Health care for all is a national need

by Lesley Politi on October 27, 2008

Health care for all is a national need

The issue: A proposal to expand health-care coverage to the uninsured never made it out of the state Legislature.

Our opinion: The effort is laudable, but we need universal health care, which is a national responsibility.

How much is health worth? The answer could well be, “It’s priceless,” but there’s a catch: When it comes to health care, the first question that comes up is price, because good health depends on good health care, and that’s expensive.

Cost is why a plan proposed by Gov. Ed Rendell to extend health insurance coverage to 270,000 uninsured adults in Pennsylvania, recently perished in the Senate. The plan, known as Pennsylvania Access to Basic Care, would have cost between $723 million and $857 million by the end of the 2012-13 fiscal year, according to the administration.

Opponents questioned the affordability even of the scaled-back version. Sen. Edwin B. Erickson, chairman of the Senate Public Health Committee, stressed that the program had to be “sustainable,” that is, fundable with no new taxes.

The administration countered that the plan could be funded by one of two options that use a combination of existing state revenue and federal money without raising taxes.

The tug of war in Harrisburg is another reminder that states are trying to fill a role best left to the federal government: providing universal health-care coverage to its citizens.

That the governor and Legislature want to help the uninsured is praiseworthy, but even the most well-intentioned effort is at best a stopgap. While 250,000 uninsured adults would have been served by the new program in Pennsylvania, what about those not included? Are they less deserving of adequate health care?

Ultimately the answer is that the inclusiveness is not a function of our compassion but of the state’s financial resources, which of course derive from taxpayers. In order to keep the system from being swamped like an overloaded boat and taxpayers from being stuck with the bill, the state needs to establish a cut-off point.

It’s even arguable that an excessively generous system would attract people from out of state, especially those with urgent and costly health-care needs, which would sink the boat even faster.

That’s why universal health care has to be a national responsibility: because only the federal government can provide uniformity. It has already done so with Medicare, which is a lifeline for our elderly, and with Medicaid, which serves the poor.

Yet the system is haphazard. More than 46 million Americans live without health insurance, among them retirees whose benefits have been cut by companies in dire financial straits and others who have been laid off. And with the current economic downturn and predicted recession, more people undoubtedly will lose their jobs and with them their health insurance.

But at the federal and the state levels, the biggest obstacle is financing. We have written before about our country’s need to establish universal health care; since then, the financial hurdle has grown even higher. As tax revenues drop because of the economic downturn, and the expense of bailing out the financial sector is added to the cost of the wars in Afghanistan and Iraq, universal health care seems even farther out of reach.

But eventually the bailout will be paid for, the money recouped, and the troops will come home. Let’s be ready for that day. It has been more than 15 years — at the start of President Clinton’s first term — since universal health care was the center of a national discussion. Let’s put universal health care back on the national agenda, because deciding what we can afford, how it will operate and setting it up likely will take years.

As the only nation in the industrialized world without universal health care, we have to bring the subject to the fore. We cannot continue to put off the health of more than 46 million people.



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