When Clinton took office, approximately twenty percent of American adults lacked health insurance, despite the fact that the United States spent more on health care than other developed countries. Many liberals advocated the establishment of a single-payer healthcare system similar to that of Canada, while a group of congressional Republicans developed a plan consisting of government subsidies and the implementation of a mandate that would require individuals to purchase health insurance. The administration formed a task force, led by First Lady Hillary Clinton, that was charged with creating a plan that would provide for universal health care. Assigning a major policy role to the First Lady was unprecedented and sparked controversy. Rejecting calls for a single-payer system, She proposed a health care plan based on the extension of employer-based health insurance. Individuals not insured by employers would be insured by the government. The plan would also expand the government's regulatory role in a concept known as "managed competition," with the government setting a minimum level of benefits that each plan could provide. Additionally, the plan would prevent insurers from charging different rates to customers based on age and pre-existing conditions.