I have questioned, on this blog, whether my teenage children will still have health insurance as young adults. The answer, provided by Governor Paterson, is yes. Because my wife and I have health insurance through our employers, under Paterson's proposal we would be able to pass that gift onto them through age 29. Presumably with tax advantages, which means (given our marginal tax rate) the federal, state and local governments would in reality be paying for about half of it. Meanwhile, those whose parents do not have health insurance, or who have moved here from other states and countries, would not receive this benefit and its back-door taxpayer subsidy. And not just them. It is estimated that 800,000 would be eligible for the program, but just 80,000 would take advantage. Which 80,000? The richest of course, since they could afford it! This is what I fear about the Democratic road to "universal health care." Rather than figure out what the government can provide for everyone, and leave other to pay for more themselves, an open-ended commitment to ever rising expenditures (or back door tax expenditures) could be kept open for those who matter, even as others get nothing once limited resources intrude. More deals and breaks, and programs, layered onto the current mess, could take the place of root-and-branch reform. Governor Paterson's heart may be in the right place, but ironically our first Afro-American Governor has just proposed a Grandfather Clause for health insurance in New York.
According to the New York Times, “Gov. David A. Paterson will propose that private employers be required to offer health insurance to workers’ dependents who are ages 19 to 29, part of what the administration hopes will be a step toward universal health care coverage in New York.” But those who read my series of posts on Equity and Eligibility in August 2007 (will someone please honor all that work I did and publish it as a book?), particularly the post on the “Thin End of the Wedge” strategy, understands that expanding government benefits to the better off in the hopes that the less well off and influential will receive them later hasn’t worked in decades. Instead, this seems like an attempt to buy better off folks like myself off, the way “gifted” programs muted opposition to New York City’s poor public schools until recently. The Governor just may be looking for someone he can help (perhaps someone politically active who would be grateful in return in 2010), but we don’t need additional separate deals for separate people. We need to start over, or we face an institutional collapse.