Due to the inexorable aging of the country—and equally unstoppable growth in medical spending—it was long obvious that health-care jobs would slowly take up more and more of the economy. But in the last quarter, for the first time in history, health care has surpassed manufacturing and retail, the most significant job engines of the 20th century, to become the largest source of jobs in the U.S.

In 2000, there were 7 million more workers in manufacturing than in health care. At the beginning of the Great Recession, there were 2.4 million more workers in retail than health care. In 2017, health care surpassed both.

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Between “80 to 85 percent of Americans are already covered by health insurance, and most of them are happy with what they’ve got.” It’s true that single payer would help extend coverage to those who are currently uninsured. But policy makers could already do that by simply expanding Medicaid or providing larger subsidies to low-income Americans.
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The term “Cadillac tax” is evocative: It suggests that the health-insurance plans it would tax—through a provision in the Affordable Care Act—are to regular health insurance as a Cadillac is to a Kia. President Obama once described the levy as targeting “really fancy [health insurance] plans that end up driving up costs.”

But what many Americans may not realize is that “Cadillac tax” is in part a misnomer. While some plans that qualify for the tax may be high-end with extra benefits, or “really fancy,” not all of them are. Nor is every employee with an expensive plan a corporate executive. Over time, the number of Americans affected by the tax is expected to increase, as is the revenue the government expects to raise from their plans.