Obama Versus Obamacare

NEW YORK – La loi américaine sur la protection des patients et les soins de santé abordables, la réforme des soins de santé emblématique du Président Barack Obama en vigueur depuis 2010, a réussi à étendre la couverture d'assurance pour des millions d'Américains qui n’auraient pas pu se le permettre par ailleurs. Et, contrairement aux avertissements énoncés par ses détracteurs, elle n'a pas poussé à la hausse les coûts des soins de santé ; en fait, la courbe des coûts pourrait être enfin orientée à la baisse.

Cependant, il n’est pas certain que "Obamacare" réussisse à freiner les coûts de santé excessivement élevés. Cela dépendra d'autres politiques de l'administration Obama, surtout dans un domaine qui peut sembler sans rapport : les discussions en cours entre les États-Unis et l'Inde concernant la propriété intellectuelle. Et, à ce propos, Obama semble déterminé à miner sa propre réforme emblématique, en raison de la pression du puissant lobby pharmaceutique américain.

Les coûts des produits pharmaceutiques représentent une composante de plus en plus grande des dépenses de santé des États-Unis. En effet, les dépenses pour les médicaments d'ordonnance, en tant que part du PIB, ont presque triplé en 20 ans seulement. La diminution des coûts de santé nécessite donc une plus grande concurrence dans l'industrie pharmaceutique – et cela signifie permettre la fabrication et la distribution de médicaments génériques. Au lieu de cela, l'administration Obama cherche un accord commercial avec l'Inde qui affaiblirait la concurrence sur les génériques, rendant ainsi des médicaments vitaux inabordables pour des milliards de personnes – en Inde et ailleurs. Ce n’est pas la conséquence involontaire d'une politique par ailleurs bien intentionnée ; il s’agit de l'objectif explicite de la politique commerciale des États-Unis.

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