A bill to replace the Obamacare obtained a majority of votes in the House of Representatives on Thursday. It must now be passed by the Senate.
In the United States, the idea of health as a real social right is not new. But, from all time, this idea has come more from a fantasy than from an anchored reality. In January 1944, US President Franklin Delano Roosevelt asked the Congress for the establishment of new economic and social rights. Number 6: "the right to the necessary medical care and the opportunity to be and to remain in good health". Seventy-three years later, after many reforms, Roosevelt's dream remains as controversial as it was then.
Under the Obama era, more than 20 million Americans gained health insurance. People who previously sold their homes to pay for their cancer treatment, or rationed their visits to the doctor to save $ 150, gained relative peace of mind. But in the country of liberalism and individualism, health has never gained the status of a fundamental right, such as education: health insurance is a service like the others, say the Republicans, who today try , Under the aegis of Donald Trump, to repeal entire sections of Obamacare, the emblematic but costly law signed in 2010. On Thursday, a replacement project for the Obamacare was justly voted by the Republican majority of the House of Representatives, 217 votes against 2013. It must now be passed by the Senate.
Private Health
After the war, the idea of a national health insurance defended by the successor of Roosevelt, Harry Truman, is fractured against the new geopolitical reality. "Socialized medicine," cried opponents. "At the beginning of the Cold War, everyone is terrified by Stalin, communism. The word socialism is a big word, "told Agence France-Presse Howard Markel, a medical historian at the University of Michigan. It is therefore companies that offer their employees insurance. Millions of new workers are covered by this type of arrangement, negotiated directly between employers and large trade union centers.
"In Europe, France, Germany and the United Kingdom, the system was designed by an architect," explained Agence France-Presse Melissa Thomasson, a health economist at the University of Miami, Ohio. "Conversely, our system has gradually been built," she explains, under the influence of insurance companies, the pharmaceutical industry, employers and doctors, all determined to limit the Role of the State.
The persistent weaknesses of a system
But the market does not cover everyone. So in 1965, Democratic President Lyndon Johnson snatched a compromise in Congress for the creation of Medicare, Public Health Insurance for Over 65s, and Medicaid for the Poor, primarily primarily women with children. The logic of solidarity has its limitations: health remains a privilege that must be deserved, through poverty, age or contributions. Poor bachelors are then excluded from Medicaid because they are considered to be able to work.
"Many Americans believe in individual responsibility," says Agence France-Presse Thomas William O'Rourke, professor emeritus at the University of Illinois. Former soldiers and Amerindians are two categories that have earned the right to health insurance provided by the state, he notes. Ideologically, the debate did not evolve in the following decades between the left, a partisan of a universal cover, and the right, which opposes for budgetary reasons and as a matter of principle.
In 1993, President Bill Clinton and his wife, Hillary, tried to resolve the squaring of the circle: to ensure that the system, an entanglement of public regulations and private actors, covered everyone. The reform fails, and that of Barack Obama, in 2010, only passes a hair. Not a Republican supports it. Obamacare creates tax incentives, individual obligation to insure and financial assistance for millions of people. But it does not call into question the private foundations of the system.
The Utopian Dream
"Having the choice is part of the DNA of the United States," told Agence France-Presse Howard Bauchner, editor-in-chief of the leading medical journal JAMA. But "the irony of the free enterprise system is that it does not work so well in the field of health," adds the expert. In practice, the concentration of the sector is increasing and competition is decreasing.
Incentives are not enough: more than 25 million people now live without insurance. At the same time, health spending continues to grow at a rapid pace, as governments have no control over tariffs. To fill these gaps, left-wing personalities such as Bernie Sanders put forward the idea of a national public system that is unique and European. A utopia, had let go, pragmatic, Hillary Clinton.
Source: AFP, LePoint
Source: AFP, LePoint
No comments:
Post a Comment