Less than a week before President elect Donald Trump’s inauguration the US House of Representatives took a first step towards Obamacare – US President Obama’s signature policy and the keystone of his legacy.
The Republican dominated House voted 227 to 198 to introduce a budget measure that is widely seen as a first step towards repeal.
This acts on an election promise made by Donald Trump during the recent election.
If Obamacare is indeed repealed Obama will unquestionably see this as a huge blow to his legacy. However such a step would also withdraw medical care for around 20 million Americans unless something is put in Obamacare’s place. As of now there is no clear idea of what if anything that might be.
Over and above the issue of the future of Obamacare, the question of health care provision in the US is completely unresolved. By every objective measure the situation with health care in the US is bad and getting worse, with costs spiralling and millions of Americans lacking proper cover. Not only is this bad in social and humanitarian terms. In purely economic terms it means that the US is spending around 17% of its GDP on health care costs whereas in Europe the figure is around 10%, with health costs in the US continuing to spiral.
This is unsustainable but the issue in the US has become so politicised that it is difficult to see any solution in sight.