Unwarranted influence against reform

If there's one area in which the US cannot teach us anything, it lies in the field of public health care. Every single Maltese is entitled to an extensive degree of free health care, including hospitalisation - free being as in financed through the general tax system. Americans pay taxes too, but millions of them are not covered by any form of adequate public health care and are too poor to buy appropriate private insurance cover.

Barrack Obama had undertaken to change all that if he was elected to the presidency. He promised to break "the stranglehold" of the big drug companies. That was a major plank of his campaign. Now firmly ensconced in the White House, true to his word he is trying to buck the system with a radical reform plan.

It is not as far-reaching as expected. Along the way he had to make compromises, not least with the pharmaceutical industry, widely known and not a little hated as "Big Pharm". Yet, notwithstanding the majorities his Democratic Party has in the Senate and the House of Representative, there is a strong possibility that President Obama will suffer his first huge political defeat.

What is going wrong? The opposition Republican Party is cynically attacking the reform plan as being pure socialism, as an affront to and an attack on personal freedom. Their cunningly projected frenzy has been whipped up further through an alliance with extremist elements in the UK Conservative Party, who went to the States to rubbish the renowned British National Health Service (NHS), despite their party's commitment to keep and improve it when in office.

Some members of Mr Obama's own Democratic Party also oppose the plan. The concept of personal freedom is taken to mean that the poor have the right to fall sick to death, with no assistance from the State through redistributive taxation. At work too are the lobbyists, especially from parts of the pharmaceutical industry who, despite recent appearances to the contrary, will do their utmost to block change to ensure that medical care is ruled by the profit motive. The insurance sector, on its part, is proving to be a massive rampart of resistance.

All this brings to mind the famous farewell address by President Eisenhower in 1961, three days before he left office. It was a brilliant speech, defining what the old general termed America's "adventure in free government" and its noble goals. He called for the principle of balance to prevail in all spheres, particularly between the public and the private economy. He drew attention to the vast military establishment that had developed in his country and the huge spending on armaments. In this regard, he made a chilling warning.

In the councils of government, said President Eisenhower, himself an old military man, "we must guard against the acquisition of unwarranted influence, whether sought or unsought, by the military-industrial complex. The potential for the disastrous rise of misplaced power exists and will persist. We must never let the weight of this combination endanger our liberties or democratic processes. We should take nothing for granted. Only an alert and knowledgeable citizenry can compel the proper meshing of the huge industrial and military machinery of defence with our peaceful methods and goals, so that security and liberty may prosper together".

President Eisenhower's words were not heard well enough. The industrial-military complex prevailed to a chilling degree, as most recently shown in the invasion of Iraq. There also prevailed other very strong lobbies, as President Obama is finding out about with unwarranted influence by the strong health-care-for-private-profit lobbies. Nothing can be taken for granted.

That applies to our health care and the wider social security system as well. They do not have powerful lobbies as their enemies. Yet abuse by users and insufficient efficiency by providers can also wreak havoc on them.