Earlier I wrote about the Obama administration's possible
backing off of the inclusion of a so-called "public option"
in health care legislation. But what's important to emphasize is
that even without the creation of a new government plan, we could
still be stuck with a government-run health care system. First
off, at this point, we don't know how this idea of a non-profit
co-op would work -- under some versions, it could easily become a
de facto government plan. Even setting that aside, however, the
reality is still troubling. The remaining parts of the proposals
in Congress would leave us with a system in which government
mandates that individuals buy insurance or pay a tax and that
employers offer insurance or pay a tax. Then government would
have to define what constitutes insurance. Medicaid would be
expanded dramatically. The government would be providing
subsidies to individuals to purchase insurance, but even if
individuals don't qualify for subsidies, at least under the House
bill, they would be forced to purchase their insurance from a
government-run exchange. And though the policies offered at this
exchange would be nominally "private" they would be designed by
government bureaucrats. In the Senate Health Education Labor and
Pensions bill, a new Medical Advisory Council would be tasked
with defining “qualifying” coverage; in the House bill, all
Americans are required to have coverage that is deemed
“acceptable” by a Health Choices Commissioner. No doubt, the
creation of a new government-run plan is the easiest way for the
country to evolve into a pure single-payer system, but even
without one, the proposals being considered would give us a
system in which individuals would be forced to purchase
government-designed insurance polices from a government store.
