Barack Obama is laboring mightily. After a state of grace, he now must confront virulent opposition to his great plan to reform the American health care system. Yet, his goal is indisputable and was featured in the program for his candidacy: assuring health insurance coverage for the 46 million Americans who are excluded from it by the present system, a system obviously unworthy of a country that purports to be developed. Moreover, at the beginning of the summer, 70 percent of Americans declared themselves to be in favor of it. In mid-August, they are but 43 percent versus 49 percent against. This collapse of popular support may be put down to an unprecedented unleashing of imprecations and abuse, orchestrated by conservative extremists and pressure groups unremitting in the defense of their own rents. On the pretext that the plan tries to introduce a bit of morality and general interest, it is accused of collectivism and an attack on individual freedoms. Untruths and outrageous allegations abound, to the point that it is useless to quote them. The regressive evolution of public opinion confirms the effectiveness of even the false propaganda.

    Yet, the issue is one of blinding clarity. The United States devotes 18 percent of its GDP to health care expenses, even as a sixth of its population is not covered, while France or Germany pay 12 percent and cover everyone. For once, American democracy is adding the prize of injustice to the red light on competitiveness. But one must reckon with the impressive parasitic architecture of vested interests and received ideas. With respect to ideas, there's the visceral distrust of any collective organization and blind devotion to individual freedom in principle. With respect to vested interests - an even more solid base - it's the profits reaped from the present system by laboratories, doctors, auxiliary health services, insurance companies; without counting the activism of "lawyers," who, by increasing juicy suits against care providers, raise the price of their insurance. This coalition, which one may well call immoral, that costs at least 6 percent of GDP (the low estimate), threatens the president himself. He cannot yield to it, since it would then destroy American society. This will be his most difficult, but most noble fight.

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        Translation: Truthout French language editor Leslie Thatcher.