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美國全民健保法案的政治效應 -- L. Sidoti
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Analysis: Health care's political lift uncertain

LIZ SIDOTI, 美聯社National Political Writer

WASHINGTON – The initial blush of President Barack Obama's health care triumph immediately gives way to a sober political reality — he must sell the landmark legislation to an angry and unpredictable electorate, still reeling from the recession.

Voters may not buy it.

And that could mean a disastrous midterm election year for Obama and his fellow Democrats.

"We proved that this government — a government of the people and by the people — still works for the people," the president said late Sunday, beginning his sales pitch from the White House one hour after Congress passed the sweeping measure.

"This isn't radical reform but it is major reform," he added. "This is what change looks like."

Obama and the Democrats are certain to look for a much-needed political lift from the legislation, a capstone for a young presidency and a party after decades of trying to remake the nation's health care system.

But there's no guarantee they'll get it.

For now at least, Obama is savoring victory; he looks strong, principled and effective for getting something huge done in a city Americans detest.

Still, the near-term reward could easily be forgotten come November.

This campaign season already has been unforgiving for the White House and the Democratic Party, with a monumental loss in the Massachusetts Senate election and a spate of debilitating congressional retirements. And conditions seem ripe for the electorate to punish the party in power.

Voters are furious. They hate Washington. They also detest incumbents. They're concerned most about the economy. And unemployment that's hovering near 10 percent. They're also split over whether Obama's health plan is good for a nation with enormous budget deficits and climbing debt.

How those variables play out is anyone's guess.

Even so, Obama reassured rank-and-file Democrats before they cast what he rightly called a tough vote.

"It will end up being the smart thing to do politically because I believe that good policy is good politics," the president said Saturday at the Capitol.

Nearby, enraged tea party protesters filled the grounds and the steps of adjacent office buildings, railing against the measure and promising to fire lawmakers who backed it. Protesters were back Sunday, the message the same.

Ahead of the vote, a Gallup poll showed more Americans believe the measure will make things worse rather than better for the country as a whole and for them personally. And most polls show most people don't like the plan although some surveys showed Americans giving high marks to individual elements.

"It's very unusual that you have a major policy that doesn't have a majority of support in the public," said George Edwards, a Texas A&M University presidential historian. "When they enjoy the benefits of the bill, they may come around. But that may take some time."

Also unclear is how voters will treat Republicans. Some of the measure's elements go into effect immediately, such as coverage for children on their parents' policy until age 26 and prescription drug benefits for seniors. Republicans could be tagged obstructionists if the electorate likes these provisions and if the economy improves.

From now on, Obama and the Democrats will promote the measure's benefits while countering Republican nay-saying and griping about process. The president also will focus primarily on voters' most pressing concern — jobs. And that may endear him to voters more than the passage of his signature domestic issue.

Obama's immediate concern is holding Democratic majorities in Congress. His own political re-election is a while off, but the White House is almost surely focused on it, too.

His job-performance rating is hovering near 50 percent and may not rise even after he put so much political capital on the line.

Past presidents have either seen their poll numbers stay the same or dip following passage of divisive, though history-making, measures.

That was true for Lyndon B. Johnson's Civil Rights Act and Great Society agenda in the 1960s, Ronald Reagan's economic measures in the 1980s, and George W. Bush's tax cuts in the early 2000s. The exception was Bill Clinton, who saw his support increase in the 1990s after signing a contentious budget measure and welfare reform legislation. But it eventually fell.

Obama's political boost may come later.

"There's a bump for the history books," said Fred Greenstein, a Princeton University presidential scholar. "When historians ask if this is a kind of squandered presidency, there will be health care to point to."

The immediate future is less certain.

Will voters give Obama credit for addressing the issue if many Americans won't feel most changes immediately? Or will voters punish Democrats for a year of partisan wrangling that has exacerbated Americans' anti-Washington feelings and diverted focus from the economy? Will health care even be on the minds of Americans struggling through recession?

Throughout the yearlong debate, the GOP derided the bill as "socialized medicine" and warned that it would be devastating. But Republicans may find themselves looking sheepish given that the status quo won't change for most people for years.

Democrats now have an accomplishment around which to unite. Also, critical constituencies like senior citizens and young voters will feel change soon. And independent voters may praise Obama for showing that a Democratic majority can make Washington work.

Still, Democrats face a public fed up with Washington and disappointed by a president elected to change it. A year of bitter haggling and legislative maneuvering may feed into the argument — successfully stoked by Republicans — that Democrats have failed to fix Washington.

That's the reason some Democrats now worry about losing control of Congress.

"The voters will have their say on the politics," says White House press secretary Robert Gibbs. Still, he adds: "The president was and the Congress were sent here to address the problems that people face in this country, and that's what voters want us to see."

EDITOR'S NOTE — Liz Sidoti has covered national politics for The Associated Press since 2003.

http://news.yahoo.com/s/ap/us_health_care_politics_analysis

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胡卜凱

開欄文的報導中有三段話值得從政和有志於從政的人三思。

"We proved that this government — a government of the people and by the people — still works for the people,"

「我們證明了這個民有、民治的政府,仍然能夠為民享努力。」(歐巴馬)

“…I believe that good policy is good politics.”

「我相信為人民造福的政策就是受人民擁戴的政治。」(歐巴馬)

 Obama is savoring victory; he looks strong, principled and effective for getting something huge done in a city Americans detest.”

「歐巴馬正因為這次勝利而躊躇滿志,他在一個被老百姓瞧不起的城市做了一件破天荒的大事,因而顯得令出必行、堅守原則、和精明幹練。」(政治記者Sidoti的評論)



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美國國會通過全民健保法案 -- D. Espo
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Congress clears historic health care bill

DAVID ESPO, 美聯社 Special Correspondent

WASHINGTON – Summoned to success by President Barack Obama, the Democratic-controlled Congress approved historic legislation Sunday night extending health care to tens of millions of uninsured Americans and cracking down on insurance company abuses, a climactic chapter in the century-long quest for near universal coverage.

"This is what change looks like," Obama said a few moments later in televised remarks that stirred memories of his 2008 campaign promise of "change we can believe in."

Widely viewed as dead two months ago, the Senate-passed bill cleared the House on a 219-212 vote. Republicans were unanimous in opposition, joined by 34 dissident Democrats.

A second, smaller measure — making changes in the first — cleared the House shortly before midnight and was sent to the Senate, where Democratic leaders said they had the votes necessary to pass it quickly. The vote was 220-211.

Obama's young presidency received a badly needed boost as a deeply divided Congress passed legislation touching the lives of nearly every American. The battle for the future of the health insurance system — affecting one-sixth of the economy — galvanized Republicans and conservative activists looking ahead to November's midterm elections.

Far beyond the political ramifications — a concern the president repeatedly insisted he paid no mind — were the sweeping changes the bill held in store for Americans, insured or not, as well as the insurance industry and health care providers that face either smaller than anticipated payments from Medicare or higher taxes.

The nonpartisan Congressional Budget Office said the legislation awaiting the president's approval would extend coverage to 32 million Americans who lack it, ban insurers from denying coverage on the basis of pre-existing medical conditions and cut deficits by an estimated $138 billion over a decade. If realized, the expansion of coverage would include 95 percent of all eligible individuals under age 65.

For the first time, most Americans would be required to purchase insurance, and face penalties if they refused. Much of the money in the bill would be devoted to subsidies to help families at incomes of up to $88,000 a year pay their premiums.

The second measure, which House Democrats demanded before agreeing to approve the first, included enough money to close a gap in the Medicare prescription drug coverage over the next decade, starting with an election-season rebate of $250 later this year for seniors facing high costs.

Much of the cost would be covered by the pharmaceutical industry, which made a deal months ago with the White House in which it pledged to spend lavishly on television ads to help pass the bill.

It also included sweeping changes in the student loan program, an administration priority that has been stalled in the Senate for months. It would have the government originate all student loans, denying banks and other private lenders of a lucrative business they have long had. Much of the savings would go into increased Pell Grants for needy college students, but black and Hispanic colleges would also benefit.

For the president, the events capped an 18-day stretch in which he traveled to four states and lobbied more than 60 wavering lawmakers in person or by phone to secure passage of his signature domestic issue. According to some who met with him, he warned that the bill's demise could cripple his still-young presidency, and his aides hoped to use the victory on health care as a springboard to success on bills to tackle stubbornly high unemployment that threatens Democratic prospects in the fall.

Obama watched the vote in the White House's Roosevelt Room with Vice President Joe Biden and dozens of aides, exchanged high fives with Rahm Emanuel, his chief of staff, and then telephoned Speaker Nancy Pelosi with congratulations.

"We proved that we are still a people capable of doing big things," he said later in the White House East Room. "We proved that this government — a government of the people and by the people — still works for the people.

Crowds of protesters outside the Capitol shouted "just vote no" in a futile attempt to stop the inevitable taking place inside a House packed with lawmakers and ringed with spectators in the galleries above.

Across hours of debate, House Democrats predicted the larger of the two bills, costing $940 billion over a decade, would rank with other great social legislation of recent decades.

"We will be joining those who established Social Security, Medicare and now, tonight, health care for all Americans, said Pelosi, D-Calif., partner to Obama and Senate Majority Leader Harry Reid, D-Nev., in the grueling campaign to pass the legislation.

"This is the civil rights act of the 21st century," added Rep. Jim Clyburn of South Carolina, the top-ranking black member of the House.

Republicans readily agreed the bill would affect everyone in America, but warned repeatedly of the burden imposed by more than $900 billion in tax increases and Medicare cuts combined.

"We have failed to listen to America," said Rep. John Boehner of Ohio, leader of a party that has vowed to carry the fight into the fall's midterm elections for control of Congress.

The final obstacle to the bill's passage was cleared at mid-afternoon when Obama and Democratic leaders reached a compromise with anti-abortion lawmakers whose rebellion had left the outcome in doubt. The White House announced the president would issue an executive order pledging that no federal funds would be used for elective abortion, satisfying Rep. Bart Stupak of Michigan and a handful of like-minded lawmakers.

A spokesman for the U.S. Conference of Catholic Bishops expressed skepticism that the presidential order would satisfy the church's objections.

Republican abortion foes also said Obama's proposed order was insufficient, and when Stupak sought to counter them, a shout of "baby killer" could be heard coming from the Republican side of the chamber.

The measure would also usher in a significant expansion of Medicaid, the federal-state health care program for the poor. Coverage would be required for incomes up to 133 percent of the federal poverty level, $29,327 a year for a family of four. Childless adults would be covered for the first time, starting in 2014.

The insurance industry, which spent millions on advertising trying to block the bill, would come under new federal regulation. They would be forbidden from placing lifetime dollar limits on policies, from denying coverage to children because of pre-existing conditions and from canceling policies when a policyholder becomes ill.

Parents would be able to keep children up to age 26 on their family insurance plans, three years longer than is now the case.

A new high-risk pool would offer coverage to uninsured people with medical problems until 2014, when the coverage expansion would go into high gear.

Obama has said often that presidents of both parties have tried without success to achieve national health insurance, beginning with Theodore Roosevelt early in the 20th century.

The 44th president's quest to succeed where others have failed seemed at a dead end two months ago, when Republicans won a special election for a Massachusetts Senate seat, and with it, the votes to prevent a final vote.

But the White House, Pelosi and Reid soon came up with a rescue plan that required the House to approve the Senate-passed measure despite opposition to many of its provisions, then have both houses pass a fix-it measure incorporating numerous changes.

To pay for the changes, the legislation includes more than $400 billion in higher taxes over a decade, roughly half of it from a new Medicare payroll tax on individuals with incomes over $200,000 and couples over $250,000. A new excise tax on high-cost insurance policies was significantly scaled back in deference to complaints from organized labor.

In addition, the bills cut more than $500 billion from planned payments to hospitals, nursing homes, hospices and other providers that treat Medicare patients. An estimated $200 billion would reduce planned subsidies to insurance companies that offer a private alternative to traditional Medicare.

The insurance industry warned that seniors would face sharply higher premiums as a result, and the Congressional Budget Office said many would return to traditional Medicare as a result.

The subsidies are higher than those for seniors on traditional Medicare, a difference that critics complain is wasteful, but insurance industry officials argue goes into expanded benefits.

Associated Press writers Jim Kuhnhenn and Erica Werner contributed to this report.

http://news.yahoo.com/s/ap/us_health_care_overhaul;_ylt=AjMZJrXzVH2CV4ZALz74SXxOxBIF;_ylu=X3oDMTNjamEzamRhBGFzc2V0A2FwLzIwMTAwMzIyL3VzX2hlYWx0aF9jYXJlX292ZXJoYXVsBGNjb2RlA21vc3Rwb3B1bGFyBGNwb3MDMQRwb3MDMQRzZWMDeW5fdG9wX3N0b3JpZXMEc2xrA2NvbmdyZXNzY2xlYQ--


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