Here's a fairy tale: The Congress passes some magic law, and everyone has all the health services they deserve and can dream of wanting…at the price to them that they think it is worth (practically nothing), and the national and/or states' economies won't be dragged down by the costs.
WAKE UP. It's just a fairy tale! However, it is a fall-back fantasy to which we return time and time again, like addicts,….despite over-whelming widespread proof that the fairy tale dream will turn into a nightmare. The nation is starting another fairy-tail extravaganza, with new bills & proposals being introduced for universal health coverage.
It just does not work! Look at Canada and other countries often used as the ideal or model for universal coverage. Those systems are suffering, and the conditions & controls (such as waiting times or being told what you may or may not have done or what medicines) would cause political revolt in this country. The key factor that makes the outcome in the US different is that Americans' expectations are much more demanding than citizens of other countries.)
Look at Medicaid. Ask any state legislator or budget official how things are going. You'll get a groan. It is the biggest scary bottomless pit of funds for most states. Many national "reforms" proposed for universal care or to shift private employer workers into state-run programs actually have the secret agenda of cost-shifting the states' Medicaid budget load. States are increasingly moving (with federal blessing) to limiting access and cutting benefits. Medicaid is the real-world model of universal coverage in the US.
Look at Medicare. Like a pyramid scheme, it is forecast to start floundering when the glut of baby-boomers shift from paying-in status to receiver status. Its costs are 900% worse than the original worst-case scenario! Meanwhile, it doesn't cover drugs, and more and more doctors are refusing to even see patients who are in Medicare, because the government payment is so low.
Look at military veterans. When the brave soldiers, sailors & airmen signed up to go to war for their country, they were promised lifetime medical care as a benefit. The government pulled the rug out from under them. The government promise of universal coverage for them turned out to be an empty lie.
All of this should set off alarm bells in your mind against government schemes designed to give universal care or coverage to some group. Not only do these government universal offerings look like sinking ships, but it is clear that government can and will change its mind and change the deal once they have the people captive.
We the people are even more of a problem in the health scenario. We have a gigantic hypocrisy and disconnect with reality. We don't know what true health care costs are, and we certainly don't feel we should have to pay it ourselves. We don't have this mental distortion of unrealistic expectation with any other consumer product.
We believe that we deserve the absolute best womb-to-tomb instant health care. We think it is our "right". Any entity that does not generously pay for all the health care we would like to have is roundly and emotionally condemned (such as employers, government, charities, etc.)
On the other hand, the record is clear that we-the-people do not put our money where our mouth is. A recent article had a very typical example. It was a tear-jerker account of a young man bemoaning living with no health insurance while he is job-hunting. However, while wiping your tears for this man, consider his value judgement. When asked why he did not buy individual health coverage, he said that it was not a priority and not worth it to him. How's that for a hypocritical disconnect between his expectations and willingness!?!?! Government programs to help people help themselves in times of being uninsured, such as COBRA and CHIPS, have had much lower participation than the hype would lead you to think would be.
For a people who say how concerned we are about the costs of health care, we sure do a lot of counter-productive things to our bodies. We smoke too much, drink too much, abuse drugs, eat too much, do dangerous sports, and pursue questionable medical fads. All of these dramatically increase the frequency & cost of health care.
The sad truth of our hypocrisy is that we want (feel entitled to) top-dollar womb-to-tomb open-ended instant health care….HOWEVER, we do not think it is worth paying if it is out of our pocket. Someone else should pay the price, and we certainly should not feel obligated to do anything to allay or have any responsibility for our actions raising those costs. Even if we said that we wanted to provide everyone womb-to-tomb unlimited health services, there is not enough money in the world to achieve that over the long term.
This is not what anyone wants to face about ourselves. This is tough-love truth. More importantly, this reality must be the test and measure applied to any and all rosy-sounding universal coverage proposals. The politicians are just looking towards today's headline and the next election. Responsible people will need to do the serious thinking; to apply the effects of human psychology (expectations) and economics 10-20-30 years ahead. Falling for the hype and wishful thinking of grandiose proposals for universal coverage is just bad medicine.