not hesitate for a moment to use 'reconciliation' to pass the damn thing. Those republicans should be held responsible for the deaths each year of 45,000 Americans because they have no access to an affordable health care. Come on Obama, just do it!

  • Comment number 66.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 67.

    Everyone seems to know how to run other people's countries. A lot of the information we receive is biased except in nations that have no external voices guiding them towards what they should and should not tell their citizens. Here is how it should happen, but keep in mind I, like the majority of these posters, have no credentials:

    1. If the majority of American's do not want a national health care system, then they should not have one. The people who do work should not be forced to pay for the lazy fools laying around. I have visited America one time and there are two types of people. The workers and the "poor." Their poor are richer than our middle class.

    2. If people do want to be covered and not pay for it, they do not have to live there. It is the country of dreams. People from my country know that if one lives there, it is a gamble and we are ok with it. Its not exactly a gamble because you have the ability to choose your outcome based off of hard work. It is not that hard to go live in Canada after living in America.

    3. They are already in debt, not to my country though because we know that they would never pay us back, to the major powers of the world. They need to actually show that they will be able to pay back their debt if they want to continue on this path. The way to show this is not by overspending.

    4. Their tax system is run on the taxes paid by the top 5% of their country. If these taxes continue to rise solely on these people, they may leave and live in a different country. I know that if I do work that is worth 10 million Euros and I lose 7 million to the government and someone does work worth 10,000 euros and they get 30,000 euros from the government, I might leave. In a country that glorifies the ease to reaching the high life, they sure do make it appear that the rich should be hated. Why would I want to go to a country to make my life through hard work only to be hated on by those who put in little work. That is why I do not plan to leave my country for it.

  • Comment number 68.

    The only way he will get the bill passed is if he moves the US torture specialist training department back to US hospitals the US blood baying public will only then go for it! and would save them on overnight flights to far off places round the world!

  • Comment number 69.

    As someone from the other side of the pond I am simply not understanding the opposition from the "grass roots". I can wholly understand and even sympathise to some degree with the opposition shown by the insurance, drugs and private hospital companies but I don't get why individuals are arguing this on the streets ? Please enlighten me... It cannot be something as base as wanting the "poor" to suffer and die earlier is it ?

  • Comment number 70.

    more is spent on killing others illegally and supporting apartheid regimes than caring for their own citizens! what a rancid country!

  • Comment number 71.

    "Shame on the USA and long live the NHS. It may not be perfect, but I would hate to live on the US if I was poor."
    American's, especially those on the right of the political spectrum, view Socialism as no different from Communism, and as such are represented by such regimes as China, North Korea, and the (now defunct) Soviet Union. The older generation, (i.e. my age) were brought up in an environment of absolute paranoia. They were taught in infants school how to get under their desk and protect themselves in case "the big one" was dropped on them.
    I personally believe that this environment is largely to blame for the extreme "bomb first, ask questions later" militaristic attitude, and
    definitely to blame for the attitude towards social programs.
    As for everything else.
    It is necessary to understand that the American population falls into several groups, not based on politics, but basically on their attitude towards other people. Primarily;
    Democrats: Who, in general, empathise with groups who are less well off than themselves (by which I mean the unemployed and the working poor, as well as the other minority groups). They support social programs to help these groups, and accept the idea that these programs need to be paid for. Most, if not all, are horrified by the fact that 30-40M people in America have no Healthcare coverage.
    Republicans: These are the "I'm alright, Jack" gang. The general attitude is that, if anyone in America is worse off than they are, then it is most likely their own fault, (and as long as the sick and dying stay away from their neighbourhood, then they don't have to think about it too much). They are generally OK with the idea of helping out the less fortunate, provided it doesn't cost them anything. They want all of the benefits of living in a wealthy, technological country, but they dont want to pay for it. They continue to insist that the American "everything" is "...the best in the world", although they present no evidence to support these contentions, and have no experience of the rest of the world, to compare it to. They believe these statements absolutely, i.e. "Americal Healthcare is the best in the World", despite being ranked 37th in the western hemisphere on Healthcare quality, 30th on life expectancy and despite paying twice as much per capita, for the healthcare they receive.
    Democratic Politicians: Bunch of feeble, spineless, whiners. Most of them overly cynical, and more concerned with reelection than with doing what they were elected for.
    Republican Politicians: Smarter than the Democrats. They have no interest in doing anything. Their primary concern is getting through the distasteful period when the Democrats are in charge, (without allowing the administration to score any points - basically they are playing for the draw (with the additional hope that the Dems will score a own-goal). Most of the Republican congressmen and Senators represent districts where they are at no risk of losing their seat, unless they are seen to be helping the Dems, in which case they are doomed.
    The Republicans are greatly assisted by the existence of the "fillibuster", a truly remarkable tool. Can you believe that in a DEMOCRACY (governance decided by the will of the Majority) that 51% would not be enough. Apparently in the American version of DEMOCRACY, a 41% Minority constitutes a Majority. (I'm still trying to figure it out.)
    We constantly hear about the Dems 60 vote majority, and how it should be able to overpower the fillibuster. Actually the Dems have 58 votes, the other two are Independents, one of whom is very right-wing (and also very cosy with the Insurance Companies), so the Dems Never had a 60 vote majority.
    And even though they could (probably) have scraped together enough votes for most of their legislation, the 60 vote requirement meant that it was never going to happen.

    They have no problem with taking on debt so that the very wealthy can have tax-cuts, after all they are doing alright

  • Comment number 72.

    According to the commonwealth club of California the USA could solve its health care problems if they simply gave Germany, France or the UK (even Greece) the medicare budget -- any one of those could provide free health care to the whole population of the US on that budget -- never mind all the private stuff that everybody pays!

  • Comment number 73.

    Obamas good will to make a Health Reform is certainly there,but i am sorry to say,that i think,it will end as those Healthcare reforms up
    to now always ended.Those only in Profit intrested Insurance and Drug
    Commpanys will have it,with the Republicanians help,their way again.

  • Comment number 74.

    Another $1 trillion and more added to the $2 trillion already added in deficit spending makes the Democrats' health bill a route to becoming a debtor nation.
    With Obama the Democrats have the power to create socialized medicine and another government bureaucracy to control the lives (and deaths) of American citizens.
    Failure to exclude illegal immigrants from tax supported government health care will trigger a massive new expense beyond the current costs.

  • Comment number 75.

    Health care reform proposed by President Obama is reasonable and fair. Yes, it is very expensive but there is a cost to providing an equitable program that includes the 30 odd million uninsured Americans. If Republicans really cared about the vulnerable citizens in their society, they could have come up with a plan a long time ago. But do they have the conviction to serve the needs of all Americans or do they only want to serve the interests of those who support their political campaigns.The richest nation in the world should look after its own citizens first and provide them with the basic health care needs. Charity begins at home.

  • Comment number 76.

    With the price of health care going up at astonishing rates, a bunch of eager drug and insurance companies, already with more cash that they know what to do with, are falling over themselves to grab even more.
    Money, you see, is the ugly monster that separates millions of Americans from access to health care. Money is the hurdle that forces big corporations to back away from contractual agreements to provide workers with medical insurance. Money is the struggle small businesses are stuck with if they are to deliver medical insurance as a so-called benefit.
    The United States leads the entire world in Money spent on health care yet, you might be surprised at what's considered a healthcare cost. When you think of healthcare costs do you think of money paid to lobbyists? Or junkets for legislators and their staff? Or campaign contributions made to ensure that the financial interests of healthcare industry organizations are promoted and preserved? How about medical conventions at fancy golf resorts? Or the price paid for television advertising?

  • Comment number 77.

    The difficulties with reaching agreements on health reform are a true reflection of how badly the country is divided. There is no unity between labor and management, political self-serving interests vs what is best for the country. No, do not start all over. Washington should be locked behind closed doors and be let out when an agreement has been reached. Deliver quality and timely results. Talk less, stand up, think and think again. Making a bad decision is better than not making a decision at all.

  • Comment number 78.

    There is one thing Brits don't understand about America. We don't want to do things like you do. What makes me scream is when you claim to have "FREE" heath care. Are you kidding? Your workers, who work for a living, pay about 15% health care tax for that "free" service. Your system is abused by the same "slacker" mentality that we don't want to have here. I have paid into the medical system all my life and take a real offense to paying extra and having my health benefits reduced to help out the majority of those who haven't contributed anything to society in their entire life! We aren't selfish, we just don't like to be suckered into giving benefits to democrats for them to give "pay offs" to certain people for their votes. That's all it is.

  • Comment number 79.

    I think health care would be a good thing and I would like to argue some of the other posts about how the US isn't really "free." There comes a time that, without regulations, there would be more harm done than good. Regulations like the FDA make sure that products are okay to sell. Does this take away our freedom? Perhaps, but it also prevents an unevitable disaster. As to the socialistic problems with the health care plan, I would like to argue that there is a huge socialistic idea in the US and the world that people do not complain about - public schools. These are government regulated, but are a great thing for citizens. If you are going to protest the health care reform by calling it 'socialistic,' find out what it is you are truely arguing.

    As for the reform itself, I believe it will be much better for the people of America. Health bills are already expensive and I can't imagine what it would be like without health care. This bill will help the quality of the people of America, which is what really matters. This idea is not a new one, and I believe it is time for it to make it's way to the USA. It seems as if companies would benefit by having more clients and patients and we all know the citizens will too. This is a time of change and I think this bill will be a good start to a new era.

  • Comment number 80.

    The summit wasn't intended to produce a compromise, it was intended to paint the Republicans as intransigent, mean-spirited foot draggers and thereby provide political cover for the Democrats to pass their health care plan on a straight party line vote. If the American people like the result then it was a brilliant bit of political strategy. If, after they see the price tag and find out what's in the plan, the people don't like the result then Democrats are setting themselves up for a voter backlash come the next elections.

    Most Americans agree that some sort of health care reform is needed, the real points of contention are what will it cost and whether it should be run by the government.

  • Comment number 81.

    Simple, let those Republicans idiots to get to power again and continuos to sink the country in to that quagmire that they left it in to.

  • Comment number 82.

    "... but Republicans say that the country cannot afford the plans"
    But they can afford to give huge tax breaks to large corporations; they could afford send the country on an unnecessary with Iraq for 7 years; they could give the bank billions.
    Republicans claim that they "support the troops" who are "defending the American way of life", yet by denying less well off Americans healthcare, they are denying the same socio-economic class that most of the troops fighting for the country come from.
    Americans have shared and also given much to the rest of the world. They have also contributed to the huge success of America the country and to corporate America. Pity their politicians and companies don't appreciate them. Pity it's often ordinary foreigners like myself care more about them.

  • Comment number 83.

    Every poll in this country, for months, has indicated that the health care bill that the President and his party advocate, doesn't cut it! His bunch can't see this. My question is, Is it not clear enough!?! The American people have spoken, and if, they don't realize it, they do not represent the people who elected them, they should be ousted. I have seen the right of recall used on the local level and it should be used more often on the state and national level. If not, November is coming up. Both Parties, BEWARE!, the American people know how to vote and they will!!!

  • Comment number 84.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 85.

    Obama has done his best to save American tax payers, American industries, American senior citizens, American way of life and expectations from its government by tackling the Health care issues, unfortunately the Republican party grazes on funds from the insurance industry, they are pawns to the moods and swings in profits for the insurance companies, they let the insurance companies present lies via the mass media and take everyone for a ride while the citizen's savings and lifestyles are being eroded. Too many vested interests to make a healthy choice!

  • Comment number 86.

    Jakovi Scott wrote: "I have visited America one time and there are two types of people. The workers and the "poor." Their poor are richer than our middle class."

    Interesting conclusion to come to after one trip to my enormous country. Where did you stay, New York's Upper East Side? Beverly Hills? Greenwich, Connecticut? Wherever it was, I'm guessing you bypassed Appalachia, the Rust Belt, the slums of our cities, or anywhere else that's been hit by the current recession and unemployment rates. And out of curiosity, where do you live that your country's middle class is worse off than our poor?

  • Comment number 87.

    Pharmaceutical and Insurance companies have donated too much money to too many US politicians for the status quo to change. The situation can be spun so it raises fears about socialism in the general population and the right-wing media can run with it to supress debate and scare people into keeping the system they have.

    There's something more scary than socialism though. Death-boards deciding people's fates based on saving the insurers money, uninsured ER patients being put in a taxi then dumped in the streets still under medication, people refused treatment even when they have insurance because they had a 'pre-existing condition' which they never even knew about. But US politicians would rather throw up the spectre of socialism than face up to sorting out the problems in the existing system.

  • Comment number 88.

    "Mr. Obama is doing his best for the American citizens. His opponents are enemies of America."

    Then it's your duty to report them to FBI.

    Have you?

  • Comment number 89.

    Gee, you know if the country wasn't bankrupt from Bush's and now Obama's war, I might actually agree that we need some health care reform.

    Where are these trillions of dollars going to come from? Obama apparently thinks the government can just print money for whatever plan he comes up with.

    Try getting the government operating in the black again, and then reform health care. What a novel concept, actually having the money to pay for something before you buy it.

  • Comment number 90.

    Thank your lucky stars that you Brits got UHC at a time when the UK was a society of consensus, with an overwhelmingly homogenous population that felt a true sense of community. These days, you would have every bit, if not more, problem with installing a system in which there will always be those who never pay, and yet benefit in full. YOu don't really think you would *now* vote for a system where anyone from any third world sink hole can enter the country illegally and enjoy full benefits, just like the Brits for whom the system was set up, and who are paying more than ever, and being told to wait in line for treatment...Need I say more?

    You won't publish this.

  • Comment number 91.

    It is indicative of the double standard that is the USA that they can give millions of dolars to a disaster fund and not treat the poor and homeless in their own country. Go for it Obama and let your people get into an ambulance without having to produce a credit card.

  • Comment number 92.

    People on these MBs persist in referring to health care as 'free'. NO health care is free - if it is truly free to you, i.e. you receive its benefits without paying *anything* at all, then you are a scrounger and someone else has to pay for you.

    The system will *only* work if everyone contributes, and those contributions exceed, or at least equal, the value of the services rendered. As soon as moochers who do not pay enter the equation in any numbers, the whole thing goes down hill. Thus, The President's insistence that everyone pay something, even if they have to be subsidized.

    And in the case of the UK and the US, yes, Virginia, there is a free lunch, but only if you are illegal or a liar.

  • Comment number 93.

    The USA is not a democracy, it's a CAPITALIST REPUBLIC and we like it that way. Apparently, so do a lot of other nationalities if one considers the large number of people within to emigrate to our country. That said, we desperately need reform that puts basic healthcare within reach of all LEGAL citizens. This should be accomplished by:
    1.Compensating healthcare providers based on the outcome of their services rather than on the total value of services they can rack up;
    2. Collecive bargaining to reduce costs of medical procedures and prescription drugs;
    3. Regulating insurance companies at the national level and allowing interstate competition between insurance;
    4. Tort reforem to limit malpractice awards;
    5. Developing a basic healthcare plan required for all citizens;
    6. Placing at least some responsibility on each individual for maintaining a healthy lifestyle.

  • Comment number 94.

    Obama and the Democratic Party have done their best to offer the Republican Party a chance to compromise. The Republicans have demonstrated that they are unwilling to compromise. They have been bought and paid for by the private insurance companies lock, stock and barrel. Personally, I'm not happy with the House and Senate bills that were passed. Too much was not transparent and the Republicans were correct in pointing that out. But too many Americans are suffering today without insurance. I know. I'm one of them. It is time for the Democrats to use Reconciliation as the way to pass the health care measures once and for all. Democrats have had to do that in the past on almost all social legislation because of the intransigence of the GOP. It's time to pass the bill and get on and pass other Democratic initiatives to keep the promise of change.

  • Comment number 95.

    The American people are angry on what is happening in the Governmet.The US Constitution calls for separation of power vested by the people for the people and with the people. The main cause for the Healthcare problem is the drafting of the Bill on partisan line and failure of the Majority Party to listen to the people and correct. The issue is not dead and the remedy is to work on Bipartisan princple

  • Comment number 96.

    Interesting chart from Nat Geographic January 2010 edition - with the noise about healthcare here how can people ignore the per capita US spend of $7,300 in 2007 vs. Switzerland, Canada and France around $4,000 and the UK around $3,000? Delivering worse ave. life expectancy for US citizens than any of the others! Free money for reduced taxes or infrastructure depending on your politics.

    Another way of looking at the numbers is to take the UK spend, convert it to US$, scale it for 300million US people vs. 60million UK people, then double the resulting number to account for bigger geography and 'fixing' sevrice level issues (real and imagined) to 'americanise' them. SO no I am spending 2x the UK per capita health care spend on EVERY US citizen. That total is a mere $850 billion less than declared US healthcare spend of $2,500 billion in 2008 and just happens to be about the same as the defense budget PLUS the cost of the two wars. So bottom line you could spend twice as much on EVERY americn's healthcare as the UK does and still save enough to pay for defense and two wars.

    It's clear that irrespective of politics and the best way to accomplish it, there is a HUGE $ opportunity in the US to bring productivity to healthcare delivery. One would think true market forces left to their own devices would naturally trend towards much better value for Americans. What is stopping that happening?

  • Comment number 97.

    I was in Cuba exactly a year ago and the current BBC features from Havana have brought back fond memories.

    I must admit the Cuban healthcare system and education system both put the UK situation to shame.

    Such a shame the US is so paranoid about the evils of the relatively mild form of UK healthcare "socialism" let alone have Cuban communism's healthcare successes rubbed in when compared to capitalism's failures. Ho hum - as long as the fat US corporation cats in charge keep the US population ignorant and unhealthy all is well in the "free" world.

    Seems strange though that the US voters don't vote for something like cheap healthcare that actually benefits them. Have they been brainwashed? We should be told...

  • Comment number 98.

    I have been living in the US for 10 years now. In my opinion, the whole US system is a vicious cycle. It is all about the money, and always lots of money. It starts with education, which is ridiculously expensive. Lots of people have to take loans to go to college. Next, the hospitals/clinics charge an arm and a leg for everything. Next, the mighty insurance companies care only about the bottom line. Next, next, next...In two words, USA is an expensive place to live, period. No system is perfect, but the american is not even close! I don't think the health care system is going to change any time soon. Too much money is involved. And "In money we trust"!

  • Comment number 99.

    Obama has tried his best to solve this health care problem that is destroying the lives of many Americans, its industries, its senior citizens and the paying public. The Republicans who are GRAZING on the funds from the Insurance industries and the drug companies are hell bent on shelving anything that will make them accountable, put some pressure on their bottom lines, which for ever are becoming bigger. If the health care is not nationalized then we will face a bleak unaffordable health care where the " Poor Cannot Afford to Live and The Rich Cannot Afford to Die".

  • Comment number 100.

    I've seen several comments about the US being a rich Country... How many trillions do they owe China? Of course they have a few billion coming in from the sale of Arms to Taiwan...

    Very similar to Premier League Football teams, constantly spending money it doesn't have.

    Most US people I know (I work with them and I have lived there) Do not want to pay more taxes for anything, especially for their neighbour.
    That is the American Dream.

    Reform is required alright, but not just their shocking healthcare system among many embarrassments they are suffering from.

    Stop buying US today and learn about how the "World turns"

    Imagine if the states were ran similar to Countries in Europe... Some States can have Healthcare etc. and those that want to keep the status quo... fine, wait that is Democracy no one will want that.


Page 1 of 6

BBC © 2014 The BBC is not responsible for the content of external sites. Read more.

This page is best viewed in an up-to-date web browser with style sheets (CSS) enabled. While you will be able to view the content of this page in your current browser, you will not be able to get the full visual experience. Please consider upgrading your browser software or enabling style sheets (CSS) if you are able to do so.