Essay by:
Michael Schapiro
American University

Our nation’s health care system is broken. While America tops lists for health care quality, each year Medicare and other health care programs continue to spiral our nation further into debt. As Congress debates the correct method to bring reform to our failing health care system, many are wary over the future of federal fiscal spending and how any health care reform would factor into government spending. Unfortunately, without a major overall or change of philosophy in how our government attacks fiscal policy, there is no easy way to get our nation out of debt.

While fiscal responsibility now ranks among Americans’ top three issues they care about, it continues to take a back seat among many politicians and average American citizens. When discussing policy and legislative action, we seem to think about the end goal before we think about how we will get there. For example, in our health care debate there are three main issues: (1) amount of coverage, (2) affordability, and (3) the overall size of the program. Despite the size and cost of a government-run single payer system or a public insurance option, many continue to advocate for these programs simply because they offer the best chance of covering Americans who wouldn’t otherwise have been able to afford health insurance. This mentality is not shocking, but it is worrisome as our country prepares to deal with the unenviable failure of Medicare and Social Security.

Even though 37 to 47 million Americans go without health insurance, the focus of health care reform is finally being shifted from the ends to the means. As was said before, one would be hard pressed to find someone who did not want to see every American covered by health insurance, however, the major problem is: who is going to pay for it? Right now, it seems there are three options: a full government system, a government intervening system, and a free market system that keeps the government on the outsides, for the most part. A full government run “single payer” health care system seems to be the most expensive option right now as it would cost the nation well over one trillion dollars to put in place the system. A semi-governmental system with a “public option,” which is being debated in Congress, would most likely cost 900 billion dollars. A free market system would most likely cost less than 400 billion dollars.

So why do Americans want to chose the options that are most likely to add to our national debt? As was said before, most Americans do not think about the fiscal consequences of legislative acts. Put simply, Americans have been spoiled since 1945 in terms of the outcome of legislative action. In the late 1940s and 1950s, there was a mixed amount of legislative action, with positive results including legislation that created the Central Intelligence Agency and the Department of Defense, as well as the first Civil Rights Act and the expansion of a national highway system. Following in the 1960s we saw many programs under Lyndon B. Johnsons, including Medicare, that were quickly very successful for the population. Up until the 1970s, Americans were very happy with the work Congress had been doing. As financial problems took their toll on America, the people began to be wearier of government and their role in enacting policies that were good for the country‘s future. In the present we see that people have truly grown weary of government and now consider these fiscal issues to be the most important to our country.

So how do we fix these problems and finally get out of debt? First, we must stop thinking that there is one solution or path to totally balance our nation’s budget and get us out of debt. America spends so much money that it is truly impossible for our government to get out of debt within one or two years without cutting essential programs that many in our country rely on. We must be progressive and think outside the box. Sticking to traditional methods of saving money (or spending it for that matter) do not help us and we need to truly audit our government and find every program that isn’t worth the money spent on it.

Finally, we need to overhaul our health care system. With the cost of our nation’s health care equaling approximately one-sixth of our budget each year, we need to find a way to provide health care that is both affordable to the buyer and to the government. The reason why Congress has not found a solution is because there are so many ideas that clash for reasons other than cost. Most arguments deal with the conservative-liberal argument over the size and effectiveness of government, as well as arguments over social issues like abortion. Since Americans and those in Congress cannot seem to find common ground on these issues, it seems inevitable that the House of Representatives and the Senate will have to come to a compromise, which in turn will not be the most comprehensive or sweeping change possible. This legislation will ultimately serve as a band-aid for our failing health care system, forcing the next generation of Americans to deal with this problem.

As I have discussed, Americans say they are concerned about fiscal responsibility, but are not willing to make the commitment to ideas that bring about sweeping reform that change the system for good. Many are worried about the outcome and not about the means for getting there, thus we will continue to see our country spiral further into debt.

Re: Health Care and National Debt

It is important to think outside the box and that it will take more then one or two years. The essay was very well written. It seems like you really thought about the options that would help us as Americans!

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