For the American politicians it is impossible to refuse the pre-election pledges as it means for them instant political death.

Barack Obama has regarded public health services reform as of paramount importance the election campaign. And consequently he has been obliged to do the utmost for its realization, becoming the president. The problem has appeared, as it was expected by many, difficult. After all that Obama offered, meant hardly probable not radical rupture with previous traditions of the USA in the field of public health services. On the importance offered by Obama it can be comparable only to reforms of president Johnson of 60th years which have entered programs Medicaid and Medicare.

The essence of innovations of Obama consists in the following. We will remind that now in the USA without the medical insurance live more than 30 million persons that makes approximately 17 percent of the population. In America there is no free medicine, and the insurance companies which the client -- or itself remits money pay for services of the doctor, or the employer pays for it.

In the majority of insurance plans it is written down that patients should pay for medical examinations independently. Cost of insurance of one person averages not less $3 thousand a year that is the serious sum for needy. It the great number of persons without the insurance also speaks. Obama's reform urged to give the insurance of 95 percent of the population. From employers it is required to do the medical insurance to all employees that today it is carried out only on a voluntary basis.

According to the president, reform will make medical insurance accessible almost for all categories of citizens, and also will forbid the insurance companies to increase the prices in connection with deterioration of a state of health of their clients.

Insurers have now no right to refuse to the diseased in the insurance. Restrictions on its cost for people with serious diseases are entered.

Also insurers are forbidden to refuse policies to sick children, and parents can include in the insurance plans of children, up to achievement of 26 years by those. Restrictions on cost of visits to the doctor will be established. Working with needy doctors will get a rise to a salary, and the needy can pass free prophylactic medical examination. Those from them who needs a permanent care, will have an opportunity to live in the specialized medical centers. For the enterprises of small and average business which will give the insurance to the employees, the tax concessions are offered.

The total cost of the project will constitute $940 billion -- only for the first 10 years. It is offered to compensate the increased costs for the account of the tax to secure citizens, collections from the pharmaceutical companies, and also the control over cost of services in a health care and toughenings of supervision of the insurance companies. The 2,9 percent excise duty on sale of the medical equipment will be entered. It is considered that as a result deficit of the state budget for 10 years will not increase, and even will decrease on $138 billion there Will be increased requirements both to insurers, and to employers. On them penalties if they do not implement more economic plans of insurance will be imposed.

It is clear that such radical offers could not be accepted on hurrah mistrustful America. Round the offered bill fierce war both in the Congress, and in public space has begun. Obama's opponents -- republicans -- at that point in time had a minority in the Senate, allowing democrats to pass any law. But even in such conditions senators-republicans thought out all to brake bill promotion. Struggle in streets of the American cities where took place mass demonstrations, pickets and other public shares against the reform of a health care offered by Obama was even more furious.

Opponents charged supporters of reforms that thus America "comes nearer to a socialism", and last till now -- a taboo of public consciousness. The USA -- a society of individualists which highly appreciate a personal liberty and choice possibility, and the socialism at them associates with absence of those. Reform of a health care did not suit them with that the state will be henceforth active to participate in care of the individual of the health, to interfere with affairs of business on behalf of the insurance both pharmaceutical companies, and private medicine. Insurers and pharmacists have the powerful lobby which in every possible way tried to brake reform.

The basic objections were the following:

• In America there was historically a health care system, rather effective if to judge after average life expectancy and level of medical technologies, and its any attempts can change to lead as a result to medicine decline.

• The Insurance companies -- an economy and financial system integral part. In them millions people work. Blow on them means blow on all occupied in insurance, on interests of hundreds millions insured.

• The State -- the bad manager, and its closer involving in a health care system means inefficient use of means.

• The Increase in expenses of the state at medicine will cause budgeted deficit growth, and without that already constituting the astronomical sum.

Nevertheless, after the long debate which has extended about year, Obama managed to make that Hillari Clinton to which her husband has given carte blanche on carrying out of similar reform was not possible fifteen years ago. On March, 23rd the president has signed Patient Protection and Affordable Care Act, accepted by the House of Representatives two days before which has installed health care reform. For Barack Obama it is an outstanding victory, its personal triumph. Result achievement costed to it of huge efforts. Except infinite trips on the country, it has conducted personal meeting with ninety two congressmen -- confidentially or by phone. Moreover, personal courage was necessary also -- to supporters of reforms from the Congress threats came, on the house to them sent empty coffins, envelopes with not clear powder.

As a result, by data sociological questioning, the majority of Americans has positively concerned health care reform. 49 percent from them have approved that fact that the Congress has approved this bill. And half of interrogated has described the reaction as "delight" and "pleasure".

Even such inveterate opponent of the USA as Fidel Castro has highly appreciated Obama's directed on reform of public health services the step. That America will have now new system of medical attendance -- extremely symbolical event. Just as "the new rate" Roosevelt meant refusal of previous ideology nothing of the constrained market, and courageous transformation of a national health care system means rupture with former dogmas, acknowledgement of that the state and a society are responsible for health of the members that it is impossible to leave to the mercy of fate millions people only because at them low incomes.

Anyway, a boundary it is gone. Return to the past cannot be any more. Uncontrollable game of the market has given in in one country, on a twist of fate the former native land and a support of market ideology.