Reforma da Saúde aprovada na Câmara dos Representantes (III): Obama elogia «coragem política»

Um artigo de Carl Hulse e Robert Pear, no New York Times:

«WASHINGTON — President Obama, seeking to build momentum on Capitol Hill after the House passed a $1.1 trillion, 10-year plan to overhaul the nation’s health care system, urged the Senate on Sunday to “take the baton and bring this effort to the finish line.”

Heavier Americans Push Back on Health Debate (November 8, 2009) Speaking in the Rose Garden exactly 24 hours after he appeared there Saturday to call for House passage of the bill, Mr. Obama praised House members for what he called a ‘’courageous vote” that “brought us closer than we have ever been” to extending coverage to millions of uninsured Americans. He said the bill fulfilled his promise to bring sweeping change to the lives of millions of Americans.

“Moments like this are why they sent us here,” the president said in his brief appearance. He also praised Iraq’s parliament for approving passing a much-delayed election law, calling the two votes “milestones that represent encouraging progress for our country.”

After an extended clash with Republicans over what has been a Democratic goal for decades, lawmakers voted late Saturday by 220 to 215 to approve a plan that would cost $1.1 trillion over 10 years. Democrats said the legislation would provide relief to Americans struggling to buy or hold on to health insurance, while bringing spiraling health care costs under control.

But Mr. Obama said the bill would ensure health-care coverage for most Americans, without increasing the federal deficit.

He said that he had telephoned a cancer survivor, one Katy Gibson of Montana, whose insurance had been canceled because of her illness, to tell her that with the vote Saturday, “We’ll be able to protect Americans just like her.”

The bill is the biggest health care legislation since the creation of Medicare for the elderly four decades ago.

Senator Harry Reid of Nevada, the majority leader, said he would bring a bill to the Senate floor for debate as soon as possible. The two chambers will still need to negotiate and approve a final bill.

As the debate moves to the Senate — with Democrats still hoping for final passage before year’s end, while acknowledging they face a tight schedule to achieve that — it was clear that the battle to fundamentally revamp the health-care system was far from over.

“The House bill is dead on arrival in the Senate,” Senator Lindsey Graham, Republican of South Carolina, said on CBS’s “Face the Nation.” He noted that the bill passed without the support of 39 House Democrats, and he predicted that such legislation would not pass in the Senate. “I hope and pray it doesn’t,” he said, “because it would be a disaster for the economy and health care.”

Only one Republican, Representative Anh Cao of Louisiana, voted for the bill; he told CNN on Sunday that he did so because many of his constituents are poor and uninsured.

House Democrats were forced to make major concessions on coverage for abortions to attract the final votes for passage — the speaker, Representative Nancy Pelosi, decided Friday to let abortion opponents try to tighten any use of federal money to fund the procedure — a wrenching compromise for abortion-rights advocates.

Abortion-rights advocates hope to modify the amendment during negotiations with the Senate. The vote brought the United States — which outspends every other country on health care while leaving millions of Americans uncovered and underperforming in important categories like infant mortality — a large step closer to the health-care practices of most other advanced countries.

Democrats say the House measure, paid for through new fees and taxes, along with cuts in Medicare, would extend coverage to 36 million people now without insurance while creating a government health insurance program. It would end insurance company practices like not covering pre-existing conditions or dropping people when they become ill.

Republicans showed no sign of lessening their nearly united opposition. Michael Steele, chairman of the Republican National Committee, said Sunday on ABC’s “This Week” that the House bill amounted to “a government takeover” that would undermine patient choice, burden states’ budgets and harm elderly Medicare recipients.

On the House floor, however, Democrats cheered wildly — and Republicans sat quietly — when the tally display showed the 218th and decisive vote.

The vote came on a day when Mr. Obama traveled to Capitol Hill to make a personal appeal for lawmakers to “answer the call of history” and support the bill.

The House also defeated the Republicans’ more modest plan, whose authors described it as more fiscally responsible, though it would have expanded coverage to just three million of the uninsured.

The Democrats who balked at the final measure represent mainly conservative swing districts, signaling that those who could be vulnerable in next year’s midterm elections viewed voting for the measure as politically risky.

Some Democrats said they voted for the legislation so they could seek improvements in it. “This bill will get better in the Senate,” said Representative Jim Cooper, a Tennessee Democrat. “If we kill it here, it won’t have a chance to get better.”

Lawmakers credited Mr. Obama with converting a final few holdouts during his appearance at an eleventh-hour closed-door meeting with Democrats.

Many Democrats also credited Ms. Pelosi for pulling off a victory that proved tougher than many had predicted. “She really threaded the needle on this one,” said Representative Jim McGovern of Massachusetts.

Mr. Obama made his rare weekend appearance on Capitol Hill as part of an all-out effort to rally Democrats. During a private meeting with Democrats, the president acknowledged the political difficulty of supporting major legislation in the face of tough criticism from conservatives.

But, those present said, he urged them on, saying, “When I sign this in the Rose Garden, each and every one of you will be able to look back and say, ‘This was my finest moment in politics,’ ” language he repeated on Sunday.

Republicans said the measure was too costly and would end up burdening the nation for decades to come. Some Democrats expressed the same view in explaining their opposition. “This bill is a wrecking ball to the entire economy,” said Representative Jack Kingston, Republican of Georgia. “We need targeted specific reforms to help people who have fallen through the health care cracks.”

The House vote was a significant step in the long-sought Democratic goal of enacting broad changes in the way health care is delivered. The House legislation, running almost 2,000 pages, would require most Americans to obtain health insurance or face penalties — an approach Republicans compared to government oppression.

Most employers would have to provide coverage or pay a tax penalty of up to 8 percent of their payroll. The bill would significantly expand Medicaid and would offer subsidies to help moderate-income people buy insurance from private companies or from a government insurance plan. It would also set up a national insurance exchange where people could shop for coverage.

“Our plan is not perfect, but it is a good start toward providing affordable health care to all Americans,” said Representative Peter A. DeFazio, Democrat of Oregon.»