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THE TRANSFORMATION OF US HEALTHCARE: FROM PRIVATE HEALTHCARE, TO MEDICARE, MEDICAID AND OBAMACARE, TO THE FUTURE OF ‘MEDICARE FOR ALL’ By Keval Shah, Economics (2020)
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n 6th November 2018, voters up and down the United States headed to the polls. Voting in congressional and gubernatorial races, this was America’s chance to make their voices heard in the most important midterm elections in a generation. After 2 years of protests, marches and twitter wars, American voters were finally given the opportunity to decide the fate of their country. Some would argue that this election was a referendum on the President. Mr Trump is a polarising figure, remaining extremely popular within the Republican party, despite achieving historically low approval ratings within the low 40s. However, one could argue that this election was also a referendum on the Democratic party. Was the country happy with one party rule, with an opposition without any real power? Or was it time for the Democrats to take back control of congress to keep Mr Trump and his economic policies in check. Prior to the elections, there were ample reasons for Democrats to feel optimistic about taking control of congress. Incumbent Presidents tend to face losses in midterm elections. Since 1934, a President’s party has only made gains in the House of Representatives 3 times. Mr Trump’s approval ratings were sitting in the low 40s, lower than Barack Obama’s and Bill Clinton’s, who saw major losses in their first midterm elections. The Democrats were most likely to take the House, whilst the Republicans were widely favoured to keep their Senate majority, and possibly even expand it. FiveThirtyEight, a polling aggregation website, used unique electoral analysis to give the Democrats an 87.9% chance of winning the House (Silver, 2018). But in the world of Donald Trump’s America, nothing was ever going to be that simple. People became very sceptical of pollster’s predictions, following the 2016 elections and the Brexit vote.
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Democrats won because of one issue: healthcare. They focused on protecting Obamacare and expanding Medicare and Medicaid. Many Democrats took a different approach in these elections to last time round in many of their key races. In Florida, the history-making candidate Andrew Gillum was running as the state’s first African-American gubernatorial nominee in the state. He ran a progressive campaign, arguing ‘to the left’ of issues such as ‘Medicare for all.’ Next door in Georgia, Stacey Abrams ran to become the first ever AfricanAmerican female governor. She ran a grassroots campaign, by focusing on fighting for policies such as Medicaid expansion. This was the most historic midterm elections in a generation, resulting in record voter turnout of 49.2% (Zurcher, 2018). In the elections, the Democrats took control of the House of Representatives in a so called ‘Blue Wave election,’ achieving the largest raw vote margin in the history of midterms. 33
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