At The American Conservative, mind you, The American Conservative Bert Peterson advocates a bizarre sort of universal medical benefit. I can’t excerpt it so you’ll need to read it in full. It hinges on medical debt and estates and is intended to replace all other forms of medical benefits including both Medicaid and Medicare.
I think the problems with his proposal are grave. Decades may pass between the point at which a medical debt is incurred and the death of the debtor. How will providers operate in the interval? Will they be forced to finance their expenditures, using debt as collateral?
These debts are likely to become confiscatory over time. I think he should heed Macchiavelli’s advice from The Prince:
But when it is necessary for him to proceed against the life of someone, he must do it on proper justification and for manifest cause, but above all things he must keep his hands off the property of others, because men more quickly forget the death of their father than the loss of their patrimony.
or, in other words, his calculations about harm are wrong.
“How will providers operate in the interval?”
The same way they do today, by taxpayers, through the mechanism of government. This guy is just proposing a crude reimbursement scheme that is better than an out and out gift, and you record the health care liability just like they do a social security account.
I’d be more concerned with how to accrete the liability or avoiding estate distribution avoidance mechanisms. But if you don’t like accreting at the rate of inflation, try 1 or 2%. And nicking the estate could be handled just like any final tax return. And if the person is forever poor, the debt is extinguished in whole or in part at the time of death.
I think the biggest problems are two: politicians lose the ability to say they gave someone something for “free,” (so it will never happen – end of discussion) and 2) if you set up a government program you can bet your bottom dollar it will be mutilated over time.