Universal Health Care Vouchers

In his recent State of the Union message President Bush promoted the hoary old idea of expanding health care access through tax credits. These proposals cannot make coverage universal, nor would they control costs in the U.S.’s wildy inefficient and unjustifiably expensive health care system.

Fotunately serious health care reformers in the US are rallying to a new (and old) idea: universal health care vouchers that could be used to buy a variety of different kinds of private health insurance plans. I advocate this idea of universal health care vouchers in Citizen Cyborg, inspired by the Clinton health care reform proposal and Ezekiel Emanuel’s book The Ends of Life.. Universal vouchers (a) make coverage universal, (b) ensure that all the plans that people can buy include certain benefits, (c) contol costs through administrative simplification, and (d) allow for radically diverse technological options, depending on the trade-offs that different consumers are willing to make.

For instance, the pro-enhancement plan could gene-tweak you instead of sending you to dieticians and smoking cessation, freeze you instead of torture you with protracted end-of-life treatment, and pay for your limb augmentation or gender reassignment instead of psych counseling. The religious conservatives’ plan would deny you abortion and birth control, and pay for extended care of the brain dead. Everybody’s happy.

Recently Emanuel joined with the respected health care economist Victor Fuchs to promote health care vouchers, and the proposal is one of the ideas being promoted by the Center for American Progress.

---

James Hughes Ph.D., the IEET Executive Director, is a bioethicist and sociologist at Trinity College in Hartford Connecticut USA. He is author of Citizen Cyborg and is working on a second book tentatively titled Cyborg Buddha. He produces a syndicated weekly radio program, Changesurfer Radio.