The Reality About the Universal Health Care Debate

Study examines history of universal health care in the United States.

A federal health insurance plan even more liberal than Obamacare shows the potential for bipartisan support on universal health care, according to a study recently published in Pediatrics.

Republican Richard Nixon first proposed a new health care plan in 1971, which would have greatly subsidized private health care costs, and insure even more Americans than the Affordable Care Act (ACA). When it failed in 1971, he proposed it again in 1974. It failed both times for not going far enough.

Nixon's plan required that all employers provide a health insurance plan to employees, including specific requirements in all plans. The ACA currently requires all employers with over 50 employees to do so, but has less specific requirements for those with fewer employees.

Nixon's plan required all full-time employees to have health care, and aimed to replace Medicaid with plans to help those not eligible for Medicare or who did not currently have health insurance. Nixon's plan was also one of cost sharing based on income level, to protect the insurance industry.

Similar to Obama's plan, Nixon met heavy backlash from the opposing party. The Democratic party of the 1970s criticized Nixon for being too conservative, and pushed for a single-payer system, where all health care payments were funded by the federal government.

"It would be a very different country today if the Nixon plan had passed," said Gary Freed, MD, MPH, a U-M pediatrician and health policy researcher. "Instead, we had 30 more years with one-third of the population uninsured."

Today, the ACA is condemned by Republicans as "socialist medicine." During the Cold War, a Republican president tried passing a healthcare plan even more liberal than the ACA, and was condemned as too conservative.

Both plans show that universal healthcare, at one time, has been a priority for both parties, but acceptance of it has been addled by distrust of the other party.

"We need to put health care in a historical perspective, and not go to extremes for political purposes," Freed said. "I would hope this history will help policy makers think about what the policy is trying to accomplish for the American people, and not turn a blind eye to proposals simply because they're proposed by one party or the other."