Ronald Brownstein argues that it’s time to revisit universal health coverage:

Ten years ago, a vicious cycle of rising prices and declining access forced health care to the top of the national agenda. Now that destructive spiral is spinning again — with the same result.

Everywhere signs are proliferating that the health-care system is breaking down under the same pressures that inspired President Clinton’s ill-fated crusade to guarantee universal coverage.

Three consecutive years of double-digit increases in health insurance premiums are straining employers and igniting conflicts with employees asked to bear part of the burden. Health-care costs have become a growing factor in labor confrontations, like the two bitter strikes underway in Southern California.

The rising costs are also compelling more employers to stop offering health coverage at all — and more employees to decline it even when it’s offered. Since President Bush took office, the number of Americans without health insurance has soared by 3.7 million, to 43.6 million, the biggest two-year increase since his father was president.

These problems of cost and access are inextricably connected. It’s easy to see how rising costs translate into reduced coverage. But the reverse is also true. The growing number of Americans without insurance means that doctors and hospitals have to provide more uncompensated care that must be subsidized by the premiums of those with insurance. As Bruce G. Bodaken, chairman and president of Blue Shield of California, put it in a speech last winter: “In essence, we are charging the private health-care system a hidden tax, a tax that can’t be sustained.”

Brownstein assesses the plans offered by the current crop of presidential contenders–including George W. Bush–and finds them all flawed.

One promising model might be the plan that Bodaken of Blue Shield proposed last winter that would impose a mandate on employers to provide coverage, a mandate on individuals to purchase coverage (which solves the problem of the young and healthy skewing the risk pool by opting out), and provide government subsidies for both.

In an economy that already spends $1.6 trillion on health care, the cost of universal coverage is almost trivial: about $75 billion more a year. But it won’t be possible to find those funds unless business, individuals and government all shoulder their share of the load.

Of course, figuring out what “their share” is has been precisely the issue.

FILED UNDER: Health, , ,
James Joyner
About James Joyner
James Joyner is Professor and Department Head of Security Studies at Marine Corps University's Command and Staff College. He's a former Army officer and Desert Storm veteran. Views expressed here are his own. Follow James on Twitter @DrJJoyner.


  1. Paul says:

    Did anyone else notice the media is suddenly running more healthcare stories and many of them plug universal healthcare?

    When was the last time that happened??? OH YEAH, When Hillary failed to take over 1/7th of the U.S. economy and wanted to send you to jail if you went to the doctor you chose.

    Now Hillary *says* she is not running… And we know what a paragon of virtue she is. [The fact she keeps showing up at the dwarf’s parties and stealing the spotlight is sheer coincidence.]

    But watching the media, it is obvious they are trying to make Healthcare a “crisis” again and are selling socialism as the cure. Just in time for the election…

    Of course the media would NEVER do anything like this… Would they?


    And to show what a twit this guy is…

    But it won’t be possible to find those funds unless business, individuals and government all shoulder their share of the load.

    Government and business don’t have money… Individuals do. The “three sides” are just one side. The other 2 are there to make you think you are getting something for free.

  2. Anonymous says:

    We should also have business and government provide Universal Food Coverage and Universal Housing Coverage since these things are needed even more than health care.

    I mean, housing costs are doing nothing but escalating and it is nearly impossible for a young worker to afford a house. And what good is healthcare is you have nowhere to live?

    In fact, why don’t we just get rid of salaries all together? We will have people work, and then all resources produced by industry will be shared by everyone. Those who need more will receive more and those that produce more will provide their extra share to everyone else.

    It’s a BRILLIANT idea!

  3. James Dasher says:

    I can’t help but wonder whether insurance prices would spiral out of control if the federal government and the states didn’t require employers to offer it under a number of circumstances. Insurers have a guaranteed market, legislatively elevated near the top of any consumer’s list of economic preferences.

    There’s nothing wrong with people – “young people” in this case – opting not to purchase health insurance, any more than there’s something wrong with people – young, old, middle-aged, fat, brown-eyed, whatever – opting not to purchase a TiVo, or a Honda, or Windows XP. Blaming young people for opting out of the governmentally-aided insurance scam is like blaming an arson victim for deciding not to live in a wood shack.