Obama’s health care reform sets a tripartite policy: regulation of private insurers in the new market called "the Exchange", mandated coverage for individuals and businesses, and broader public intervention in health care (especially through Medicaid and Medicare’s overhaul and subsidies). The meaning of Obama’s reform can be understood only taking into account the special history of health care in the United States: the privileged status conferred to private interests, the absence of an idea of social citizenship, the distinction between insurance and assistance in social policies, the market’s centrality, and the residual role of public policies have been fundamental in shaping the current reform.
Keywords: Stati Uniti, Obama, riforma sanitaria, assicurazione, cittadinanza sociale