Study On The Evolution Of American Medical Insurance System From The Perspective Of New Political Economics

In order to achieve economic development and increase national wealth,one country must have sufficient and healthy labor resources.Many countries have established medical insurance systems that are suitable for their respective political and economic development characteristics to protect and strengthen the value of human capital.America is the only developed country that has not achieved universal health insurance.The characteristics of its medical insurance system are quite different from those of other developed countries.First of all,compared with other developed countries,the involvement of the U.S.government in the health insurance system is very limited.The development and evolution of American medical insurance system mainly depends on the private medical insurance sector.Although the government has invested a lot of money in the field of medical insurance,it has made a very low level of government intervention.At present,the medical insurance system in the United States is dominated by private medical insurance projects and supplemented by government public medical insurance projects.The vast majority of Americans still have group health insurance provided by employers,which is private health insurance.The government only provides public health insurance programs for vulnerable groups such as the elderly,the disabled and children,and only accounts for a small part of the total.Second,unlike other developed countries,the United States does not have universal health insurance,and one sixth of the population does not have health insurance,although after the Obama health reform in 2010,the ratio has fallen by half.As the most developed country in the world,the United States has economic strength to establish universal health insurance,but become a different kind of western developed countries.It is the only western developed country without universal health insurance.What is the reason? In short,the evolution of the American medical insurance system is not only an economic issue,but also highly related to the political system of the United States.In the final analysis,the evolution of the American medical insurance system is determined by the political and economic characteristics of the United States.Since the 1960s,the research methods of new political economics have emerged.New political economics uses the normative analysis of economics,the strategic behavior of rational individuals in pursuit of maximizing their interests under constraints,to explain the origin and maintenance of political process and the formulation and implementation of public policies.From the perspective of new political economics,this paper analyses the driving force behind the formation and evolution of the American medical insurance system.Studying the evolution of American medical insurance system from the perspective of new political economics is of great value in explaining why the United States has not established universal medical insurance,why all presidents of the United States attach great importance to the reform of American health care.At the same time,China has also entered the stage of medical insurance reform.To study and analyze the American medical insurance system has important reference value for how to construct China's medical insurance system.This paper study the evolution process of American medical insurance system with the method of historical evolution,and divides it into two stages: the historical review of the evolution of American medical insurance system before Trump and the new trend of the evolution of American medical insurance system under Trump,the historical review of the evolution of American medical insurance system before Trump can be divided into four stages: the establishment of employer-based private group medical insurance system before 1965,the government's involvement in the field of medical insurance in 1965,mainly the adoption of Medicare and Medicaid,the Federal Public Medical Insurance Project,and Clinton's reform of national medical insurance.President Obama's National Health Insurance Reform.At this stage,the evolution of the U.S.government from never intervening to gradually strengthening its involvement in the field of medical insurance is presented,with the result that the coverage of medical insurance in the United States is gradually increasing and evolving towards universal health insurance.At the New Stage of Evolution of American Medical Insurance System under Trump,this paper introduces the background of Trump's abolition of Obama's health care reform,the content of Trump's alternative health care reform plan,the course and direction of Trump's health care reform,and the new trend of the future development of American health care reform are introduced.Based on the analysis of the evolution process of American medical insurance system from a historical perspective and from the perspective of new political economics,this paper explores the interest motivation and decision-making mechanism behind the government in the process of leading the evolution direction of medical insurance system.On the basis of the new political economy theory,this paper constructs two models to find out why the government does this.Firstly,the interest group model is constructed,and Peltzmann government optimal regulation model is used to assume that the government does not have its own interest preferences,and the direction of the evolution of medical insurance system is determined only by the balanced role of external interest groups.Then,a rational government decision-making model is constructed,assuming that the government has its own preferences,and the direction of the evolution of the medical insurance system is determined by the government in the process of pursuing its own utility maximization,in order to maximize its own interests.Since the establishment of the medical insurance system in the United States,after continuous development and reform,a form of medical insurance system has been formed,which is mainly composed of private commercial medical insurance and supplemented by government public medical insurance projects.This paper study the evolution process of American medical insurance system and analyses with the new political economy perspective,and draws the following basic conclusions:Firstly,the relationship between government and market is the essence of the evolution of American medical insurance system.Secondly,the game situation of interest groups is the external factor that decides whether the U.S.government will change the track of the evolution of the medical insurance system.Thirdly,the government's own preferences,or the pursuit of maximizing its own utility,are the internal factors that determine the evolution direction of the American medical insurance system.Fourthly,in the evolution of the American medical insurance system,it is an inevitable trend to gradually enhance the role of the government,but the "market-oriented medical insurance model" in the United States is unlikely to change substantially.The essence of the evolution of American medical insurance system is the allocation of the relationship between government and market,The Decision on Several Major Issues of Comprehensive Deepening Reform promulgated by the Central Committee of the Communist Party of China in November 2013 pointed out that the market must play a decisive role in the allocation of resources,and at the same time the government must play a better role.In the field of medical insurance in China,there may be different opinions on whether to make the market play a decisive role in the allocation of resources.However,drawing lessons from the experience of the United States,giving better play to the role of government and more to market in this field should be a useful inspiration worthy of our consideration.