As has been noted here repeatedly, health care could be made more affordable and more easily accessible for millions of Americans with incremental changes that don’t drastically alter the fabric of American life. But many proponents of health care seem determined to squander America’s future. This debate is about fundamental change to our system, not just providing better health care. Robert Samuelson today explains how the proposed changes could usher in a future of reduced standards, something decidedly different from the always-brighter future American has always offered the next generation:

Are we condemning our children to downward mobility?

Good question. Considering how health spending could threaten future living standards, it ought to be center stage in the “reform” debate. Instead, it’s ignored. An oft-stated view is that the growth of the U.S. economy will make the young so much richer than their parents that they can afford a bigger health-care sector and still enjoy large increases in their living standards. Complaining about providing more generous health care is selfish. This is a powerful argument; unfortunately, it isn’t true. …

Downward mobility is possible. Expanding health spending would raise taxes (to pay for government insurance), lower take-home pay (to pay for employer-provided insurance) or increase out-of-pocket medical costs. Other drains also loom: higher energy prices to combat global warming; higher taxes to pay for underfunded state and local government pensions and repair aging infrastructure; higher federal taxes to cover deficits and payments to retirees (much of which reflect health spending). The pressures will undermine private living standards and other public services (schools, police, defense)….

The road to downward mobility is paved with good intentions. The health debate has focused on insuring the uninsured and de-emphasized controlling runaway spending, much of which is ineffective. The priorities should have been reversed. The chance to reorder the medical-industrial complex to restrain costs and improve care has been mostly squandered. Some call this “reform”; no one should call it progress.