Government-Run Health Care Is Here

Andrea Stone

WASHINGTON (Dec. 8) -- So what if the Senate ditches the public option? Even without so-called "socialized medicine," there still will be plenty of government-run health care to go around.

Never mind that the public debate and advocacy ads depict nightmare scenarios of "government bureaucrats" denying medical care, the recent controversy over breast cancer screening being only the latest. Taxpayers already cover nearly half of the nation's health care spending.

The government paid 46.2 percent of medical bills in 2007, according to the federal Centers for Medicare & Medicaid Services. By 2016, under current law, taxpayers will bear more than half.
Federal, state and local governments combined shell out more than $1 trillion a year for health care. That's an estimated $3,871 this year for every man, woman and child -- regardless of whether they get direct government help.

Consider:

• Medicare, the federal health insurance program for nearly 43 million seniors and disabled people, will cost the government more than $500 billion this year alone. It remains wildly popular even though government experts say the program is hurtling toward bankruptcy unless premiums or taxes are raised or costs brought under control.

During the height of the public tizzy over "death panels" last summer, President Obama spoke at an AARP town hall about a letter he received from a woman decrying "socialized medicine" and warning, "don't touch my Medicare."
"That's what Medicare is," Obama said with a chuckle. "A government-run health care plan that people are very happy with."

One option being considered in Congress is to allow uninsured people between ages 55 and 65 to buy coverage through Medicare.

And Tuesday, the government announced that for the first time Medicare would cover the cost of HIV screening.

• Medicaid, the state-administered program for low-income people, will cost taxpayers $386 billion this year to provide health care for more than 42 million people. Some of those are poor seniors and people with disabilities who also get Medicare.

Another idea being debated is to allow more people to qualify for Medicaid.
• Other government programs. In 2007, the federal government spent $137 billion to provide health care to veterans, children, Native Americans, active-duty military members and their dependents, and drug users.

Tax dollars also went to fund public health services, federal workers' compensation and maternal and child health programs.

"The government has a pretty substantial role, no doubt," said John Holahan, director of the Urban Institute's Health Policy Center. And most are happy with the care they receive.
"People are very satisfied with Medicare," said Holahan, citing numerous surveys. "If you begin to talk to veterans about giving up (VA health care) and getting private insurance, they go ballistic."

The taxpayer-financed share of health spending is near 60 percent, Steffie Woolhandler and David Himmelstein of Physicians for a National Health Program wrote in a recent paper in the journal Health Affairs. They note that federal estimates don't include health care-related tax subsidies and public employee health benefits.

In the United States, "tax-financed costs exceed total costs in every nation except Switzerland," Woolhandler and Himmelstein wrote. That's hardly a hands-off approach.

Federal income-tax subsidies for health care, including the hotly debated exclusion of employer-provided health insurance from taxes, reached $186 billion last year, Holahan wrote in a paper with Stan Dorn last year. That exemption helped 61 percent of those under 65 pay for their health care.

Indeed, "only 5 percent of the insured population in the United States does not receive some kind of government subsidy, either directly or through a tax benefit," Holahan and Dorn wrote.

No wonder some call ours a "health care nation."