The reform of American health care system

Summary The US health care system is not well known to the French. It is organized around private insurance linked to employment and public insurance reserved for specific groups (retirees, military personnel, low income people). It espouses the benefits of the free marketand uses competition as a regulator. These factors create a system with its own logic very different from the European social protection. A comprehensive analysis of the system reveals its strengths and its shortcomings and explains why reforming it became an objective of the newly elected US President in 2008. The US Constitution does not give the president all powers: B. Obama took a year to pass a bill that is not as ambitious as he had desired but will still address a significant portion of the current system's defects when it is actually implemented. The Republican opposition made this reform, which divides Americans, a decisive argument in the battle for midterm elections, which they won. President Obama has to defend a bill that is passed by Congress, but dependent for its implementation on a collaboration between Washington and individual states under the supervision of the Supreme Court. This reform is a compromise: only the reelection of B. Obama in 2012 will anchor definitively the Patient Protection and Affordable Care Act (PPACA) of March 23, 2010 as the new reality for the American healthcare system. Prat Organ Soins. 2011;42(4):265-75