Healthcare reforms

Healthcare reform has become Obama's top domestic priority in recent months as millions of Americans look to their president to make good on one of his key pledges in his election campaign.

The pressure on Obama to overhaul the country's $2.5 trillion (1.7 trillion euros) healthcare system is intensifying as he prepares to address Congress on Sept. 9 to outline his latest vision and gears himself for what could turn out to be a bitter battle between Democrats and Republicans set to a background of public skepticism.

Healthcare experts believe that Obama has no other choice but to press on with his ambitious plans. Few believe that he will be able to achieve all that he has promised. At the same time they say he can't afford to abandon his plans with so much public opinion and political currency at stake.

"Obama won't abandon his plans, he simply can't afford to," Uwe Reinhardt, professor for healthcare economics at Princeton University told Deutsche Welle. "He can't do all the things he said he could do. The most he can do this year is to make sure that of the 47 million uninsured people in the US, maybe 20 million will be helped to get insurance."

Claus Wendt, project director at the Mannheim Center for European Social Policy Research, agrees that a solution must be found - and fast.

"Obama has to do something," Wendt told Deutsche Welle. "Today, 16 percent of the total economy is spent on healthcare and this will only increase. In ten years, it will be more than 20 percent. Take the situation with Medicare, the insurance system for the elderly - it is very expensive. If Obama does nothing, then caring for the elderly will become even more costly as the population ages and this will be an even bigger burden on the economy."

Uninsured Americans demand expensive healthcare

In a country that prides itself on providing equal opportunities for all, it's a shock to find that almost 50 million Americans are without any type of healthcare. Yet that doesn't stop them from making undue demands, according to Professor Reinhardt.

"Americans do imagine themselves to have an enormous range of rights," he said, "but at the same time they are skimpy on responsibility. Their thinking is that no one has the right to tell them to purchase insurance but when they're sick and not insured they have the right to healthcare that may cost $200,000. I don't think you would find that many Germans to be so juvenile about it," he said.

With such political and public pressure growing, Obama will have to come up with a reform plan which brings both sides of the political spectrum together and eases the concerns of the American population. With his critics citing all manner of evils from communism to Nazi Germany in their opposition to anything resembling public healthcare, Obama needs to look for a model that the US can accept and one which will work in its complex healthcare arena.

Both Reinhardt and Wendt believe Obama should look towards Europe when considering his next move.

European models offer compromise solutions

"It was recently written in the New York Times that the best model for the reform of the insurance system was that of Germany, which doesn't have a government-run plan but where there are private health funds," Reinhardt said. "They compete but within a regulatory structure which makes that competition fair and humane.

"You could pick either the German system, the Dutch system - even more so as they allow for profit-orientated insurance companies - or the Swiss system," he continued. "All these systems are fairly similar in having a structured, regulated market for private insurers, either non-profit or profit-making."

"But I think a mixture of the Dutch and German systems would be perfect for the insurance reform in the US," he added. "It's a shame that instead of having a rational discussion on the German system or taking a plane load of senators and congressmen and flying them over there, you have this shouting match over euthanasia, and pictures of Hitler being waved about. It has descended into quite an ugly scene."

Wendt agrees that that the German model is a political hot potato in the US and that the Dutch healthcare system could provide Obama with the compromise model he is looking for.

"I don't think it's a good idea to refer to the German model in the US for political reasons," Wendt said. "In general, I would say that the German model in comparison to the US model is in quite good shape because Germans have competition between different plans and the patients can choose between different plans and healthcare providers.

"But the Dutch model might be a good option for the US," he continued. "This would show that a new healthcare system could be run through private organizations and as a publicly-run concern, which is a fear in some circles in the US. The Swiss model may also work as the insurance business is conducted by private organizations, and this could be implemented in the American healthcare system."

Obama needs to explain his plans, says expert

Should Obama choose to follow a European model or combine a number of them in a plan to suit the American healthcare landscape, he is going to have to sell it to the people, something many Americans have accused the president of failing to do so far. A CBS News poll recently said most Americans think Obama has not clearly explained his plans to overhaul the system.

"Obama is a very intelligent man but I would not be surprised if he's not that well informed on the European healthcare systems," said Reinhardt. "The big mistake he has made is that he hasn't been able to explain to people in simple terms what he wants to do and appeal to that big, broad centrist middle class. And because it is a big unknown, everyone expects the worst. You have educated, intelligent people like the Catholic bishops believing that Obama's plan will lead to old people having their life-support systems turned off. This information vacuum is President Obama's fault. He should have taken hold of this issue much earlier."

Interviews: Rob Mudge
Text: Nick Amies

Editor: Kristin Zeier