In the United States in the early 1990s, both public opinion and political actors agreed that healthcare system did not work properly anymore. The American system is based on employment, i.e. those who work can benefit from a healthcare insurance, but unemployed people and half-time workers cannot afford it. With the depression of the 1980s, this system excluded many American citizens from health care. In the early 1990s, more than 40 million of American citizens had no health coverage . It is also one of the most expensive systems in the world; in 1992, $ 838,5 billion were spent in health care in the country . During the presidential electoral campaign of 1992, this question emerged as the electors' biggest concern. Candidate Clinton made the issue of healthcare reform the main point of his program. He promised "to end welfare as we know it." When he came to power, one of his first decisions was to set up a task force to work on the health care reform.
[...] It also prevented the United States from a health care reform for a long time. Today, the system had not changed, and great inequalities still exist. The United States are the most powerful country in the world, but their healthcare system is the least efficient and most unfair among the developed countries. This lack of social justice weakens the cohesion of the American society. BIBLIOGRAPHY Starr, Paul “What happened to health care reform?” The American Prospect no (Winter 1995): 20-31. [...]
[...] The health care reform was to epitomize the liberalism”, as says J. Micklethwait. Its advantages were to reduce the rising cost of healthcare, to make it easier to switch jobs and to solve the injustices in society. But the reality of the plan was “Hillary a very complex report of 1367 pages which combined private financing, managed care, competition, universal coverage and cost containment. The task force proposed to maintain a work based insurance. All employers would have had to provide insurance for their employees. [...]
[...] The fact that companies had to provide insurance for their employees through a system government based system was described as a soviet style health care, without any freedom of choice. According to Paul Starr, they focused on what people who were already covered could lose, and not on what people who had no health coverage could win. Some decided to campaign on the fact that the health care system did not need any reform, because it was not in crisis. [...]
[...] He first promoted a “managed-budget” and the competition in the health care industry which made him lose the support of the more liberal Democrats. Then in 1993, he decided that health care should pay back a large numbers of medical interventions, in which abortion, which was against the ideas of the conservative Democrats. In his article, Paul Starr explains how President Clinton strategy failed: don't go to a negotiation with your final offer on the table.” This is what Starr calls the “onion's strategy”. [...]
[...] www.upenn.edu/pnc/ptbok.html Seedhouse, David Reforming health care; The philosophy and practice of international health reform. Chichester, Wiley. Ham, Chris Health care reform; Learning from the international experience. Buckingham, Open University Press. Micklethwait, John The right nation; Why America is different. New-York, The Penguin Group. Micklethwait, J The Right Nation ; Why America is different . New-York, The Penguin group. Hacker, C “Health reform in the United States” , in Reforming healthcare; The philosophy and practice of international health reform. Chichester, Wiley. [...]
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