At a time when unemployment is rising to 6

This seems a priori contradictory, but specialists of the system of health in the United States believe that the financial crisis and recession will lead to a reform. "It is one-third of State spending and crisis requires to change", argued Chris Jennings, former advisor to the health of Bill Clinton, at a conference held in Nashville on health in the second presidential debate.

With more than 40 million Americans who are not insured, the terrible stories of missing care abound. Health care costs have become absolutely prohibitive, the system is terribly unequal, and State funds finally very inefficiently 46 of care in the United States. They represented 2,600 billion in 2006. "This is 17 of the gross domestic product when other countries have a better system for only 11 of GDP", is John Podesta, President of the Center for American Progress.

Explosive invoices

Today, most Americans get their employer health insurance. They are 100 million in this case and are listed in a "health maintenance organization" (HMO) which impose a rigid framework where physicians and sometimes even the types of treatment are imposed. Companies do not pay tax on these health benefits that they fund, which has encouraged to do so. But the constant increase in the cost (they accounted for approximately 8 of the annual salary of an employee in 2007) eventually grow them they also on the path of reform. Until these last month, where some employers, in the throat, now threaten to cut the benefits they offer in terms of health against a continued employment.

At a time when unemployment is rising, to 6.1, and party to 8.5, according to IHS Global Insight, this means that more and more people will lose their health coverage. The other, those who are employed by small businesses who do not have the means to finance insurance to their employees, must obtain insurance at their own expense, even though they have high deductibles and the causes of multiple exclusions. Having insurance is never a guarantee be properly treated in the United States. This is not a firewall against the explosive bills.

Young people and persons of low resources tend to make more than the economics of insurance. It represents, on average 12,000 per year for a family with two children. Persons over age 65 are on the other hand access to Medicare, a public program, while the poor may request the use of Medicaid, but under very strict conditions of income.

The consensus on the need for reform seems to be built, but each questioned the ability of the State to fund necessarily costly measures. To Charles Kahn, President of the Federation of American hospitals, it will be because "the program of insurance of children must be réautorisé soon, that the public demand reform and require the crisis as the deficit that we act on the budget of the health".

At least two senators have in their drawers of the proposals of Act well to reform the health care system, which already rallied the support of Republicans and Democrats. They are ready to offer them as a basis for work to the next administration. "This will be leadership in the future President to present this issue to the Congress." "But if we don't act, this will be very costly for the economy," said Charles Kahn. "If Barack Obama is elected, believes his side John Podesta, it will try to implement parts of reform as early as 2009, but should not expect something major before the election of the next House in 2010 and a new democratic victory."