More than a passing interest grabbed me in the debate for health-care reform in the United States because my son and daughter are naturalised American citizens and my two grandsons are born and bred Americans, all of whom, along with thousands of Jamaicans living in the USA are expected to benefit from the plan to bring everyone in America under health-care insurance. An estimated 32 million additional Americans who do not now have health insurance are expected to be brought into the system.

In the early years, most Americans will see only minor changes in the health care system. It will almost immediately end some insurance company practices, such as denying coverage to children with pre-existing conditions. Dependent children

under the age of 26 would be allowed to remain on their parents’ policies, if they cannot get health insurance elsewhere. Adults with pre-existing conditions would be able to buy coverage through expanded high-risk pools. The reform in totality represents a complete overhaul of the health-care system.

After a struggle lasting more than 100 years, and just over a year of intense campaigning by the Democratic Party under the leadership of President Barack Obama, Congress last week passed the health-care reform plan which was quickly signed into law by Obama. Not a single Republican voted for the legislation, mainly because of politics.

The real heroine of the Democratic push was Nancy Pelosi, Speaker of the House of Representatives. She fought with determination, perseverance and style. When Obama was prepared to drop some of the provisions in order to get more Democratic support Pelosi would not yield one inch. And in a final speech before the vote, she showed a cynical smile as if targeted at the Republicans.

Pelosi’s final words were moving. She said: “We tonight will make history for our country and progress for the American people. Today we have the opportunity to complete the great unfinished business of our country.” And history it was as the House voted 219-212 in favour of the legislation. Ted Kennedy, the giant Democrat who argued for health-care reform for 45 years, must have applauded from his grave. In the end, only 34 Democrats failed to support the legislation.

The Republicans came out shooting from the hip against the reform. Sarah Palin, former governor of Alaska and John McCain’s running mate in the last presidential election said: “No retreat. Reload.” On the House floor, one Republican referred to “baby killer” as he spoke against supporting abortion in the proposed legislation, with tears in his eyes at one point. Obama issued an executive order reiterating that no federal funds would be used to pay for abortion.

Protesters fomented violence and issued death threats against Democrats. Thousands of demonstrators descended on Washington in an attempt to “kill the bill”. Racial epithets were hurled at black congressmen. John Lewis, hero of the Civil Rights Movement in the 1960s, had to bear the brunt of the attack. At the time of writing this column – on Saturday – democrats were hitting back although many said the response came too late.

Many observers were of the view that much of the opposition to the legislation was because Obama is the first African-American president and some of the Republicans and racists did not want him to succeed. Republicans accused him of wanting to build a socialist utopia. Once again many Republican supporters went back to the nasty talk about Obama not being born in the USA and calling upon him to resign. Obama, whose popularity was down during the debate, suddenly gained strength in the public popularity polls.

Yet the Republicans made a valid point that with the country having record deficit it really could not afford health-care reform. However, the Senate passed two pieces of legislation which aim to reduce federal deficits by an estimated $143 billion over a decade and to crack down on insurance industry abuses, stripping banks and other private leaders of their ability to originate student loans in favour of a system of direct government lending.

As the debate continued, the Republicans were preparing to campaign on the slogan to “Repeal and replace” the legislation in the 2010 mid-term congressional elections. Obama said he welcomed the fight.

US commentators described the passage of the health-care reform as the most significant social legislation since the Great Society initiatives of the 1960s that saw the passage of Medicare, Medicaid and Civil Rights.