U.S.A. HEALTHCARE POLICY IN THE DYNAMICS OF POLITICAL COMPETITION

Abstract

The article analyzes the specific features of the U.S. healthcare system and proves its role not only as a mechanism for providing medical services but also as a key factor in political development, public trust, and stability. It is viewed as a space of active political competition where the interests of the state, business, and civil society intersect, and policy decisions directly affect the accessibility and quality of medical services.The structural characteristics of the American model are examined, highlighting the historical dominance of private insurance combined with state programs such as Medicare and Medicaid. This structure has led to fragmentation of the system and significant disparities in access to medical services across regions and social groups, which are further amplified by the political autonomy of the states.The Affordable Care Act reform is reviewed as a key stage in attempts to unify basic standards and expand access to healthcare services. Despite intense political conflicts, most of the reform’s provisions have been preserved, although the repeal of financial penalties in 2017 and reduced funding for public information campaigns have lowered public engagement in the insurance system.The article explores the deep political polarization surrounding healthcare issues. Debates on Medicaid and Medicare reforms, mandatory vaccination, pharmaceutical market regulation, and reproductive rights have highlighted a profound ideological divide between the major U.S. political forces.It is demonstrated that the U.S. healthcare system is a politically saturated and structurally fragmented space that combines ideas of individualism, market freedom, and social solidarity. The future development of this model will depend on the ability of the political system to overcome institutional barriers, reach sustainable compromises, and respond effectively to key healthcare challenges.