Snowed in at home in Norfolk on Saturday, a slight rise in the freezing temperatures means we are now able to slide a car slowly down the lane to the main road rather like steering a boat. I had some sympathy with Senators in the US yesterday, trying to get into their crucial vote on the Healthcare Bill with Washington covered in two feet of snow and major delays in public transport. It is said that Government jets were commissioned to get some senators there. I wonder if Baroness Royall would commission a helicopter for me from Norwich International to get the Equality Bill through? Probably not I fear.
The Senate Health Bill is quite substantially modified from President Obama’s original universal coverage bill; it omits the notion of a public insurance system to cover those who do not have any cover at all and fall outside Medicaid and Medicare but nevertheless it is a triumph of last minute deals and some unseemly ‘incentives’ but will provide cover for another 30 million people out of the 47 million who at present fall out of the system. It’s expected that the final vote on Christmas Eve will ratify the current shape of the Bill.
Opposed on grounds of costs by Republicans, opposed by many doctors on the grounds that obligatory insurance schemes curtail freedom of clinical practice (and hence their potential remuneration) and the insurers themselves, it is the best that can be achieved at the moment, and a step that it is unlikely any future government can undo. If Obama does nothing else this will be an important legacy. Now they have to find ways to curtail health care spending, just like other western democracies.
I was surprised to see that the Senate vote was at 1.00 a.m. What is it about politicians that they like to legislate at unseemly hours of the night? Having endured the Equality Bill marathon to 11.00 p.m. last week, I think it’s time to start a campaign for parliament working ordinary hours. Nothing we do is so urgent that a decision needs to be made when many of us are too tired to stay awake. As a junior doctor I knew that when I worked long hours and through the night it really was because people’s lives depended on me being there. I find the whipped up false deadlines of political life rather absurd, a reflection of the egotism that makes politicians feel self-important. Staying up all night to staff A&E or an ambulance can be good; staying up all night to vote on fox hunting is simply balmy.