When it comes to healthcare, liberals have an end game. They are patient. And they are willing to coordinate a grand strategy at the federal, state and local levels. That endgame is socialized medicine. They are using incremental means to get there. The strategy is this: slowly destroy whatever is left of the insurance market – piecemeal – until citizens demand that the whole system be scrapped. All the while, they will insist the failure is one inherent in private insurance, rather than in the distortions and problems caused directly by state regulation.
In this grand strategy, Medicaid and Medicare are the foundations – the given. Medicaid is for the very poor. Medicare is for the old. Each represents state provision of healthcare at the bookends*. But there is the population in between that is covered by the heavily regulated (but still private) insurance market. That market is more a series of isolated, state-locked, protected monopolies than a market, but it is still private. In any case, if you want socialized medicine, how do you make the current system even worse?
Find wedges that drive a "death spiral"—i.e. the vicious circle of prices going up resulting in the slow deterioration of the private healthcare market. One example of such a wedge is “children.” First they called for Medicaid for all poor children. Now they are calling for Medicaid for all middle class children. Soon they will call for universal healthcare for children (nevermind this apparent distinction). And children will be defined very broadly (in some states up to 26 years of age). So why children?
Politically it is difficult for anyone to deny any proposal offered in the name of children. Moreover, children are low risk because most are young and healthy. If you remove children from the insurance risk pool, older, sicker people remain. Since expanding Medicaid to children means removing more and more children from the risk pool, premiums of the remaining older, sicker people will go up, because that group is riskier. Soon the premiums get so expensive more people—particularly “young invincibles” opt out and cry out. They don’t understand the political machinations that got them to this point, only that insurance is too costly. Soon politicians will offer to take away their pain in exchange for government control of healthcare. Right now we are in the stage where people are crying out. “45 million uninsured” they cry, or simply “we can’t afford it.”
When you couple the incrementalism of children being lured from the risk pool by expanded Medicaid, the addition of costly state coverage mandates, and many other regulatory cost-drivers, healthcare becomes a vice designed to tighten the population until the population submits. Submission is socialization. That’s it. That is the grand strategy and the end game and it must be stopped. Socialized medicine – arrived at piecemeal via the political use of children – will offer us much less than people might wish for. Socialized medicine is a system that cannot exist without rationing, waiting lists, the denial of choice, and tax increases the likes of which we’ve never seen.
Am I being overly conspiratorial? You be the judge.