Intended for healthcare professionals

Observations US Health Reform

Obama’s reform: no cure for what ails us

BMJ 2010; 340 doi: (Published 30 March 2010) Cite this as: BMJ 2010;340:c1778
  1. David U Himmelstein, associate professor of medicine1, co-founder2,
  2. Steffie Woolhandler, professor of medicine1, co-founder2
  1. 1Harvard Medical School and Cambridge Hospital, Massachusetts
  2. 2Physicians for a National Health Program
  1. david_himmelstein{at}

    As the applause fades for President Obama’s health reform, David Himmelstein and Steffie Woolhandler fear that the new law will simply pump funds into a dysfunctional, market driven system

    It was a stirring scene: President Obama signing the new health reform law before a cheering crowd, and a beaming vice president whispering in his ear, “This is a big fucking deal.” As doctors who have laboured for universal health care we’d like to join the celebration, but we can’t. Morphine has been dispensed for the treatment of cancer—the reform may offer a bit of temporary relief, but it is certainly no cure.

    The new law will pump additional funds into the currently dysfunctional, market driven system, pushing up health costs that are already twice those in most other wealthy nations. The Medicaid public insurance programme for poor people will expand to cover an additional 16 million poor Americans, while a similar number of uninsured people with higher incomes will be forced to buy private policies. For the “near poor” the government will pay part of these private premiums, channelling $447bn (£300bn; €330bn) in taxpayer funds to private insurers over …

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