But many employers Caterpillar Boeing Xerox

Reform of American health care system is almost, but its funding much less. Since the beginning, the White House stressed its willingness to finance the bulk of the reform (871 billion over ten years) by the cost control and improved management of existing programs (Medicare, Medicaid...). "This reform should help us to reduce our deficit by an amount as important as 1,300 billion over the next few decades, has launched Barack Obama, also seeing a cure for the resulting"waste"of the current system. More precise, the Congressional Budget Office (CBO) estimated that the reform should result in 483 billion in savings and a positive net impact of 132 billion dollars on the reduction of the deficit over the next decade. But major differences remain between the House and the Senate on the modes of funding of the reform.

"There will be a little of both in the final text", said Barack Obama to the National Public Radio, without hiding his interest in the proposal of the Senate's tax "Cadillac plans", the medical insurance "of luxury" reserved for the privileged persons. But the two texts vary even significantly on funding arrangements. While the Senate proposed the creation of a 40 tax on insurance policies the most advantageous, allowing to reach 149 billion in revenue over 10 years, in addition to a total of $ 238 million of additional fees on insurance companies and manufacturers of medical over the same period, the lower House put mainly on high direct taxation revenues. According to its text, the creation of a surcharge of 5.4 on households whose annual revenues exceed 1 million dollars (or $ for single 500,000) would reach $ 461 billion in additional revenues over 10 years.

Concern of employers

The introduction of "Cadillac plans" is perceived by the Senate as one of the best ways to curb the inflation of medical costs. But the unions are opposed to this formula which could affect the professions at risk and quickly affect the middle class. Whatever the chosen final schema, the extension of health coverage to some 30 million Americans by subsidies would have an impact on the Federal deficit in the short term. The horizon of a decade, CBO believes that reform should be neutral for the budget plan, or even to even reduce deficit Federal grace of the economies of management on existing programs and the lifting of additional recipes (498 billion over the 2010-2019 period). According to the text of the Senate, reform should reach $ 500 billion of savings in the Medicare program for more than 65 years, by reducing the growth of subsidies paid to hospitals, retirement homes and other care providers.

The objective of the reform by Barack Obama is to expand without additional budgetary costs Americans health coverage. A critical objective in light of the level of federal deficit of 1,400 billion in 2009 (10 of GDP) and the current amount of the cumulative federal debt (12.100 billion), which the Senate had also to vote, on 24 December, an increase of 290 billion from the current ceiling, Treasury finance needs.

For the White House, it is untenable evolution of the cost of the current health care system which makes it imperative reform. But many employers (Caterpillar, Boeing, Xerox...) are worried about having to bear the bulk of the financing of the extension of Medicare, providing experts that the share of us health spending still risks from 18 to 20 of GDP by 2018.