Barack Obama promises to reform the health system without widening the deficit
Posted on June 18th, 2009 in Uncategorized
The U.S. president, Barack Obama, urged on Saturday 13 June, the second most important phase of its “major projects: the reform of health insurance, the most expensive of all the rich countries while leaving by the roadside for the largest proportion of its population. This ambition in the American political and industrial, is a challenge, and in conditions of deepening chasm of public deficits, of squaring the circle.
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MORE THAN 45 MILLION Americans without health coverage
Cost The United States spends the equivalent of 16% of their GDP in health costs. At this rate, health costs would reach 20% of GDP in 2020. It is 10% in Germany, 11.1% in France.
Medical Insurance It is private to 80%. Only retirees who have contributed (Medicare), disabled veterans and low income (Medicaid) are provided by the public sector. The debt accumulated Medicare exceeds 2 000 billion. In 2008, more than 45 million Americans were uninsured. Their current number is approaching 50 million (16.5% of the population).
Fifteen years ago, President Bill Clinton had his first serious defeat in trying to establish a form of universal health coverage in the United States. Mr. Obama has learned its lesson. He began by reassuring. His plan, he promised, will not the public debt. The creation of a health insurance accessible to all will cost, according to surveys, 1 000 to 1 500 billion dollars (between 710 and 1 100 billion euros). According to the President, its services reach cut 313 billion dollars on public health spending, in addition to 635 billion set aside for this purpose in the 2010 budget.
The “method” presidential remains the same: All the goals and set their budget without detailing the measures, and let the elected officials discuss ways to access them – then left to reveal a plan of action. For now, a vague so the measures will begin to be debated in the House of Representatives “in one or two weeks,” said its president, Nancy Pelosi.
As a first step, Mr. Obama had met on 10 May, hospitals, medical professionals, pharmaceutical industry, insurers and asking everyone to make an effort. Saturday, he repeated his belief: “The status quo is no longer tenable.” Without rapid decline in costs, health coverage for all will be threatened (…) Some believe that reform would cost too much, but doing nothing would cost much more in the coming years, “he continued. The President referred to the negative impact – in terms of employment and purchasing power – the rise in the price policies of private medical insurance (+ 87% over the eight years of President Bush while the family income median fell by 1%).
The fact remains that difficult decisions must be taken that the prospect is already causing controversy. Saturday, Mr. Obama has raised the possibility of trimming $ 200 billion in ten years on reimbursements to public hospitals, and 75 billion over the prices at which drugs are sold. He immediately aroused the hostility of the American Hospital Association and pharmaceutical companies. White House dare she frame, in whole or in part, the price, free in the United States?
Thursday, Green Bay (Wisconsin), the President was welcomed by Republicans opposed to reform who brandished placards: “NObama” and “No Socialism.” The same day, in a Wall Street Journal article entitled “How to stop a socialized health coverage,” Karl Rove, the former eminence grise of George Bush, warned: “If the Democrats vote the option of public health insurance , America will become a welfare state of European type. ”
Faced with such a worrisome “threat,” Mr. Obama had wanted to reassure him: “Nobody in Washington – and certainly not me – does the system of nationalized health care.” However, in the absence of a universal system of assessment, the only way to provide coverage for those who do not have is to offer a public insurance at a lower price. For Mr. Obama, this option would have the advantage of “moralizing” the private sector.
In Washington, Congress, powerful lobbies are busy. Those pharmaceutical companies seek to convince elected officials to challenge the tax in whole or in part with a fixed price of medicines. Insurers, however, want to limit the areas of intervention of a nationalized. The White House expects a bill by August and its adoption in October. It will be satisfied if it includes 80% of its objectives. Mr. Obama held, Saturday, that “four to five years” were a “realistic” to install collective health protection.
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