(Friday’s Populist Capitalist Blog Post)
Many government programs are so-called “defined benefit”: “X” level of benefits will be provided regardless of the total cost.
“Defined cost” is another approach: “X” dollars (say a $100 billion?) of medical care will be provided annually. When it is gone, it is gone.
The message of defined cost? Spend it well, make it last. Don’t take more than you need or there won’t be enough for everyone. The knowledge that the well is not bottomless, the clear realization that choices must be made, forces thrift and conservation.
Some staggering percentage of health care dollars go to the last few months of life, frequently prolonging bare existence, producing an abysmal quality of life. Given limited resources, every yes to spending in one place is a no to spending elsewhere. Perhaps if that “unseen” choice were made more explicit, if we more clearly faced what we are saying no to when we say yes, then we might make better choices.
America is running huge annual deficits. The “unseen” choice we are making currently is to mortgage the future of our children. It is an extremely selfish choice. Any “universal” health care (or any other program) that adds to the deficit, that is not completely funded by additional taxes, is further mortgaging our children’s future. And that is not right.
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