The health care legislation that has just been passed by the U.S. Congress after almost a year of political wrangling is being hailed as a sweeping overhaul of a troubled system. For some, the reform package does not go far enough. President Obama's opponents describe the health bill as a costly move toward "socialized medicine." Yet, almost certainly, the new legislation will improve access to health care for millions of Americans and will help to rein in a system that has imposed huge costs without delivering commensurate benefits or security for citizens. For America's transatlantic partners, passage of this new legislation should be good news. It shows that the U.S. and European social systems may be converging rather than diverging, and it may allow President Obama to devote some additional attention to international policy.
For years, observers have worried that Europe and the United States are drifting apart. Issues of concern have included diverging attitudes toward power and the use of force, the role of the state versus the markets in our economies, and social values and domestic policies. But the global economic crisis has encouraged a similarly sober approach to finance on both sides of the Atlantic, and transatlantic debates about employment, regulation and safety nets have also converged in key respects over the last year. If American health care reform spells the end of a laissez-faire attitude toward social goods, then this, too, is a sign of attitudes moving closer together rather than farther apart. The desire for a wider range of social benefits, with a larger role for the state if necessary, clearly is no longer confined to Europe. The economic crisis and the widespread perception of economic insecurity in the United States have reinforced this shift in social and political outlook.
At the same time, demographic trends and slower growth have underscored the need for reform in Europe's own social entitlements. The need for adjustment is most obvious in the troubled public finances of Greece and Portugal, but Europe as a whole has been driven to reassess the level and character of its pension and health arrangements. The trend toward convergence, in other words, is not one-sided.
The health policy debate in the United States has also encouraged a new interest in other models, mostly European, but also Canadian and Japanese. To be sure, much of the American debate on key domestic policy questions, including education and the environment, remains inward-looking and self-referential. But the fight over health care led to greatly increased interest in the media and the informed public about other approaches, in other settings. More Americans are now aware that most of the developed world treats health care as a public good rather than as a commodity. Europe should now be aware that American preferences are not as far removed from their own as some public intellectuals would like to believe. The health care reform debate has also led to greater transparency about systems, practices, and public expectations across the Atlantic, and that in itself is progress.
Finally, the success of President Obama's health care package also has direct foreign policy implications. Global leaders want the Administration to pay attention to a series of critical international issues, from the Middle East peace process to the future of arms control, from policy toward Russia and China to climate change. The sharp increase in positive views of U.S. leadership -- the "Obama bounce," well documented in GMF's most recent Transatlantic Trends survey -- has shown signs of erosion in recent months, especially among European elites. Ongoing economic challenges and domestic political battles, including the heath care agenda, have limited the president's attention to foreign policy. And when international issues have taken center stage, Europe has not been the priority concern.
With an important domestic policy achievement, the administration is now in a position to devote greater attention to -- and spend more political capital on -- strategic challenges and strategic alliances. This should include more visible engagement with partners on issues of key importance to Europe and transatlantic relations: Iran, nuclear arms control, peace process diplomacy, and the stabilization of global finance. Having opted against a visit to Europe for an EU-U.S. summit at a time of domestic political distractions, the November 2010 NATO summit in Lisbon will be a critical opportunity for high-level dialogue... just after the crucial mid-term elections in which the health care issue is sure to figure prominently.