Government efforts to broaden health insurance coverage should not do for people what they can and should do for themselves. Hawaii offers a lesson for Congress and states as they consider expanding health care coverage.
Hawaii last year enacted the nation's first universal health insurance program for children. The program, Keiki Care, launched in April with premium costs shared by the state and a private insurer. ... But health officials found that 85 percent of the children in the program were previously covered by private health insurance policies. So the government decided ... to scuttle the program as of Nov. 1.
That some Hawaiians would drop their private policies was predictable. Keiki Care had no income-eligibility test. To qualify, children simply had to be state residents, ineligible for other health care programs, and uninsured for the previous six months. Why would parents pay private health insurance premiums if the state offered to pick up the tab?
Hawaii was right to retreat from the Keiki commitment. Families that can afford their own health insurance should not have the option of enrolling in a taxpayer-financed government program. And the state's low- and middle-income residents continue to have affordable options. ...
That said, there is a difference between people who cannot afford health care and those who simply would rather not buy health insurance. It is a proper role of government to take care of the former. But governments cannot afford the latter. Programs that subsidize everyone, regardless of income, are irresponsible.
Such blanket entitlements are the wrong response to the challenge of broadening insurance coverage. Not only do these entitlements drive up public costs and discourage personal responsibility, but they do nothing to address the central reason for discontent with the nation's health care system: the escalating price of drugs and treatment.
Still, the California Legislature this year passed SB840, which would have made all state residents eligible for a government-run program. Gov. Schwarzenegger vetoed the bill Sept. 30. And President Bush last year vetoed a bill expanding SCHIP, arguing that it was a step toward government-run health care for all. Congress will likely seek a SCHIP expansion from the next president.
Congress and the states should ensure that Americans who can't afford insurance have access to health care. But policymakers need to learn that broad entitlements will simply encourage those who can pay their own way to get on the public dole instead.
This editorial first appeared in the Riverside Press-Enterprise last week.
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