Healthcare in the USA: America's headache

Résumé du document

America is the only rich country that does not guarantee universal health coverage. Instead, there is an interlocking mosaic of programs, some federal, some offered by the states, and some provided by private insurance companies. This system is more or less successful, though highly complex, and it leaves citizens without sufficient coverage. Mickael Moore's latest film, entitled Sicko, underlines the gravity of the situation in the USA, as people cannot afford their own private insurance and enter a vicious circle when they get ill. For example, they have to choose between two operations they require, and have to face debts, while in Guantanamo, America's worst enemies are better cured. How does social protection in the US work? Most social programs provided today date back either to the tenure of Franklin Roosevelt in the 1930's or to Johnson in the 1960's. Both these Democratic presidents had declared war on poverty by setting up a sort of safety net for the poor and the needy.

Extraits

[...] This "permanent underclass" is considered as an insult to the American work ethos. The solution found then was to cut back federal intervention, transfer some welfare costs to the states, encourage private initiative and try to get people back to work. The reason for diminishing welfare expenditures is not only ideological but also financial since the US has a huge budget deficit. However, social security bas remained untouched by these cuts, which means that the pressure created by powerful lobbies is strong. [...]

[...] At the federal level, the Department of Health and Human Services deals with health matters. As far as social security is concerned the initial Social Security Act was signed in 1935 and consists of 4 insurance programs: retirement pensions, disability insurance, unemployment insurance and Medicare. ln general, individuals are eligible for Medicare if they are a U.S. citizen or have been a permanent legal resident for 5 continuous years, and if they are 65 years or older. Social security programs are “entitlements” to which all Americans are entitled for life. [...]

[...] He wants bipartisan agreement on long-term health care reform before the costs become unsustainable. CLINTON She advocates universal healthcare coverage through compulsory health insurance subsidised for poor people. As First Lady, she oversaw an unsuccessful project to give full cover to all Americans. OBAMA He wants a universal coverage but he will start by requiring all children to have insurance, underwritten by subsidy. Insurers would be unable to refuse coverage because of pre-existing conditions. [...]

[...] But everyone knows that these products would also have meant an indirect tax on poor people. This attempt foundered and a welfare reform was instead adopted in 1996. Conclusion To put it in a nutshell, health care reform currently is a very important political issue that will have a great impact on the primaries, and also, on the presidential race. ln Sicko, Moore is astonished by the level of subsidy granted by the French government to its citizens. THE CANDIDATES'POSITIONS ON THE ISSUE MC CAIN He has highlighted his record on supporting health care for military veterans. [...]

[...] Medicare spending is expected to grow by about 7 percent per year for the next 10 years. As a result, the financing of the program is out of actuarial balance, presenting serious challenges in both the short-term and long-term. Besides, American medicine is expensive because of sophisticated technologies but above all, because of the cost of exorbitant insurance premiums that doctors must pay to be covered against malpractice suits. The American appetite for trials is casting even more and more money and causing more and more problems. [...]