Universal Coverage: A Recipe for Deficits Over the Horizon

Once enacted government entitlement programs grow and expand. Medicare covers more people and services than when it was first enacted. SCHIP has been expanded to cover children in households above the poverty level. The Senate Finance Committee is considering a similar expansion of Medicaid.

Tens of millions of Americans lack health insurance. Extending coverage to them has been a core goal of health reform proposals since the 1960s. President Richard Nixon offered a universal health plan in his first administration, but since then Republicans have hesitated to commit the nation to so costly an undertaking. Is it time to rethink? Should Republicans accept universal coverage as a goal?  We posed this question to NewMajority's contributors.

If Congress fails to pass  healthcare legislation, the demand for universal healthcare will persist and if "universal healthcare" turns out to be a codeword for "single payer care" it should be resisted.

The fact is that once enacted government entitlement programs grow and expand. Medicare covers more people and services than when it was first enacted. SCHIP has been expanded to cover children in households above the poverty level.  The Senate Finance Committee is considering a similar expansion of Medicaid.

Couple these developments with a continued demand for putting illegals on a path to citizenship while granting benefits prior to citizenship actually being obtained and suddenly universal healthcare looms as a recipe for deficits as far as the horizon.

Still, more and smarter steps need to be taken to improve America's healthcare. For starters, we need to lower America's infant mortality rate.  It is too high. One serious impediment to improvement may be cultural barriers. Regardless, the effort must be made.

A good place to start would be expansion of community health centers that make healthcare available to all comers, and charge users on a sliding scale tied to income.

Obviously, health issues go beyond infant mortality. Another step would be to step up NIH funding and encourage further research on the health problems that America faces like swine flu and cancer. With the exception of doctrinal libertarians, Americans are comfortable with government lending a hand to fight illness.

Americans applauded FDR's launch of the March of Dimes to combat polio.  Conversely, Americans were critical of the prior Bush administration's restrictions on stem cell research.  And so, an open public health strategy, as opposed to a confusing opaque bid at "health insurance reform", could well win the public's plaudits and imagination.

A recent release by the Center for Disease Control shows that average life expectancy continues to rise. The questions we face are whether we want that trend to continue, or whether we want to "bend the curve" by nudging grandma into the not so gentle "night?"  Do we want to simply transfer incomes, or do we want to expand health opportunities for all?

With the exception of some healthcare experts, I have a hunch as to which direction the public would go.

To read other contributions to this symposium, click here.