Vidhya Alakeson on the US election

After the Democratic Convention last week, when healthcare featured in almost every major speech, I had been waiting all week to see whether the Republicans would talk about it at all during their Convention in Minneapolis. Yesterday, on the last day of the Convention, healthcare reform finally got a mention when John McCain took to the stage to deliver his acceptance speech.

He spelt out little of the detail of his own plan except to say that it would make things better. Instead, he used the platform to launch a familiar right wing attack on Barack Obama’s plan. Obama’s plan would create a big government solution to America’s healthcare problems, he claimed, and would take choices away from the American people and put them in the hands of bureaucrats.

Republicans know that this kind of attack works. Any suggestion that government will get to decide which doctor you see is an immediate turn off for Americans and can spell failure for any reform effort as the Clintons know all too well from the 1990s. For Americans, choice and high quality healthcare are inextricably linked. How can you possibly get good care without the freedom to seek a second or third specialist opinion, even if that means juggling different expert views and coming up with a treatment plan yourself?

The rest of the week’s discussion in Minneapolis was dominated by more traditional Republican themes designed to rally the party faithful behind John McCain – national security, energy independence and the right to life. McCain’s choice of Sarah Palin, Governor of Alaska, as his running mate, inevitably brought abortion to the fore at the convention. Not only is Palin a vehement campaigner for the right to life but the revelation that her seventeen year old daughter, Bristol, is five months pregnant and will marry her teenage boyfriend and raise the baby, brought the issue vividly to life. There was not even a whisper to suggest that Bristol’s pregnancy represents a further challenge to the Republican focus on abstinence as a form of contraception.

At the end of the two conventions, American politics appears to have reverted to a familiar fight between left and right in which a small number of social issues dominate – abortion, gay marriage and gun ownership. But this is more than simple posturing to shore up the party faithful on each side. On his campaign website, John McCain describes the Supreme Court decision in the Roe vs. Wade case that granted American women the right to abortion as ‘flawed,’ and pledges as President to nominate judges to the Supreme Court who will overturn it.

His aim is to return decision-making on abortion to the individual states and allow the people of each state to decide for themselves whether or not it should be legal, in the same was as gay marriage is currently treated. There is no doubt that, given the power, some states would ban abortion outright.

There is an untested assumption that the US Supreme Court would not go so far as to overturn Roe vs. Wade for fear of unleashing the wrath of liberally-minded women across the country. But the Court is only one judge away from a socially conservative majority. If McCain wins the election and sticks to his campaign promise, America could become the first developed country to repeal the right to abortion

Vidhya Alakeson is a former Harkness Fellow in Healthcare Policy based in Washington DC.