Health Care Rights and Responsibilities

Published August 17, 1994

Most politicians in Washington and many citizens believe “universal coverage” is a proper goal of health care reform. According to a recent poll, 62 percent of Americans believe achieving universal coverage would justify imposing government price controls on medical care and insurance. Unfortunately, the rhetoric of universal coverage is far more appealing than its reality.

Universal coverage is not a gift. We would all have to pay for it, some of us through our taxes, others by the loss of our jobs. Moreover, universal coverage is not voluntary. It is a mandate, like the military draft. The president proposes a mandatory na tional identification card–the “Health Security Card”–something Americans have opposed ever since we saw Adolph Hitler use them to track and exterminate “undesirable” people in Nazi Germany.

Under a plan of universal coverage, what we pay for health care would have little relationship to our demand for health care. Quite naturally, many of us would use more health care services than we really need. Unless the U.S. resorted to health care rati oning (as have Canada and Britain), a universal coverage plan would face insurmountable cost overruns and could quickly bankrupt America. As pundit P.J. O’Rourke has said, “If you think health care is expensive now, wait until it’s free.”

The Clinton Administration’s proposed health care plan would cover a wide range of services . . . yet it won’t necessarily cover the kind of health care an individual might want. And once the budget deficits begin to balloon, benefits will be cut further and further until we are all left with “bare bones” coverage. “Universal” cannot mean “unlimited,” even for a government that regularly runs hundred- billion-dollar deficits.

Universal coverage will not give American citizens a “right” to health care. It will force us to accept one-size-fits-all health care that cannot possibly suit our individual needs and preferences. And it will punish us with fines and even prison sentence s if we try to go outside the government program to get the services we want.

Universal coverage would require government price controls. Remember price controls? They destroy not only economic freedoms, but personal freedoms as well. They create shortages and lead to rationing, black markets, evasion, fraud, and corruption. They a lways favor the well-connected and politically privileged. There is no better way to limit choice and destroy freedom than to control prices.

Many politicians recognize that universal coverage would be a singular disaster. But they support it anyway, because their polls and “focus group” meetings tell them the concept is poorly understood and very popular. Some politicians prefer a takeover of the health care industry, and they correctly see universal coverage as a means to this end. Universal coverage would be the first big step toward increasing the government’s control over Americans’ health care benefits and coverage.

There is little doubt that the rhetoric of universal coverage makes good politics. But the reality makes very bad policy. Unless Americans reject this notion now, we’ll be stuck with it for the rest of our lives.

Eric Banfield is a policy analyst for The Heartland Institute and owner of Banfield Analytical Services.