El impacto global del debate sobre el sistema de salud de Estados Unidos

CAMBRIDGE – Desde que asumió la presidencia a comienzos de este año, el principal interés legislativo de Barack Obama ha estado centrado en reformar el financiamiento del sistema de salud norteamericano. Sin embargo, sus propuestas se topan con una fuerte oposición de los demócratas fiscalmente conservadores así como de los republicanos, debido a su potencial impacto en futuros déficits fiscales. Como esos déficits son la causa principal del déficit de cuenta corriente de Estados Unidos -y, por ende, de los desequilibrios globales-, el resultado del debate sobre el sistema de salud afectará a gobiernos e inversores de todo el mundo.

Aproximadamente el 85% de los norteamericanos hoy están cubiertos por alguna forma de seguro de salud. Todos los individuos de más de 65 años tienen derecho a estar asegurados por el gobierno federal a través del programa Medicare. Las familias de bajos ingresos (y aquellas cuyos ingresos y activos se han visto afectados por los altos costos médicos) están cubiertas por el programa Medicaid, que está financiado conjuntamente por los estados y el gobierno federal. Muchos no asegurados obtienen atención gratuita en guardias de emergencia de hospitales públicos y privados y reciben atención gratuita para enfermedades crónicas en esas mismas instituciones.

En el presupuesto más reciente, está proyectado que los desembolsos del gobierno federal destinados a Medicare en 2010 superen los 500.000 millones de dólares, mientras que Medicaid le costará a los contribuyentes más de 250.000 millones de dólares. El seguro de salud privado normalmente es proporcionado por los empleadores, lo cual se incentiva ya que los pagos del empleador para el seguro médico son considerados como un gasto comercial deducible de impuestos, sin incluir el valor de ese seguro como ingreso tributable para los empleados. Ese régimen reduce los impuestos a las ganancias y sobre la renta de las personas físicas en más de 200.000 millones de dólares.

To continue reading, please log in or enter your email address.

Registration is quick and easy and requires only your email address. If you already have an account with us, please log in. Or subscribe now for unlimited access.

required

Log in

http://prosyn.org/eWxhqdy/es;
  1. Television sets showing a news report on Xi Jinping's speech Anthony Wallace/Getty Images

    Empowering China’s New Miracle Workers

    China’s success in the next five years will depend largely on how well the government manages the tensions underlying its complex agenda. In particular, China’s leaders will need to balance a muscular Communist Party, setting standards and protecting the public interest, with an empowered market, driving the economy into the future.

  2. United States Supreme Court Hisham Ibrahim/Getty Images

    The Sovereignty that Really Matters

    The preference of some countries to isolate themselves within their borders is anachronistic and self-defeating, but it would be a serious mistake for others, fearing contagion, to respond by imposing strict isolation. Even in states that have succumbed to reductionist discourses, much of the population has not.

  3.  The price of Euro and US dollars Daniel Leal Olivas/Getty Images

    Resurrecting Creditor Adjustment

    When the Bretton Woods Agreement was hashed out in 1944, it was agreed that countries with current-account deficits should be able to limit temporarily purchases of goods from countries running surpluses. In the ensuing 73 years, the so-called "scarce-currency clause" has been largely forgotten; but it may be time to bring it back.

  4. Leaders of the Russian Revolution in Red Square Keystone France/Getty Images

    Trump’s Republican Collaborators

    Republican leaders have a choice: they can either continue to collaborate with President Donald Trump, thereby courting disaster, or they can renounce him, finally putting their country’s democracy ahead of loyalty to their party tribe. They are hardly the first politicians to face such a decision.

  5. Angela Merkel, Theresa May and Emmanuel Macron John Thys/Getty Images

    How Money Could Unblock the Brexit Talks

    With talks on the UK's withdrawal from the EU stalled, negotiators should shift to the temporary “transition” Prime Minister Theresa May officially requested last month. Above all, the negotiators should focus immediately on the British budget contributions that will be required to make an orderly transition possible.

  6. Ksenia Sobchak Mladlen Antonov/Getty Images

    Is Vladimir Putin Losing His Grip?

    In recent decades, as President Vladimir Putin has entrenched his authority, Russia has seemed to be moving backward socially and economically. But while the Kremlin knows that it must reverse this trajectory, genuine reform would be incompatible with the kleptocratic character of Putin’s regime.

  7. Right-wing parties hold conference Thomas Lohnes/Getty Images

    Rage Against the Elites

    • With the advantage of hindsight, four recent books bring to bear diverse perspectives on the West’s current populist moment. 
    • Taken together, they help us to understand what that moment is and how it arrived, while reminding us that history is contingent, not inevitable


    Global Bookmark

    Distinguished thinkers review the world’s most important new books on politics, economics, and international affairs.

  8. Treasury Secretary Steven Mnuchin Bill Clark/Getty Images

    Don’t Bank on Bankruptcy for Banks

    As a part of their efforts to roll back the 2010 Dodd-Frank Act, congressional Republicans have approved a measure that would have courts, rather than regulators, oversee megabank bankruptcies. It is now up to the Trump administration to decide if it wants to set the stage for a repeat of the Lehman Brothers collapse in 2008.