The Exchange

This year the families of 18 million Americans—more than three-quarters of whom already have health insurance—will spend more than 25 percent of their income on health care.

Supporters of a public plan say the government should mandate that every American have health care coverage by establishing a government-regulated marketplace for private insurance and requiring larger employers to offer health insurance to their workers or pay a tax. They say that health care companies will have to compete with the government system by lowering the costs consumers pay for health care.

Opponents say that this is the first step toward a government controlled and administered health care system instead, which will destroy the free market’s ability to solve the health care crisis. They say that insuring every American might well cost as much as $1.5 trillion over the next decade.

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