Re: Regular * Folks * United – 2/16/2009 – “Democrats: Hey, Let’s Destroy Health Care So We HAVE To Fix It” – Tabitha Hale

We should note that the issue of universal child health care is very different from the issue of universal adult health care.

In a democracy like ours, all adults are presumed by society and in law to be in control of actions affecting their own wellbeing, and the only steps government should take in limiting adults’ personal choices in action are to protect others from the direct effects of the actions. There are some arguable exceptions to this, prominent among them the legal prohibition of the personal use of dangerous drugs and of suicide, but in general, we should all be pretty much free to behave in any way that does not materially hurt others.

In a democracy like ours, adults, presumed responsible for the effects of their actions on themselves, should be allowed to reject health insurance but at the same time be expected to demand no medical treatment when they cannot afford it. Government shouldn’t provide health care financing for those who don’t want it, either before or after the health care is needed.

We should note that if there is universal health care for adults, someone has to pay for it. Health care is expensive and leaving payment for those who choose to be uninsured to all of us is preposterous --- the insured would end up paying for their own health care as well the health care of those who, because of lack of insurance, could not afford to pay for their own health care. The financial burden of paying for our own health care (either thru insurance premiums or on a cash when needed basis) is nearly unbearable. The financial burden of paying for our own health care and someone else’s would be unbearable.

That’s why we do not have universal adult health care insurance --- the only affordable way to finance it is to make those with insurance stop paying for their own insurance and instead pay into a pool insuring us all. Although there are ways to do this efficiently and effectively without government intrusion into medical services covered by health care insurance, they will probably never be implemented in our current bimodal political climate. Despite claims of the necessity of universal health care insurance by some of the political left in our country, a significant fraction of the political left and a strong majority of the political center and right do not support any universal health care insurance proposal.

But children are another matter. Children are presumed by society and in law to be incompetent to make some decisions for themselves and adults must make these decisions for them. Parents are assumed to be the decision makes for their children, but under certain circumstances (for example, when there is child abuse present) government must be able to override the decision making power of parents. Perhaps failure to provide adequate funding for health care for a parent’s children is a failure in a parent’s responsibility that, like abuse, requires government intervention.

While the arguments against universal adult health care payment proposals are compelling, the arguments against child universal health care payment are less so. But the same major financing problem that has doomed universal adult health care coverage to date dooms past attempts to implement universal child health care insurance --- parents who pay for their own children’s coverage cannot afford to pay for coverage for others’ children. Hawaii did not adequately face that problem and until government recognizes that problem, universal child health care will not work. But that doesn’t mean it can never work.