In a country where 60% of self-insolvency is said to be the cause of medical expenses, the ACA (Affordable Care Act) commonly named as Obamacare was a dream-like system for people who were not insured in the United States, which has become a heavy burden for those who already have insurance. President Trump pledges to abolish Obama care and announces the American Health Care Act as an alternative plan. Despite being rejected by Congress, the motivation to realize his own promises is still not waning. President Obama who won the presidential election with medical system reform is being challenged by President Trump who highlights the elimination of its policy. What is he really trying to accomplish? The medical system reform in the United States, which was a long-standing national task, is still very confusing.

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The medical expenses in the United States, which has been prominent even in this industrialized country at 18% of its GDP, is the biggest cause of self-insolvency with one in six people unable to afford the benefits of medical insurance in its current state. The problem of the medical system is that it does not only affect the people with a disease, but also the economy of the rest of the Americans. This started a movement for public healthcare by the American Labor Legislation Association in 1910. In 1912 Theodore Roosevelt became the first to endorse this system. Later, Franklin Roosevelt, Harry Truman, Richard Nixon, Jimmy Carter, Bill Clinton, all tried to create a national healthcare system, but they continued to fail.
All aspects of the idea that  socialized medicine is a communist idea, infringing on personal freedoms, opposing medical associations and labor organizations, combined with the moral dilemma that offering free or low-cost insurance for low-income families and individuals may cause fraudulent or lazy behavior in this area are complicatedly intertwined.
Although Obama Care was established in 2010, it is said that it will cause a large tax increase of about 1 trillion dollars in 10 years. As for President Trump, the tax reform bill signed in December last year is said to decrease the deficit(about $ 1.5 trillion in tax cuts in 10 years). The motivation to repeal Obama care as a pillar of policy is not declining and the abolition of it will be an issue until the midterm election for President Trump who advocates for the white middle-class workers.

1. Medical insurance obligation

Obama care → Yes
· Trump Care → None, Insurance premiums will rise by 30% if you are not subscribed to an ongoing policy

2. Employer’s duty

· Obama Care → Employers of more than 50 full-time workers are obligated
· Trump Care → No obligation

3. Presence or absence of medical history

· Obama Care → Insurance companies can not raise insurance premiums or cannot refuse subscribers due to past medical history
· Trump Care → determined by the state government

4. Minimal health aid

· Obama care → cover the following 10 items (① outpatient, ② emergency services such as using an ambulance, ③ hospitalization ④ pregnancy, infant care, ⑤ psychosomatic medicine ⑥ prescription medicine ⑦ rehabilitation ⑧ lab exams, ⑨ chronic illness management and prevention, ⑩ pediatric service including oral cavity and ophthalmology)
· Trump Care → determined by the state government

5. Medical insurance assistance

· Obama care → Assistance to those that are under 400% of the poverty level set by the federal government
· Trump Care →Assistance to those that are under 350% of poverty level set by federal government with additional assistance through tax credits determined by age and income

6. Cost burden of public medical insurance (Medicaid) for low-income people

· Obama Care → The federal government will bear at least 1 dollar each time the provincial government pays $ 1
· Trump Care → Expand Medicaid in stages by 2026

7. Medical savings account (HSA)

· Obama Care → Singles can contribute $ 3400 per year (households $ 6750) per year
· Trump Care → Expansion Policy

 

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