U.S. Health Care -- Good for America, Bad for the World

Obama's show of strength, in fact, most closely resembles the fight for greater civil rights for African-Americans in the South during the 1960s. Democratic President Lyndon B. Johnson pushed through the Civil Rights Act because he believed it was the right thing to do. But he did it in the clear knowledge that the Democrats would have to pay a heavy political price.

Concerned about Re-election

Obama has made it clear that he too is less concerned about the political consequences than about doing the right thing. "We rose above the weight of our politics," he said after the bill was passed. "When faced with crisis, we did not shrink from our challenges. We overcame them. We did not avoid our responsibilities, we embraced it. We did not fear our future, we shaped it."

However, many Democrats are deeply concerned about their prospects for re-election and have only hesitantly followed their president. It is difficult to say whether mid-term elections in November will bring punishment or reward for passing the reform. One thing, however, seems clear: the debate over health care is far from over.

Even during the vote in the House of Representatives on Sunday, the Republicans were trying out what will likely become their new campaign message. Who will be forced to pay for the $940 billion reform? Can America afford it now? Can America afford it at all?

Obama counters by saying that the reform will pay for itself, indeed, he claims, it will ultimately save money. Nonetheless the billions of dollars he is currently juggling seem to be making many Americans feel faint.

Further Successes Doubtful

The debate will dominate the next few months -- and will no doubt also have an impact on the other projects that Obama is finally planning to tackle. The attention that the president will have to continue to pay to health care, in fact, makes further successes that much more doubtful.

Every other issue has become a sideshow, particularly those outside the borders of America. The Afghanistan mission: of marginal interest. Protecting the environment: postponed. Peace in the Middle East: off in the distance. Sanctions against Iran: delayed. Europe: not even worth a trip.

The one remaining global superpower has succumbed to navel gazing. The nature of Obama's hard-fought victory means little will change in the near future. On the contrary: Now he must explain to the country and to his own party why the entire health care journey, as all-encompassing as it turned out to be, was worth it in the end. He will have little time for anything else.

Such a realization should not spoil the celebration over health care for the Americans themselves. But the rest of the world won't be joining the party quite so enthusiastically.

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