The Comprehensive Health Insurance Act

Imagine: the president of the United States proposes a bill promising comprehensive health care for Americans. He mentions the rising cost of health care and the burden it places on the average American family. He talks about the 25 million Americans who remain uninsured and the lack of comprehensive coverage for those who are. Sound familiar? It might, but in this case the president was Richard Nixon and the year was 1974.

History

• In a special message to Congress on Feb. 6, 1974, President Nixon called for the creation and passage of legislation intended to finance health care on a national basis. Previously, he had overseen the largest expansion to Medicare eligibility up to that point. He enabled nearly 2 million people under 65 years of age who were receiving Social Security disability insurance payments to be eligible for Medicare coverage.

Purpose

• Nixon intended to correct the two major flaws he saw in the health insurance system. The first flaw was that those who were uninsured were often those who needed the coverage the most and were the least likely to obtain it. The second flaw concerned the existing health coverage. Those who were insured were often done so with coverage that was not "balanced, comprehensive and fully protective," in his words.

Function

• The plan would offer broad and balanced coverage through one of three programs. Employee health insurance would split the costs between the employer and employee. Improved Medicare for citizens 65 and older would have included additional, needed benefits. The final plan, Assisted Health Insurance, was intended for lower income persons or those who were not eligible for either of the other programs, with costs beyond the insured's means shared by federal and state governments.

Features

• Nixon's proposed Comprehensive Health Insurance Plan (CHIP) was based on seven principles. First, it would offer every American the opportunity to obtain comprehensive health insurance. It would cost no more than any citizen could afford. The third principle was building on the strength of existing private and public plans and harmonizing them into a single system. The plan would use public funds only where needed and would not require new taxes. It would maintain patients' freedom of choice and ensure doctors worked for the patient, not the government. The plan would also encourage more effective use of existing health care resources. The final principle the plan was built on was making sure all relevant parties would be invested in making the system work.

Benefits

• The three plans would offer identical benefits for all customers, regardless of age or income. The benefits included hospital care, prescription and life-saving drugs, laboratory tests, medical devices, ambulance services and physician's care in and out of the hospital. The proposed benefits also included "other ancillary health care," in President Nixon's words.