Socialized Medicine for Seniors and Children: Are You Next?

Today’s young adults may recall the famous “Harry and Louise” ad campaign that assisted in halting President Clinton’s 1993-94 proposal to create a government-financed health care system in the United States. But the push to establish government-sponsored universal health care did not end in Harry and Louise’s kitchen. Efforts to establish government- sponsored health care are stronger now than at any time in the past. The only differences are that today socialized medicine is being successfully implemented and it is occurring with little or no public debate.

Most American seniors already are forced into government health care. Medicare’s “Part A” program is a mandatory hospital insurance program that covers the majority of the nation’s elderly. Medicare Part A originated in 1965 as a health insurance plan that promised not to interfere with the right of seniors to purchase private health insurance. Today, however, seniors covered by Medicare are forced to drop their primary health insurance and prevented from seeking medical care privately.

A recent judicial decision ruled that seniors participating in Medicare do not have a right to pay privately for their own Medicare-covered health services. Meanwhile, most seniors are unable to opt out of Medicare if they receive any Social Security benefit–even if there is a recognized religious or philosophical reason. Once an individual begins receiving a Social Security benefit–retirement, survivors, or disability–he may opt out of Medicare Part A only after repaying all benefits received from both Social Security and Medicare Part A.

The result has been that most seniors are forced into government-sponsored health care and have lost their legal right to pay for health care services privately. The Medicare program offers seniors health care rationing, reduced health care choice, and compromised quality of care. According to a recent government audit, the cost of fraud and abuse alone exceeds $54 million per day.

As tyrannical as it may seem to force seniors into government-sponsored health care, children’s health may already be traveling down a similar, dangerous path.

The government Medicaid program, which provides medical assistance to low-income families, is rapidly evolving into a middle-class entitlement program that could soon replace private insurance for our nation’s children. One-quarter of America’s children already participate in the government program.

School clinics have long delivered first-aid and emergency care. But that has changed as school-based health centers have expanded their missions, adding a broad array of services such as psychological and reproductive counseling. Today, more than 900 school-based health centers are operating in all but seven states and most have established mechanisms to deliver and finance health care services in public schools using Medicaid funds.

Under the new State Children’s Health Insurance Program (SCHIP), passed by Congress and signed by the President as part of the Balanced Budget Act of 1997, states have several options for spending $48 billion in new federal health care funds to cover uninsured children. Most states are using this money to expand Medicaid to cover uninsured children.

While efforts to expand health care access and affordability for children’s health may be well-intentioned, this current trend could have serious unintended consequences. Evidence already exists that Medicaid expansions affect private health insurance coverage for children. According to Harvard University and Massachusetts Institute of Technology health economists, families substitute Medicaid for their children’s private health care coverage.

By creating or expanding school-based health clinics and providing government-sponsored health insurance for children, government health care programs could encourage families to drop their private health insurance, reduce health care choices, infringe upon parental rights, and threaten medical privacy. School-based health centers give public schools broad responsibility and considerable latitude regarding medical treatment and psychological and reproductive counseling of children–trumping what should be a parental responsibility.

Another concern with school-based health care is the lack of health privacy. In many cases, children are subjected to intrusive physical examinations and psychological testing without parental consent. Health information and records can then be shared between state government agencies, again without parental consent.

The framework of socialized medicine for children is becoming entrenched at the federal and state levels. It is not difficult to envision how a children’s health care system, delivered through the public school system and financed through Medicaid, could evolve into a socialized health care system for all American children in the same way Medicare has evolved for seniors.

The same type of government-sponsored health care plan that Americans resoundingly rejected in 1994 is being implemented on an incremental basis. First it happened to seniors and now it’s happening to children. Are you next?

More than one quarter of the nation’s 31 million workers under age 30 lack health insurance–that is the highest uninsured rate for any age group of workers. One reason for this is that in the United States health insurance is virtually owned by employers, not employees. This comes as no surprise because federal law exempts employer-provided health insurance from taxation, but does not exempt income that goes toward individually purchased health insurance.

Today’s young workers are the most entrepreneurial generation in the 20th century. More young workers are starting their own businesses or choosing self-employment than at any time in the past. Another large segment of today’s young workers are employed in temporary-service jobs and in the restaurant sector where many of the employers do not provide health care benefits. For all of these workers purchasing health care on their own, with after-tax dollars, health insurance can be prohibitively expensive. At the same time, workers in this age group are typically healthy. Thus, it is understandable that forgoing health insurance is a low-risk option for young, entrepreneurial professionals.

Recent studies from the Cato Institute and The Heritage Foundation show that providing favorable tax treatment for individuals who purchase health care on their own would help alleviate the problem of the uninsured in this country. For example, a tax credit paid directly to individuals who do not receive employer-provided health care could be used to purchase health insurance, health care services, or to create a medical savings account. In this way, health care for young workers would be more affordable and they would retain control over their own health care decisions.

Our health care “crisis” must be understood and addressed with free-market solutions if we are to avoid fates similar to those of seniors and children. Today’s young workers should know about and debate the government’s role in providing health care before we become the next group of Americans forced into government-run health care.

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