The Agenda

We’re Slowly Nationalizing Health Care

Slate’s Moneybox columnist Daniel Gross offers an interesting take on insurance coverage, one that takes into account the role of public sector employment. 

The system of employer-provided health care coverage is crumbling before our eyes, and for more Americans—and for more American insurance companies—government-funded health care is all that separates them from financial disaster. A Gallup poll found that the percentage of Americans who say they get their health insurance from an employer has fallen from 58.9 percent in January 2008 to 56.5 percent in May 2009, while the percentage who get it from the government (Medicare, Medicaid, VA benefits) has jumped from 26.5 percent to 29 percent. (The rest purchase it on their own.) But this poll understates the case. About 17 percent of payroll jobs today are government jobs. Crunch the numbers, and it’s more like 39 percent getting insurance from government sources (public programs and public-sector jobs) and about 47 percent from private-sector jobs.

Simply by doing nothing, we’re slowly nationalizing health care.

This is part of the reason why I’m so sympathetic to root-and-branch reform. Some will object that Obamacare will simply accelerate the process Gross describes. But other reform approaches can take current public spending and redistribute it in such a way as to deliver better outcomes across the health system; this is the basic goal of the Luft approach, and also that embraced by Graetz and Mashaw in True Security. My sense is that the Luft plan would be more politically viable.  

Reihan Salam is president of the Manhattan Institute and a contributing editor of National Review.

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