Published 23 September 2008, doi:10.1136/bmj.a1563
Cite this as: BMJ 2008;337:a1563

Feature

US health care

America’s health choices

¹ US Department for Health and Human Services, Washington DC, USA

Feature, doi:10.1136/bmj.a1672

Getting American voters to back much needed healthcare reforms will be a challenge for both contenders for the White House. Vidhya Alakeson explains the difficulties

The first 150 words of the full text of this article appear below.

US presidential candidate Barack Obama was not even born when national health insurance was first proposed under the Truman presidency in the 1940s. Twenty years later, Congress voted in Medicare, a publicly funded, national insurance programme for everyone over 65. At the time, Medicare seemed to be the first step towards universal coverage. But further steps were never taken. Failed health reforms in the 1970s and 1990s have left the United States as the only developed country not to provide all its citizens with access to health care.

America’s inability to fix something that all other developed nations take for granted may seem baffling. But two facts begin to explain the puzzle: 94% of Americans who vote have health insurance,¹ and nearly three quarters of people who have insurance think that what they have is either good or excellent.² While most voters agree that everyone has a right to high . . . [Full text of this article]

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