*Clinton Cited President Johnson’s Success In Establishing Medicare And
Medicaid And Said She Wanted To See The U.S. Have Universal Health Care
Like In Canada.* “You know, on healthcare we are the prisoner of our past.
The way we got to develop any kind of medical insurance program was during
World War II when companies facing shortages of workers began to offer
healthcare benefits as an inducement for employment. So from the early
1940s healthcare was seen as a privilege connected to employment. And
after the war when soldiers came back and went back into the market there
was a lot of competition, because the economy was so heated up. So that
model continued. And then of course our large labor unions bargained for
healthcare with the employers that their members worked for. So from the
early 1940s until the early 1960s we did not have any Medicare, or our
program for the poor called Medicaid until President Johnson was able to
get both passed in 1965. So the employer model continued as the primary
means by which working people got health insurance. People over 65 were
eligible for Medicare. Medicaid, which was a partnership, a funding
partnership between the federal government and state governments, provided
some, but by no means all poor people with access to healthcare. So what
we've been struggling with certainly Harry Truman, then Johnson was
successful on Medicare and Medicaid, but didn't touch the employer based
system, then actually Richard Nixon made a proposal that didn't go
anywhere, but was quite far reaching. Then with my husband's
administration we worked very hard to come up with a system, but we were
very much constricted by the political realities that if you had your
insurance from your employer you were reluctant to try anything else. And
so we were trying to build a universal system around the employer-based
system. And indeed now with President Obama's legislative success in
getting the Affordable Care Act passed that is what we've done. We still
have primarily an employer-based system, but we now have people able to get
subsidized insurance. So we have health insurance companies playing a
major role in the provision of healthcare, both to the employed whose
employers provide health insurance, and to those who are working but on
their own are not able to afford it and their employers either don't
provide it, or don't provide it at an affordable price. We are still
struggling. We've made a lot of progress. Ten million Americans now have
insurance who didn't have it before the Affordable Care Act, and that is a
great step forward. (Applause.) And what we're going to have to continue
to do is monitor what the costs are and watch closely to see whether
employers drop more people from insurance so that they go into what we call
the health exchange system. So we're really just at the beginning. But we
do have Medicare for people over 65. And you couldn't, I don't think, take
it away if you tried, because people are very satisfied with it, but we
also have a lot of political and financial resistance to expanding that
system to more people. So we're in a learning period as we move forward
with the implementation of the Affordable Care Act. And I'm hoping that
whatever the shortfalls or the glitches have been, which in a big piece of
legislation you're going to have, those will be remedied and we can really
take a hard look at what's succeeding, fix what isn't, and keep moving
forward to get to affordable universal healthcare coverage like you have
here in Canada. [Clinton Speech For tinePublic – Saskatoon, CA, 1/21/15]