I began to post a comment on an Eric Zorn column in the Chicago Tribune: "If basic education is a 'right,' why not basic health care?", but it was too long for the comments box. I didn't want to lose it, some I'm posting the complete comment here, but please read the column for context of you haven't.
Eric,
While free education is not enshrined in the U.S. Constitution, it is provided for in the Ilinois Constitution. Might be splitting hairs as to whether that's a right, but in any case the state is obligated to pay for it through secondary education. There is no need for the Federal government to take on such an obligation when the States are well within their rights to do it themselves. Even it was not customary, the State of Illinois is on the hook for it. And I suspect many more States have similar provisions.
Regarding health care, there is no reason States can't also take the same approach. So, why isn't there a much bigger push for States to do so? I'd venture it's because when States have attempted single-payer programs, e.g. Vermont, they have not gone well. Notwithstanding, I would argue that a big reason that people are pushing for Federal universal health care is because they know they can't get States to pull the trigger. And it's probably going to be much easier to get one Congress and President to go along than it will be to even get a few blue States.
The limited cost of education vs. healthcare as someone else noted is actually a very important point. By capping educational coverage at secondary levels, you have at least some limited upside to what it could cost. With health care, potential costs are unlimited -- unless you do limit them. And with that you go full circle to rationing. This goes to a basic definition of economics -- the allocation of scarce resources amongst unlimited wants. If I get a disease that can give me 6 more months for $100,000, would I get it? What if I can get an additional 2 months for $1,000,000? Well, if it's a state constitutional right, could you deny me that? (Considering we can't mess with future pensions, I'll assume you couldn't.) But if you could limit, who gets the expensive stuff? The one who has a disease that has celebrities wearing pins? Or the one who has a drug-maker CEO that goes fishing with the 4 Tops? Choices will be made, as always, and there will be winners and losers.
Speaking for myself, I would argue against Illinois covering all health care for its residents, but if it happened, that's something I'd accept. And eventually, we'd see if I was right or wrong. But for the Federal government has no Constitutional obligation for providing health care, and it's very likely to get it wrong. I like the chances of States being able to develop it better for their own citizens.
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