Barack Obama's administration had as its greatest challenge facing the effects of the global economic crisis. Voters who supported Obama created high expectations regarding the political practices of the Democratic president, whose party has a history of promoting interventionist policies in the economy and assistance in the form of projects social. This character of the Democratic Party was drawn during the economic crisis of 1929. During the Great Depression, it was released in 1933 by Franklin Theodore Roosevelt, the New Deal, a set of policies applied to mitigate the economic and social effects of the crisis, inaugurating a modality that was present in all subsequent democratic governments: the strengthening of the role of the State.
At the time known as Keynesianism, the ideology of state regulation began to be seen with disrepute during the 1970s, when neoliberalism, a doctrine favorable to the deregulation of markets, reached notoriety. In the 21st century and at the height of the neoliberal doctrine, Obama returned to some interventionist practices, necessary, in a way, to provoke a reinterpretation of the role of the State in the face of a serious crisis. economic. In this case, health reform was the mainstay of social policies that the current US government tried to establish.
The US health care system is the result of policies implemented in 1965 by Democratic President Lyndon B. Johnson, who took over after the death of John F. Kennedy. In fact, it was Kennedy who tried to change the legislation to promote a medical safety plan for the elderly, but his initiative was unsuccessful with Congress. Johnson managed to approve these changes, creating the Medicare - exclusive health program for seniors over 65 - and the Medicaid - provision of exclusive medical care for the low-income population.
In 1993, another Democrat, Bill Clinton, presented a broad proposal to update the laws in question, with greater state control that would reduce the freedom of action of private companies. His ideas faced opposition and lobbying from insurance companies, were not well regarded by Republicans and divided opinions among Democrats, resulting in one of the government's biggest political defeats. Clinton. Oblivious to the controversies, Obama resumed the debate early in his term with a bold proposal: the mandatory coverage of a health plan for the entire population present in the US until the year 2014.
In summary, the proposal called Affordable Care Act and nicknamed Obamacare by the press defines that:
- Every US citizen must have private health coverage, under penalty of fine, even in symbolic amounts;
- Those who do not have enough income to pay for services can receive government subsidies;
- Young people up to 26 years old have the right to remain dependent on their parents' health plan;
- Health plans must offer assistance with certain preventive exams, such as mammography, free of charge;
- Greater scope and quality of services offered by Medicaid;
- Companies cannot deny their services to people who have pre-existing illnesses.
The economic crisis produced a greater number of unemployed and, consequently, people without the assistance of a health plan. Another component related to the crisis was the lack of encouragement from the business community and employers, who simply eliminated the benefit of their employees to reduce their expenses. As a result, nearly 50 million people do not have this type of coverage in the United States.
By winning Senate approval in 2010, Obama won an important victory for the Democrats and for their ideology of strengthening the state's role as a provider of social projects. What represented a counterpoint to this achievement was the reaction of the republicans, who began to impose difficulties for the approval of other projects of interest to Democrats, such as the increase in the country's foreign debt ceiling, voted in 2011. Despite the consensus that the US government needed a permit to increase the borrowing limit to remedy public spending, Republicans recommended cuts exactly in the Medicare to reduce public spending, while Obama proposed raising taxes on the wealth of the country's citizens. If the measure was not implemented, it could make the United States declare a moratorium on the its main creditors, which would further undermine confidence in the economic stability of the parents.
Several states claimed that health care reform was unconstitutional, but in a landmark decision in 2012, the The Supreme Court ruled the constitutionality of the new rules a few months before the elections presidential elections. Republican candidate Mitt Romney even said he would undo the proposed changes, and about 60% of the population did not agree with the Obamacare, according to research carried out during the electoral race. Controversy aside, the polls were favorable to Obama. As for the success of the health system reform, it will take more time to make this kind of assessment. Or maybe wait for the next 4 years of Barack Obama's term...
*Image credits: Spirit of America and Shutterstock.com
Julio César Lázaro da Silva
Brazil School Collaborator
Graduated in Geography from Universidade Estadual Paulista - UNESP
Master in Human Geography from Universidade Estadual Paulista - UNESP
Source: Brazil School - https://brasilescola.uol.com.br/geografia/reforma-sistema-saude-nos-estados-unidos.htm