We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
What most Americans identify as government "welfare" are payments to single mothers, food stamps and (perhaps) Medicaid, the federal-state health insurance program for the poor. But that's not the half of it. Since 1960, government has changed radically. Then, 52 percent of federal spending went for defense, 26 percent for "payments for individuals" -- the welfare state. By 2008, 61 percent consisted of "payments for individuals," 21 percent for defense.
Social Security and Medicare -- programs for the elderly -- represented the lion's share: $1 trillion in 2008. Most Americans don't consider these programs "welfare," but they are. Benefits are paid mainly by present taxes; there's little "saving" for future benefits; Congress can alter benefits whenever it wants. If that's not welfare, what would be?
Pressures on private and public welfare won't abate.
This is what Tait Trussell of the Acton Institute wrote in an article just last week:
“[I]n just three years from now, Social Security and Medicare will need one out of ten tax dollars, John Goodman, president of the National Center for Policy Analysis points out. And just 11 years in the future—by 2020—Uncle Sam will need one out of every four income tax dollars to fund these programs for seniors. If we continue with all other government programs in operation today and raise the taxes to pay for Medicare, plus Medicaid—the health program for low-income folks—the Congressional Budget Office estimates a middle-income family by the middle of this century will have to pay two-thirds of its total income in federal taxes.”
This situation defines the term “unsustainable.” Why is not President Obama proposing a “fix” to avert this approaching catastrophe? Curiously enough, not only he is unconcerned, but he seems to think that the unviable entitlements constitute some sort of achievement. This is what he said about them in Chicago:
Presidents have called for health care reform for nearly a century…But while significant individual reforms have been made – such as Medicare, Medicaid, and the Children's Health Insurance Program – efforts at comprehensive reform that covers everyone and brings down costs have largely failed.
The president apparently believes that these failing federal programs already represent reform and that all that is needed now is to create something that would quickly become the mother of all entitlements – governmentally guaranteed universal healthcare.
Americans should really worry when their president fails to recognize the real dilemma we face as a nation: Either we reform entitlements or we let them drag us down the dark pit of insolvency.
"efforts at comprehensive reform that covers everyone and brings down costs have largely failed"
That has two parts.
Comprehensive reform? No you mean mandated change. Not everyone is getting their medical care through a government program. Even in part.
But in various ways government funds already get into almost all of the macro health system - clinics, hospitals, emergency care, laboratories, medical research, drug development.
So most medical care does involve some government spending. The spending is just not targeted at any individual.
The new plan amounts to this: your doctor will consult with a bureaucrat about your care, its expense, etc. And the bureaucrat will decide if you specifically are worth it.
But government workers and union workers (and no doubt other favored groups will be found, they always are) will continue with their own better plans.
I offer an alternative. Federalize all public employees medical plans. And include employees of federally controlled entities, the Post Office, the TVA, the FDIC. Toss them all in.
One plan from Alaska to Florida. And when I say "all employees" I mean all. Teachers, city councils, police, judges, janitors, and public health workers. The staff and faculty of every public university and college. And every government retiree. For every jurisdiction from the smallest water district to the TVA and Fannie Mae.
That plan would face constitutional challenges. But today there seems no limit on what the constitution allows. So just do it; abolish the huge variety of plans for public employees and reap the massive savings.
We would then have a standard plan that covered perhaps thirty million employees and seventy million including their dependents. It should save a lot of money by Obama's math. Or would he contend such people are already in the most cost efficient and effective plan possible?
Run the plan for five years. Let the cooks taste the soup.
Then use the lessons learned to set future medical policy.
I suspect the rest of the US can limp along for five years. And as the huge benefits of the New Medical Order become apparent everyone will clamor to get in.