A Promised Land

Part 4, “The Good Fight,” focuses on three major battles Obama took on during his first year in office: the global financial crisis, the fight against terrorism, and the battle to provide Americans with affordable health care. One of Obama’s strengths as a writer is his ability to contextualize current events. In Chapter 14, for example, he provides background information about the BRICS to explain their stances and motivations at the G20, which focused on righting the economy. With his European suits and youthful physique, Medvedev was the poster child for post-Soviet Russia. As Obama explains, however, the real power lay in the hands of Vladimir Putin, a former KGB agent and two-term president who now served as the country’s prime minister. Obama met with Medvedev to discuss a wide range of national security issues, including nuclear nonproliferation, all the while knowing that Putin was pulling the strings. Obama is similarly insightful in his analysis of China, noting that the country’s exploding GDP and powerful military would eventually challenge the US. However, Obama concluded that China’s rise on the world stage would not occur in the immediate future, as evidenced by the attitudes of President Hu Jintao and Premier Wen Jiabao at the G20. The former “appeared content to rely on pages of prepared talking points, with no apparent agenda beyond encouraging continued consultation,” while the latter “had little to say about how to manage the financial crisis going forward” (338). Obama surmised that “the Chinese were in no hurry to seize the reins of the international world order, viewing it as a headache they didn’t need” (338).

Obama’s honest and sometimes colorful descriptions of world leaders make long passages about current events entertaining and readable. For example, he characterizes conversations with Sarkozy as “amusing and exasperating, his hands in perpetual motion, his chest thrust out like a bantam cock’s” (335). By contrast, Obama describes Brown as dour and lacking “the sparkly political gifts of his predecessor” (334). Prime minister Manmohan Singh of India makes out better than Sarkozy and Brown, with Obama calling him “wise, thoughtful, and scrupulously honest” (337). For his part, President Hu was not “a particularly strong leader, sharing authority as he did with other members of the Chinese Communist Party’s Central Committee” (338).

Obama’s contextual analysis extends beyond current events. Throughout his memoir, he sketches out the history of various issues and policies relevant to his administration. For example, in Chapter 16, he provides a detailed history of the quest for universal healthcare in the US. Universal health coverage exists in different forms in North, South, and Central America, the Caribbean, Europe, Africa, the Middle East, Asia, and Oceana. The idea that the US would devise a universal healthcare system began under Theodore Roosevelt, a Republican who ran on a progressive platform calling for the establishment of a centralized national health service. His loss in 1912 set the tone for his party’s approach to progressive politics. FDR’s wage freeze during World War II prompted companies to offer private healthcare to compete for workers. This system remained in place after the war ended. In 1945, Harry Truman proposed a national healthcare system, repeating the proposal in 1949 in his Fair Deal package. Lyndon B. Johnson’s Great Society campaign introduced Medicare for seniors, a universal single-payer program partially funded by taxes. Johnson devised a similar program for the poor—Medicaid—supported entirely by federal and state funding. Over time, unregulated drug prices and the lack of oversight sent healthcare costs soaring, and the uninsured increasingly relied on hospital emergency rooms for care, resulting in increased costs for insured patients, which in turn raised premiums. To maximize profits, insurance companies introduced high deductibles, co-pays, and lifetime limits, in addition to rejecting customers with preexisting conditions. By the time Obama took office, the US spent more on healthcare per capita than any other advanced economy, yet received similar or worse health outcomes. The statistics were sobering: 43 million Americans were uninsured and families who had insurance saw their premiums rise 97 percent in less than a decade. The historical background provides the context for the country’s current predicament, while simultaneously emphasizing the urgency of the problem. Obama’s goal was to move the country toward a single payer system. The ACA was a step in that direction.

The entwined issues of duty and legacy run through Obama’s memoir. For him, bringing affordable healthcare to all Americans was a moral imperative. Thus, he moved forward with his plan, despite serious reservations from his staff:

The prospect of trying to get a big healthcare-reform bill through Congress at the height of a historic recession made my team nervous. Even Axe—who’d experienced the challenges of getting specialized care for a daughter with severe epilepsy and had left journalism to become a political consultant in part to pay for her treatment—had his doubts (377).

Getting his team on board was the least of Obama’s problems. Congressional Republicans vehemently opposed healthcare reform, as did Big Pharma, but Obama was undeterred. Indeed, his interest in healthcare was not simply political, but also personal. Parents confided in him about the financial strain of getting their sick children treatment when he was on the campaign trail. These stories reminded Obama of Sasha’s bout of viral meningitis when she was three months old. He recalled the terror and helplessness he and Michelle felt when nurses took Sasha to get a spinal tap. He was also acutely aware of how lucky they were to have health insurance and a regular pediatrician they felt comfortable calling in the middle of the night. Fueled by heartbreaking stories of Americans not being able to afford healthcare, Obama pushed to pass the ACA.

Obama’s sense of duty also informed his approach to foreign policy. He wanted US military operations to be as effective as possible. To this end, he sought to improve intelligence gathering and sharing, strengthen the country’s diplomatic ties, and, importantly, make the world a safer place. Obama announced his priorities in his Cairo speech, emphasizing democracy, human rights, women’s rights, religious tolerance, and the need for lasting please between Israel and Palestine. Thoughts about his legacy set in shortly after he delivered the speech, during a visit to the ancient Egyptian pyramids. His body man, Reggie Love, pointed out a carving inside the corridor of one of the Pyramid’s lesser temples. It depicted a man’s face, in frontal view, with protruding ears like Obama’s:

I tried to imagine the worries and strivings that might have consumed him and the nature of the world he’d occupied, likely full of its own struggles and palace intrigues, conquests and catastrophes, events that probably at the time felt no less pressing than those I’d face as soon as I got back to Washington. All of it was forgotten now, none of it mattered, the pharaoh, the slave, and the vandal all long turned to dust. Just as every speech I’d delivered, every law I passed and decision I made, would soon be forgotten. Just as I and all those I loved would someday turn to dust (367).

A visit to the Buchenwald concentration camp reminded Obama to stay the course—to keep trying to better the world—even in the face of obstacles. He recalls pausing before a set of stone slabs carved with the names of Buchenwald victims, including Wiesel’s father. Wiesel described the strategies prisoners used to survive, including sharing food with the weak and dying, and holding meetings in latrines so foul the guards never entered them. At the end of the visit, Wiesel urged Obama and Merkel to promote world peace: “He beseeched us, beseeched me, to leave Buchenwald with resolve, to try to bring about peace, to use the memory of what had happened on the ground where we stood to see past anger and divisions and find strength in solidarity” (369).