We often talk about government taking over health-care under the current Democratic plans. In a must-read column, economist Robert Samuelson explains how we got that precisely backwards:
What’s happening is the reverse, which is more interesting and alarming: Health care is taking over government. Consider: In 1980, the federal government spent $65 billion on health care; that was 11 percent of all its spending. By 2008, health outlays had grown to $752 billion — 25 percent of the total, one dollar in four.
Even without new legislation, the health share would grow, as an aging population uses more Medicare (insurance for the elderly) and Medicaid (the joint federal-state insurance for the poor, including the very poor elderly). Obama would magnify the trend by expanding Medicaid and providing new subsidies for private insurance. Thirty million or more Americans would receive coverage.
So maybe the Democrats should slow down? No, remember all that stuff about “fundamentally” changing America? Well, Samuelson, points out, this health-care legislation is the stealth way to do that:
All this is transforming politics and society. The most obvious characteristic of health spending is that government can’t control it. The reason is public opinion. We all want the best health care for ourselves and loved ones; that’s natural and seems morally compelling. Unfortunately, what we all want as individuals may harm us as a nation. Our concern sanctions open-ended and ineffective health spending, because everyone believes that cost controls are heartless and illegitimate. The recent furor over proposals to reduce mammogram screenings captures the popular feeling.
The other disturbing consequence was foreshadowed in the president’s recent Afghanistan address (in which the biggest-spending administration in history worried over the cost of the war):
One consequence is a slow, steady and largely invisible degradation of other public and private goals. Historian Niall Ferguson, writing recently in Newsweek, argued that the huge federal debt threatens America’s global power by an “inexorable reduction in the resources” for the military. Ferguson got it half right. The real threat is not the debt but burgeoning health spending that, even if the budget were balanced, would press on everything else.