“Give me your tired, your poor, your huddled masses yearning to breathe free” reads the Statue of Liberty, an ever-present reminder of the spirit with which America was founded. Now the richest country on earth, and the most ardent advocate of human rights internationally, it seems remarkable that nearly fifty million of its three hundred million citizens have no access to basic healthcare.

A recent study at Harvard University showed that roughly 45,000 people per year die in America simply because they lack health insurance (higher than the total number of deaths from homicide and drink driving combined). As Wade Henderson, CEO of the Leadership Conference on Civil Rights, argues, “disparities in access to quality care and the resulting prevalence of illness are woven through the entire health system and throughout the American landscape.” It is with this in mind that President Obama announced to congress recently that “the time for bickering is over.”

There is general agreement amongst both parties that they need to close the loopholes within the current system which enable pharmaceutical companies to earn as much as $2 billion per year. One such loophole prevents patients from receiving treatments for recurring injuries, meaning that if a woman were the victim of repeated domestic violence, she would only qualify for treatment after the first instance. Other than stark examples such as this, however, there has been little bipartisan cooperation on the issue. Every time one hurdle is overcome, another seems to appear, leaving many wondering if we will ever see the finish line.

To be sure, this is no small problem to tackle. Politicians, voters, civil rights groups and the immensely powerful pharmaceutical lobby will all try to swing the balance in their favour and, in doing so, may once again stymie reform. Nevertheless, with the right leadership and a willingness to compromise, genuine healthcare reform might just be on the cards if moderates from both sides are willing to heed President Obama’s calls.

In the latest round of U.S healthcare debates, Congresswoman Virginia Foxx of North Carolina announced that, “we have more to fear from the potential of this bill passing than we do from any terrorist right now in any country.” (No prizes for guessing her party affiliation.) This comment has been seen by many as an act of desperation from a Republican party which cannot afford to lose such an important political battle. It would be naïve, however, to ignore the power that such comments carry within sections of an American public that views the concept of universal healthcare with suspicion. The politics of fear have been invoked before and the consequences are still visible to this day in Iraq and Afghanistan.

The latest problem in the House of Representatives is over the issue of whether abortion will be funded on a government-run healthcare program. A recent letter signed by 183 members of Congress argued that “real healthcare is about saving and nurturing life, not about taking life.” For its part, the Democratic leadership is attempting to maintain the pro-choice status quo. Compromise will be needed if the bill is to pass but the question for speaker Pelosi is how to achieve this without alienating the liberal base of her party.

The Senate’s disagreements centre on the so-called ‘public plan’, whereby anyone not covered by their employers would have the option of subscribing to a cheaper government plan, thus making it affordable to those who need it. Most Democrats, in particular President Obama, have argued that such a plan must be in the bill if they are to support it. Republicans, and more than a few Democrats, argue that this ‘socialist’ idea is a precursor to a poorly-run government healthcare system which will make all Americans worse-off: yet another example of the pervasiveness of the politics of fear within the current climate.

In the face of a revolt from the more conservative members of his party, Senate Leader Harry Reid has touted the idea of allowing states to opt out of the ‘public plan’, thus giving flexibility to the system. Whilst this is a nice attempt at compromise, as yet nobody knows how such a system would work and even if it is possible for it work.

Nevertheless, with public opinion shifting against the idea of universal healthcare such solutions may represent the lesser of two evils. The longer the debates drag on, the bigger the partisan divides will become and the greater the chance of failure. Compromises are always difficult to make but if they are not made soon, healthcare reform may have to wait for yet another generation.

In 1943, Congressman John Dingell Sr. attempted to pass a comprehensive healthcare plan for the first time. Since then, numerous politicians have taken forward his vision and never has America been closer to realising his dream. Now, more than ever, America needs its leaders to lead.