A Study On The Predicament Of Social Welfare System Under The Reform Of American Medical Insurance:2009-2018

In 1912,the concept of universal health insurance appeared in the United States for the first time.However,after more than a century,the United States has become the only developed capitalist country that does not realize universal health insurance,which shows that the American welfare system is in deep trouble.This paper compares the similarities and differences between Obama administration and trump administration in the reform of medical insurance,discusses the reasons behind them,and then analyzes the welfare system of capitalist society.The purpose of this paper is to demonstrate that the American welfare system is in deep trouble and to reveal that the adjustment of capitalist welfare system cannot fundamentally solve the problems of value conflict,interest game,etc.After Obama came into power in 2009,he was eager to fulfill his commitment during the general election,to promote the reform of medical insurance system.After many revision and improvement,he finally launched the Affordable Health Care Act in 2010,aiming to improve the coverage rate,reduce medical costs and improve medical quality,most domestic scholars think that Obama's health care reform has a positive effect.However,Trump immediately stopped the reform of Obama's medical insurance system when he became the president of the state,which made Obama's health care reform not fully implemented.There are few reasons that the universal healthcare has been abandoned again.Firstly,the ruling party and the people they represent hold different ideas;secondly,the internal drive of interest groups in the capitalist society;the last but not least,it's the result as the stratification of residents under the capitalist system.From the perspective of medical insurance reform,all previous governments are only trying to ease the contradiction rather than solve it.At present,they can only mend it on the original basis,and can t make a thorough change in a short time.The repeated twists and turns of the reform of American medical insurance make us see that the American welfare system is in a dilemma,which is reflected in the high cost of welfare,the unsustainable welfare policy,the insufficient coverage of the welfare system and the negative effects caused by social welfare.However,this dilemma has been maintained in the United States for more than half a century.The apparent causes of this phenomenon lie in the insufficiency of effective demand and personal demand,the excessive pursuit of profits by medical insurance capital,and the aggravation of government fiscal deficit,while the underlying causes lie in the inherent contradictions of capitalism.It can be seen that under the value conflict and interest game in American society,it is very difficult to get out of the dilemma of welfare system.This is a drawback brought about by the capitalist system.The advantage of the construction of socialist welfare system in China is that under the premise of public ownership of means of production,it can avoid the impact of capital profit seeking behavior brought by private ownership of means of production in capitalist society,and it can be more fair and efficient in the construction of socialist welfare system.From the perspective of medical insurance,in the structure of welfare system,the difference between China and the United States lies in the government led and market led.Drawing on the advantages of the market-oriented medical insurance in the United States,we can give a hint for the further reform of medical insurance in China:while the government leads the basic medical insurance,we may as well develop some private capital to carry out additional medical insurance,for example,for the individual Insurance for special diseases or for special groups of people.In this way,we can partly transfer the pressure of medical insurance on the government s finance,at the same time,we can also promote the operation of private capital,promote economic development;in terms of the selectivity of welfare demand,we can learn from the free choice mode of the United States,mobilize the flexibility of China' s welfare security,in terms of medical insurance,we can further promote the hierarchical diagnosis and treatment system to avoid the medical resources in the Bureau The phenomenon of oversaturation and waste of resources.