Why doesn't Congress use Medicare for everyone?

United States

Christian Lammert

To person

Dr. phil., born 1969; "Research Associate" at the Center for North America Research (ZENAF) at the Goethe University Frankfurt am Main and visiting professor for North American politics at the John F. Kennedy Institute at the Free University of Berlin, Lansstrasse 7-9, 14195 Berlin.
Email: [email protected]

After months of dispute, a decision on the controversial health reform is now within reach. Obama's future room for maneuver also depends to a large extent on the success of this reform.


US President Barack Obama said in a speech to both houses of Congress on September 9, 2009: "I am not the first US President to tackle the problem of health insurance reform, but I am determined to be the last. "[1] This remark not only shows the historic extent of the reform initiative in the health sector, but also the commitment and optimism with which Obama stands behind his proposal. Even during the election campaign between him and his Republican rival John McCain, reform of the health insurance system was at the top of the political priority list. And despite the massive economic crisis, the wars in Iraq and Afghanistan and the resulting desperate state of the public finances in the USA, the 44th US President started the comprehensive reform project in his first year in office, also knowing that the power to act of a president is greatest in the first year.

Although the existing system is criticized from all sides as being too expensive and inefficient, there is no consensus on the steps necessary to reform the system. The situation is exacerbated by the strong polarization of party political positions between the Democratic and Republican parties, and the congressional elections in 2010 are already casting their shadows: the Republicans currently operating as a minority party in Congress can hardly afford to give Obama and the Democratic Party a domestic political party To admit reform success of such magnitude. Republican Senator Jim DeMint is certainly speaking in the interests of his party when he says: "If we are able to stop Obama on this matter, this will be Waterloo. It will break him." [2] Furthermore, try Powerful interest groups in the pharmaceutical industry, doctors' representatives and business associations also wanted to exert their influence on the reform. Even if the overall resistance of these interest groups in the USA to a change in the health system has decreased, key elements such as the introduction of public health insurance are rejected by most of the interest groups mentioned.

In order to better classify the reform process and Obama's plans, the following first deals with the acute problems of the health insurance system in the United States. On this basis, the reform considerations of the Obama administration will then be presented in a second step in order to then take a closer look at the progress of the reform process in Congress and the discussions and debates in public.