Universal health care, or universal cost shift?

When I had Champus health insurance (for Active Duty military and families), I required specialized physical therapy. My PT had advanced degrees. Each appointment took an hour - a real hour, not a psychiatrist's 45-minute hour. My PT maintained an office in San Francisco, a business license, PT licensing, etc. She paid rent, malpractice insurance, utilities, continuing education, taxes, all of her own benefits, and licenses - out of her reimbursements - before she saw a dime of income. Champus reimbursed $25 per one hour office visit. (I paid the other $100+ out of pocket.) That's government-run health care.

In some areas, government medical reimbursements amount to a fair wage for medical providers. In other areas, government-funded patients (whether on Medicare, Medicaid, Champus, etc.) have precious few providers to choose from, as providers have opted out altogether. Providers who feel that government reimbursements run too low - they can opt out, or shift the cost onto their private-pay patients. Many shift the cost to private payers.

Government also mandates that hospitals treat emergencies without regard for the patient's ability to pay. Hospitals shift those costs to private-pay patients, too.

As Baby Boomers approach the age of Medicare eligibility, the government faces a mounting problem - health-care costs are projected to increase per service, growing life expectancy increases the lifetime services used per patient, and a whole bunch of new patients are expecting the Federal government to start covering their bills. Massive tax increases are always unpopular. Reducing services for the elderly makes lawmakers look like heartless thugs. But declaring bankruptcy is not an option, either.

The proposed solution to the mess is to force citizens onto the rolls of private health insurance, which would increase the cushion of cash available for absorbing cost-shifting from under-reimbursement for Medicare. Meanwhile, insurance companies get a quick influx of cash, which makes them feel all warm and fuzzy about the lawmakers who passed the bill, and voters get to believe that the government has "done something" about health care.

The problem with this "solution" is that 1) it's unAmerican to force citizens to purchase something from private companies; 2) it does nothing to address the genuine problems in the system that have caused enormous medical-cost-inflation and will continue to cause enormous medical-cost-inflation; and 3) it does nothing to solve the Medicare tsunami, except to shift the blame from elected officials (tax hikes) to private insurance companies (rate hikes).