One of the mantras of the opposition to meaningful health reform has been a fear of a government takeover of the health care sector. This fear is expressed virtually nonstop on talk radio, the right wing blogosphere, Fox News and at town hall meetings across the country. As we know, for better or for worse, the Obama administration is not proposing a government takeover of the entire health care system, but overstatement and exaggeration is unavoidable in these kinds of debates.
The image of government takeover of health care is meant to strike fear into good market oriented Americans who believe the government can do nothing right, particularly in an area as difficult, personal and important as health care. The fear of government involvement in any aspect of our life is a deeply held American value which allows us to continue to believe in the myth of small government. It is any easy fear to exploit even when speaking to people who have good jobs because they studied at public universities, know their parents have enough to eat because of social security, drive to work on federally funded highways and generally live in the 21st century industrialized world.
Nonetheless, opponents of health care reform believe fear of government involvement in health care to be something shared by all Americans. Before we collectively start quaking in fear of a government takeover of health care it might make sense to slow down and consider that a fair amount of our health care system already has strong government involvement.
Old people, some poor people and veterans already have government supported health care through Medicare, Medicaid and various veterans benefits. These programs are, of course, far from perfect, but they are pretty good. While many seniors would like to see Medicare reformed, it is rare to see senior citizens, or organizations of senior citizens call for abolishing Medicare. Similarly, many veterans, some who served decades ago rely on veteran's hospitals for an important part of their health care. My father is a veteran who voices more than the occasional criticism of the US government, but I have never heard him say that he wishes veterans didn't get any health care or that the government should close the veterans hospitals.
Senior citizens and veterans are both well organized and powerful interest groups, representing tens of millions of Americans, but government involvement in the health care sector has hardly caused any pubic outrage among these two key constituent groups. On the contrary, both usually push very hard for the expansion of Medicare and veterans benefits. If the American people really wanted government out of the health care industry, or if the government was unable to play a useful and positive role in the delivery of health care, it is pretty likely that these groups would have made a lot of noise about this issue years ago, but they have not.
Medicaid recipients are not as well organized as either veterans or senior citizens, but recipients of Medicaid very rarely argue for weaker Medicaid programs or less involvement by the government in providing health care services. Again, the opposite is true. Recipients of Medicaid have often shown a preference for bigger programs with more government involvement.
Medicare, Medicaid and veterans' benefits have become an indispensible part of our health care system providing valuable services and benefits to people, many of whom would have very few health care options were it not for these government programs. This is something which should be kept in mind when scare tactics about government takeover of health care are used. These programs also demonstrate the inaccuracy, or perhaps nuttiness, of some of the more outlandish claims about Obama's proposed programs. For example, if the government were really going to ration health care or set up "death panels" as part of government health care programs, wouldn't the government have started by doing these things to the poor, the elderly or disabled veterans-precisely the people who rely on the government for health care today.
The Obama administration, of course, is not proposing a full government takeover of the health care system, but they are proposing increased government involvement in health care. An incremental change of this kind, while likely to make a tremendous difference in the lives of some, although unfortunately probably not all, of those currently uninsured, is simply not a radical measure. It does not represent a new way of paying for health care services in the US, but a readjustment to the relative balance of the public and private sectors in health care and a way to leave fewer people with no health care at all, which is what most Americans really fear.