Obama’s Health Care Speech: French Reax (& Preax)

Obama gave his big Health Care speech to a joint session of the US Congress early this morning (Central European Time). Let’s take a look at some material about that from the national press of France, the country which, it is widely admitted, has much to teach the Americans about how to run a national health care system.

We first need to consult the French paper-of-record, and that is still Le Monde, which provides initial coverage in a piece jointly credited to it, the AFP news agency, and Reuters (Obama’s big oral exam on health) and put on-line only a couple of hours after the event itself. Graphically, the article stands out due to the two YouTube videos embedded within it, which feature no dubbing or subtitles or any other concessions to French-only readers but which of course include that electric passage when the president was loudly heckled (Vous mentez!, he shouted – or would have, in French, if he had had any bit of class) by South Carolina Congressman Joe Wilson. The main insights of note here come at the very beginning – Barack Obama joue le tout pour le tout, or “Barack Obama is going all-in,” in poker-speak – and at the end: the piece remarks that Obama knows he needs to achieve something this year, as it will be even harder to do so next year, an election year.

That’s fine, but a bit broader coverage is offered by Washington correspondent Laure [sic] Mandeville in Le Figaro, Nicolas Sarkozy’s favorite French daily, in a piece placed on line more than an hour later (Health reform: Obama raises the tone) – including a brief remark about Michelle Obama that she was toute de rose vêtue, or “all dressed-up in rose”! (“Laure” must certainly be a female French name!) More pertinently, Mandeville gives the President’s performance a clear thumbs-up:

The entire Democratic camp was awaiting with impatience this presidential intervention, after a particularly eventful summer marked by violent attacks from Republicans and the president’s fall in popularity. He did not disappoint. Far from being beaten down by a politically-trying month of August, Obama appeared smiling, offensive-minded, and determined to use his political capital to defend a cause which, if it fails, could get the better of his young presidency.

Nonetheless, there remain worries, Mandeville notes, particularly in the financial realm. All of this expanded coverage will cost plenty of money; at the same time, Obama’s contention that costs can be reduced through reduction of waste and abuse strains credulity. Such cost considerations, at a time of ballooning federal government debt, are no doubt the “principal serious lever” left to Republicans for opposing the administration’s plans.

Heavy Lobbyists

Unfortunately, Republicans are not the only ones attempting to derail President Obama’s health care initiative. A more-complete understanding of the difficulties of the issue requires a descent into the house-of-horrors that is the world of American political lobbyists, which Ms. Mandeville is game for and discusses in a parallel article (USA: the lobbies’ weight in health reform).

The easiest way to approach such a subject for a non-US readership is simply to start reciting numbers: 42,000 officially-registered lobbyists trying to influence federal policy and legislation, who collectively are currently spending $1.4 million per day on the campaign over health care reform; the $28 million they spent on TV advertising in the month of August alone. Of course, some are acting to support such reform, but many interests – e.g. the pharmaceutical industry lobbyists, even the American Chamber of Commerce – want to limit any reform or even kill it off entirely. But that’s how the American lobbying system works; Mandeville gets a prime quote from a Washington lobbyist for Venezuelan strongman Hugo Chavez (no less), who says “The beauty of the American political system and of lobbying is that any cause can come defend itself on the Hill [that’s Capitol Hill, where the Congress is]. But the ugly side comes from the fact that it’s often he who has the most money who best makes himself heard.”

Indeed. Mandeville is thorough enough to recall for her readers some ugly lobbying figures from the past, such as Jack Abramoff – arrested back in 2006 for his blatant bribery of members of Congress – and Billy Tauzin, who became president of the pharmaceutical industry’s lobbying organization PhRMA (earning $2 million per year) immediately after serving as a congressman from Louisiana and playing a key role in the 2004 passage of the Medicare Prescription Drug Bill, which many view as much too generous to pharmaceutical companies. Fast-forwarding to today, Mandeville reports how PhRMA has somehow managed to recruit two former chiefs-of-staff of Max Baucus (she misnames him as “Mark”), the Senator from Montana who has a pivotal role in passing any health care reform legislation. Against this influence-peddling cesspool Mandeville casts Barack Obama as a modern-day Cato the Elder, coming to Washington to destroy the influence of special interests. (I guess Jimmy Stewart and “Mr. Smith Goes to Washington” aren’t part of her French store of cultural references.) But he has found that the special interests are much harder to fight than he expected, and that the effectiveness of his presidency has truly come to hang in the balance with the struggle he has undertaken.

Accounting for the System’s Gangrene

Finally, to Libération, a rather more left-leaning French daily paper, which among other things does offer the full video of the president’s address with French overdubbing, if you happen to be interested. Rather more valuable towards getting the true French take on the American approach to health care, though, is an analysis written by Bernard Cohen in preparation for Obama’s speech, entitled To the sources of the gangrene. Lede: “American health is totally locked-up by the private insurers.”

The reality about American health care, writes Cohen, is damning: although the country spends 16% of its GDP on it (while France spends 10%), it still ranks only 37th on the World Health Organization’s list of top world health care regimes. 48 million Americans are uninsured; each year at least 85,000 of them travel overseas on “medical tourism” to have an operation and/or receive care that they cannot afford at home. And preventive medicine? Forget about it:

A philosophy and practice totally opposed to that of prevention has imposed itself in America, that of the private insurers which, to protect their profits, keep the threat hanging of rescinding their policies – or simply refuse to honor them – until they can invoke a “pre-existing medical condition.”

Nonetheless – and, rest assured, to the considerable shock on the part of those observing from the other side of the Atlantic – the administration’s attempts to fix this situation met over the summer with crazed accusations of “death panels!” and “socialism!” More broadly, no true progress has been made in the modern era on state assistance for health care, other than Medicare/Medicaid under President Lyndon Baines Johnson. Why, Cohen asks, is it so fearfully difficult to pass a reform that would seem to be so indispensible?

He offers two answers. For one, the health care issue necessarily involves a lot of emotions among the citizenry and, secondly, government involvement somehow touches on their sense of individual liberty. Basically, he explains, you can class the Americans’ hang-up on health care alongside their hang-up about being able to buy (and use) as many guns as they want: they are both things “that, with time, have revealed themselves to be more damaging than enriching.” But that’s just the way that they are, and they simply won’t listen to reason. The same goes in particular for the Democratic Party: although health care reform has for decades been that party’s “grand cause,” now that the time has come when something can be done about it, with a president willing to lead, that party remains disunited. “Today the left wing of the party reproaches [Obama] for having tried to find a way to work with the Republicans, while the right-wing blames him for having offended conservative opinion by raising the specter of collectivism.”

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