The reform of the US Health System
18 - March - 2010 | 0Issue 19/ February- March 2010
By Franco D. Bonaro
Without highlighting the technical details that are common knowledge, I would like to focus on the ideological debate that the much discussed plans for the new Health Act proposed by the Obama administration.
Is the US society prepared for a change of this scale?
The answer is not clear cut as yet, however, it is apparent that a large part of the contributors do not favour the politics of inclusiveness that the democratic government wants to implement. The US economy albeit one of the largest in the world fails to meet the basic health needs of its inhabitants.
The model of a Welfare State, following Sping Andersen, adopted by the USA characteristically focuses its social politics on those sectors of the population that show a need (1).Within this scheme of a liberal state, social help is only aimed at the “losers” of the system, generating a negative effect of stigmatization of the poor. These people receive health coverage through a system of medical assistance called Medicaid. Whereas, senior citizens of 65 years and older receive medical care through Medicare.
The better off sector of society accesses the health system through private healthcare, at excessive rates due to the perversity of the system that generates an exaggerated demand for training and performance.
However, 47 million people do not have any cover at all, as they are not “sufficiently” poor to qualify for state help, but are not rich enough to be able to afford private health care. That is where the Obama initiative comes in; guaranteeing universal access to the health care system for each and every US citizen.
Faced with this initiative, numerous sectors of the US society do not agree with the fact that part of their taxes will be used to subsidise those who cannot afford their health care.
The fact that a political - economic superpower such as the USA operates a social care system that excludes so many of its inhabitants. The expressions of the society reflect a crude individualism and disrespect for those marginalised by the system.
Undoubtedly, the neoliberal paradigm is more alive than ever and the private health care sector is putting pressure on the US congress in an attempt to prevent a reform of the system. The health care reform would not only curtail a fabulous business, but it would also improve the quality of life of millions of people.
The intervention of the state in the economy does not meet the approval of certain pressure groups and these respond when their interests are at stake.
Curiously, the very same pressure groups that oppose the reform, do not object to the lavish deficit the state spends on its military-industrial complex.
Opponents of the reform claim the reform is an attempt to “socialise” the system and call the initiative “communist” in an attempt to disqualify an initiative that would offer medical coverage to over 15 % of the country’s population.
In the congress, the bill would not just meet the opposition of the republican sector, but also of a part of the democratic sector that does not support the government initiative. This is partly due to the fact that the senators and representatives are not disciplined within their parties which at times acts in favour of democracy and at other times hampers government initiatives.
This leads to another question; how would the president’s image be affected if the bill is rejected?
This initiative formed one of the pillars of Barack Obama’s programme on becoming president and if this reform bill is not passed this year, his political figure will be seriously weakened considering that next year his mandate reaches its midterm.
Also, if the bill is rejected, this would constitute a political defeat that could very well be the beginning of the end, as it would be the end of the hope thousands of Americans who voted for a change within the system that would minimize the scandalous inequality that nowadays exists in US society.
Will the Obama administration have sufficient “actual power” to carry out such reforms?
Franco D. Bonaro
International Affairs and Political Science
Catholic University of La Plata, Buenos Aires - Argentina
References
(1) Gosta Sping-Andersen “The Three Worlds of Welfare Capitalism”, 1990
(2) Organización Panamericana de la Salud new.paho.org/hq/
(3) www.barackobama.com
The views and opinions of contributors expressed herein do not necessarily state or reflect those of Global Affairs
