On the policy issue of health care reform, a decision is approaching any day now by the Supreme Court whether some of the legislation will be deemed unconstitutional. What exactly is at play and where have we come on this debate? First, to understand a little about universal health care in general, it's wise to see where they have been successful and that's Europe. There's no direct comparison to be drawn here and the proposal going through the nation's highest courts doesn'tdraw it's influence necessarily from any of these policies but they provide an interesting viewpoint.
England eventually adopted a free healthcare system in 1948 but after a introductory phasing in of the final plan after conditions had subsided after WWII. The initial plan began in 1939. A large relocation of residents living in London and other cities took place out of fear for invasion that pushed people into rural areas. Necessary facilities weren't going to be adequate given the circumstances and the government foresaw a need to supportcitizens facing the financial burden of war and the medical communities unprepared to give care to ordinary civilians and soldiers. The plan resulted in hospitals being mostly owned by the government, nearly 90% of the British Medical Assoication agreed, consequently salaries were increased, and all citizens were provided free care.The plan was enjoyed by the country and when the policy expired in 1944 during the wars' end, citizens welcomed a permanenet enactment under the same terms.
The French healthcare adoption paints a similarly impressive story. Adoption of their nationalized plan came shortly after the war's end with the government needing to assist those many who needed care in a country drasticallly set back by the war. Their plan extended a payroll tax policy already in limited effect for purchase of private insurance to cover the populations' health care needs. It now stands as the best health care plan in the world according to a 2000 World Health Organization ranking. Switzerland's plan adopted in 1994 and has a universal health care mandate where policies aren't to excede 10% of a citizen annual salary by providing subsidies. These plans have been hugely succesful.
Trying to assign an appropriate time to implementing major change in this part of our society has challenged lawmakers for decades. The current proposal was signed into legislation by Obama on 3/23/2010 and requires that most American's purchase health insurance. The idea of mandated insurance policies began entering US political discussion widely during the Bill Clinton term with the Health Equity and Access Reform Today Act, calling for all employers to provide insurance. Republican's proposed an alternative, in response for what they also saw as needed change but disliked the potential burden and disincentive on employers. The counter plan was crafted by John Chafee of Rhode Island and cosponsored by 18 Republican Senators including the minority leader, Bob Dole. It was based largely on the Heritage Plan and revised to be named Assurring Affordable Health Care for All America which proposed the individaul payment mandate. Neither of these passed both chambers of congress and so the policy agenda fizzled late within Clinton's term, but some lawmaiers continued to voice support including Ted Kennedy of Massachusetts. Ten years later, the individual mandate policy reemerged with bipartisan support and was seldom disputed when discussed between both parties. It became a bill in 2007 and sponsored by 11 Republican Senators and 9 democrats. It came to be known as the Wyden-Benet Plan, named after it's drafters Senator Ron Wyden and Utah Republican Bob Bennet, later receiving praise by Mitt Romney. The result, after touting the policy was what was to become Obamacare aka the Patient Protection and Affordable Care Act. In late 2009 at the time that congressional deadlock had begun to take place, every Senate Republican voted against the bill. Ron Wydner's comment was, "I would characterize the Washington D.C. relationship with the individual mandate as truly schizophrenic." That's not how many would envision policy makers to handle such large issues." The think tank groups that have been supplying thoughts and direction for these lawmakers to abide by have been influential on the changing stance of many Republicans. Governing to the vote isn't anything new but is certainly a brazen example with this matter.