As I watched US President Barack Obama's nationally televised discussion of healthcare with his political opposition, it occurred to me there was a particularly well informed source missing at the table - Malta.

Malta would have had a good deal to add to the inquiry into social justice that Obama's health reform efforts represent. If Malta, with virtually no natural resource other than 'love of neighbour' can provide universal healthcare, is it really true that the abundantly endowed United States cannot approximate that ideal with a reasoned insurance reform that merely enacts into law what should have been felt and pursued as a matter of personal ethics?

Malta would help the President stay true to his inaugural promise to work with all those "who come with outstretched hand rather than clenched fist".

Obama's patience and outstretched hand was well on display at Blair House as he sat down with his opposition at the legislative drafting table, under the microscope of national television, to try to extend healthcare to some additional 30 million Americans who lack health insurance.

His thoughtful ability to keep directing the conversation away from fruitless recrimination towards constructive proposal illustrated the wisdom of the people's choice in 2008.

It was an afternoon well spent because it reminded our impatient body politic of the real work that is needed to deliver on the inspirational campaign rhetoric of the 'change we need'. Indeed, the event puts this question to all US citizens: did we really believe it when we proclaimed "Yes we can!" or were we indulging in a nationally embarrassing exercise of unjustified hubris?

Obama stood on no prerogative of office or protocol when he sat down at the discussion table with those whose public persona and competing responsibilities were of a far lesser magnitude.

If there was a positive contribution from left, right or centre to be heard, it mattered not whether one was a congressional backbencher or a staff aide.

Seeing the chief executive at work was a tonic for the nay-saying, too often mean-spirited opposition and our own self-doubt.

Which returns me to the example of Malta.

Obama might well want to invite the Prime Minister and the leader of the opposition over for a visit. Malta's commitment to the provision of healthcare for all its citizens is unshakeable, even as the means of that commitment are subject to constant and useful re-examination. There can be honest differences of view over how best to allocate care, or whose medical judgment is best obtained to chart a patient's course of treatment, without disserving the fundamental principle. Indeed, the current debates over these matters in Malta might usefully guide the American reform prognosis.

Obama is a problem solver. To him, the perfect is not to be made the enemy of the good.

In giving me my charge for my work here at the US Embassy in Malta, special mention was made of the President's interest in promoting mutual respect through a mutual understanding of the different faith traditions of the world.

As the communitarian scholar Amitai Etzioni has commented: Obama understands from his own inter-faith study that "there is no clash of civilisations but a clash within each civilisation; namely, between the moderate people who reject violence and those who legitimise it.

In Christianity, it is the division between those who see Christ as a prince of peace and those who see him as the sword; in Judaism, between rabbis who interpret 'an eye for an eye' as a call for compensation and the Jews who interpret the text as a call for revenge."

During Lent, as we prayerfully await the visit of the Holy Father to this largely Catholic place, it is fascinating for this visitor to contemplate how much Malta adds to the world's better understanding of itself.

Whether it be respect for life from the earliest point to natural death through the responsible provision of healthcare for all, or the insights drawn from neutrality, Malta's way reminds us that what matters in international relations is a commitment to peace, and not a utopian pursuit of perfect harmony in matters of political governance or an identity of belief in how we know or appreciate the transcendent.

Yes, Mr President, invite Malta's leaders for a chat. Better still, next time you're in the neighbourhood, stop by.

Prof. Kmiec will be at the Mater Dei Hospital Medical School on Tuesday to discuss President Obama's recent public discussion on healthcare and the future of his healthcare initiative. For further information, contact the American Embassy at

Prof. Kmiec is US Ambassador to Malta.

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