… who is worthy?
The political right has tried to derail efforts to reduce the number of uninsured with mostly silly arguments of extreme consequences like putting grandma at the mercy of
death panels. To reclaim some conservative dignity, here are some dispassionate arguments that have been largely ignored for why we’re leery of Democrat-designed reform. First some facts: Poor people are insured through Medicaid. Veterans are covered. Seniors have good coverage through Medicare.
Only 18% of Americans are without health insurance.
Of those, 20% are not citizens, 22% earn three times the poverty line, and 23% are eligible for Medicaid or the State Children’s Health Insurance Program but don’t sign up for it.
The left wants to mandate covering most or all of the uninsured one way or another. The right rejects that intervention because we resent paying for healthcare for those who could pay for it themselves but don’t.
Here’s a model that might get the left and right communicating again: the education model.
We decided years ago that universal public education is good and a basic right. So, we finance 100% of grades K-12. That’s enough for some of us. For the rest, there’s Harvard University, Stanford University and the like. But most of us can’t afford these “Cadillac” institutions.
So California and other states offer subsidized universities like UCLA, and a network of community colleges. The cost to taxpayers in California: 15% of the University of California budget, 49% of the state college budget and about 30% of the community college budget. The rest is paid by tuition, fees, scholarships and research grants. So, everybody gets a basic education and we help those wanting more. Could this work for healthcare?
Where conservatives rise up in opposition is to the notion of sending people to Stanford at taxpayers’ expense, especially people who could afford to pay the tuition themselves. We need first to decide if healthcare is a basic right. We have already covered the safety net with Medicare, Medicaid and SCHIP (like grades K-12). What we’re struggling with is how much the taxpayer should chip in for those who need health insurance but don’t buy it.
The current debate in Congress is over the wrong subject. Our legislators should be looking at the uninsured carefully to decide who is worthy of subsidy before designing the program to subsidize them.
Jeffrey J. Denning Medical practice analyst Practice Performance Group
La Jolla, Calif.