The Risk Shift We Can't Afford

For less than half of the cost of the Bush administration tax cuts, the federal government could cover its share of the cost of a health care system that insures nearly all Americans.

That is according to Yale political science professor Jacob S. Hacker, who discussed the nation's broken health care system Tuesday in a speech at the Economic Policy Institute, sponsored by the Campaign for America's Future.

Hacker has been challenging the country—progressives included—to think creatively about how to end the dysfunction represented by the nation's 47 million uninsured citizens and the larger challenge of the undoing of the nation's social safety net—private sector protections such as pensions as well as government assistance programs.

In his new book, "The Great Risk Shift," Hacker proposes changing the way the nation approaches health insurance, by giving employers the choice of either continuing to provide the private sector health plans they do now or paying into a Medicare-type national insurance plan. That, he said, would put all employers on a level playing field while making health insurance accessible to all employees, regardless of where they worked. He figures the federal cost would work out to about $100 billion a year—about the same amount spent annually on the war in Iraq.

Hacker readily acknowledges the many political hurdles that getting such a plan approved by Congress and the White House would have to jump, of which cost is only one. But, as he put it, "Ultimately we pay in so many ways today for our failure to provide security. We pay individually, but we pay socially" through uncompensated chairity case, bankruptcies caused by health care costs, and through "the endless stream of mopping-up operations" done at all levels of government and by the private sector.

While the people who have historically railed against "governmemt-run health care" or "socialized medicine" are prepared to unleash their scare tactics again, Hacker says that a health care system that is "drowning employers and killing American consumers at the same time" gives progressives a unique opportunity to change the ststus quo. But, as Hacker warns, activists will have to match smart politics with smart policy.

Hacker's research will become the centerpiece of a health care policy initiative to be launched by the Campaign for America's Future in January. Hacker will explain his approach in greater detail in a commentary that will appear on TomPaine.com on Wednesday .

Views expressed on this page are those of the authors and not necessarily those of Campaign for America's Future or Institute for America's Future