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Brief History of Universal Health Care in America

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In 1993, President Clinton pushed for universal health care to lower the Medicare budget. First Lady Hillary Clinton led the initiative. Hillarycare used a managed competition strategy to achieve its purpose. The government would control the costs of doctor bills and insurance premiums. Health insurance companies would compete to provide the best and lowest cost packages. The plan encountered too much resistance from doctors, hospitals, and insurance companies to pass Congress.

In the 2008 presidential campaign, Senator Barack Obama proposed universal health coverage. Obama's health care reform plan proposed a publicly-run program, similar to that enjoyed by Congress. People could purchase the government-run "public option" or they could buy private insurance on an exchange. No one could be denied health insurance because of a pre-existing condition. The federal government would expand funding for Medicaid. It would provide subsidies for those who made too much to qualify for Medicaid. Despite all these benefits, many people were afraid of this intrusion of the federal government into their lives. They said it was leading down the path toward socialized medicine. 

Once elected in 2009, Obama proposed universal health care called the Health Care for America Plan. It provided medical insurance similar to Medicare for everyone who wanted it. Those who were happy with their existing health insurance could keep it. The federal government's size meant it could bargain for lower prices and reduce inefficiencies. By pooling the uninsured together, it decreased insurance risk.

Monthly premiums were $70 for an individual, $140 for a couple, $130 for a single-parent family, and $200 for all other families.

It gave employers a choice, as well. If they provided health insurance that was at least as good as Obama's plan, they just kept what they had. If not, employers paid a 6 percent payroll tax, similar to unemployment compensation, to help pay for the Obama plan. Self-employed workers paid a similar tax.

It covered mental, maternal, and child health. It limited annual out-of-pocket costs paid by enrollees and provided direct drug coverage. A federally-managed exchange regulated health care information. Obama also promised to modernize health care patient information under an all-electronic system.

The plan promised to lower health care costs by 1.5 percent per year. The federal government could bargain for lower prices and reduce inefficiencies. Lower health care costs translated to $2,600 more savings per family in 2020 and $10,000 by 2030. It reduced the budget deficit by 6 percent of GDP by 2040. This would lower unemployment by 0.25 percent per year, creating 500,000 jobs.

Obama's 2009 health care plan would have reduced visits to the emergency room by the uninsured. This would have saved $100 billion, or 0.6 percent of GDP, per year. Government-sponsored health insurance removed this burden from small businesses. It would have allowed them to be more competitive and attract higher-skilled workers. 

Again, too many people were afraid of universal health care. In 2010, Congress passed the Patient Protection and Affordable Care Act. More than half or 57 percent of Americans incorrectly think the ACA is universal health care. It attempted to enforce mandatory health insurance, similar to Germany's plan. But it allowed too many exemptions. It also allowed states to decide whether they would expand Medicaid. As a result, 13 million people have no insurance. Trump's tax plan removes the mandate in 2019. 

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