Why the conservatives gave us universal health care: a parable

The provider and financing segments of health care are now in a "destabilization" phase, using Eli Ginsberg's perfectly descriptive term. Even with the lowest unemployment levels in years, the numbers of people who have no health insurance, most of them employed, keep going up. The health sector has been on a competitive binge that was supposed to contain cost increases, but aggregate expenditures for health care are rising on about the same curve as before. As Americans continue to spend more for health services, more health care providers, insurers, and "managed care" enterprises are in deep financial trouble. These providers include many HMOs that were supposed to apply the incentives that save money and the investor-owned hospital chains that were supposed to give health care big business efficiencies. These and other anomalies have created a situation where politicians are likely to take desperate and impulsive measures, especially on the issues of access and cost. This means that anything can happen, and nobody knows what. The many futurists in our midst are predicting intensification of "marketplace" behavior, but they don't know, either. This is a parable of one of the things that could happen. The conservatives could decide that having a universal health care entitlement is the conservative thing to do. Even though some of the events in this parable seem on the edge of absurdity, all of them are merely extensions in time of things that have already happened in our country in a pattern that is now rapidly unfolding.