The Deficits of U.S. Democracy and the Implications for Health and Social Policy THE POLITICS OF HEALTH CARE REFORMS IN U.S. PRESIDENTIAL ELECTIONS Vicente Navarro This article analyzes why people in the United States have major problems in accessing medical care that are due to financial constraints. The author suggests that the cause of these problems is the way in which medical care and elections are funded in the United States, with private sources being the largest component in the funding of both activities. The article includes a comparison of funding of the electoral process in the United States with similar electoral processes in the countries of the European Union, and postulates that privatization of the funding of U.S. elections (primary and general) is responsible for privatization of the funding of medical care—the root of people’s problem in paying for their medical care. Privatization of election funding gives undue power to the economic, financial, and professional groups that dominate medicine in the United States. THE U.S. AND EUROPEAN POLITICAL CULTURES ARE VERY DIFFERENT I appreciate the invitation from the Harvard Health Policy Review to discuss the relationship between national health care systems and the policy process. One cannot analyze this relationship without analyzing the political context in which it occurs, and since the United States is now in the midst of a very important political process—the presidential primaries of 2008—it may be of special interest to readers of the Review to focus on the impact of the political process on the health care reform proposals put forward by the presidential candidates in this and past elections. 1 International Journal of Health Services, Volume 38, Number 4, Pages 597–606, 2008 Ó 2008, Baywood Publishing Co., Inc. doi: 10.2190/HS.38.4.a http://baywood.com 597 1 See Note on p. 606.