
If Obama achieves universal coverage, ordinary Americans should be financially secure on the health front, but his plan may not do all that much for overall cost. In the first place, it won't include a single-payer system, an important element in reducing costs.
And that's only a start. After hearing from the pharmaceutical lobby, the White House and the Senate have agreed to omit from proposed medicare legislation the government's right to negotiate prices directly with drug companies. This measure has been highly successful in Canada in controlling costs, not surprisingly since drugs are the fasting rising component of the health care bill. Nor will the U.S. government allow cheaper drugs to be imported from Canada. Obama had included both these items in his campaign platform.
Obama and the Senate know that if they are going to get health care legislation passed, they have to take Big Pharma's money out of the equation. American politicians, like our own, answer to two constituencies: the people and the corporate sector. The American political system, again like ours, is less a democracy and more a hybrid system, with a democratic component and a plutocratic component. Both have to be placated. The American people will get the health care system they want to the extent the pharmaceutical companies get the health care system they want. Such is politics in the 21st century.
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