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Government already helps health care

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By John Burbank
S tevens Hospital in Edmonds — is that government health care? Well, actually it is.
Stevens, Cascade Valley Hospital in Arlington and Valley General Hospital in Monroe are part of a system of public hospitals throughout our state. They are funded in part by local property tax levies. They are governed by boards of directors elected by the public. And they are part of our government.
When folks say keep the government out of health care, do they really want to close down Stevens Hospital?
So what is government health care? Let’s start with something that provides health coverage for one of every seven Washington residents. That’s Medicare, which practically all Washingtonians 65 and older — that’s more than 700,000 people — depend on every day for their health coverage. Medicare also covers 125,000 disabled residents younger than 65, people unable to work due to diseases like MS and Parkinson’s.
One of the reasons that the proportion of seniors in poverty is less than the general population is because they have guaranteed health care. That’s right, a guarantee from the federal government.
How about other health care provided through our government? Tricare, the government-financed program for active-duty military service members and their dependents, as well as retired military and National Guard and reserve members, provides health coverage for 300,000 Washington residents. My father-in-law is one of these, and let me tell you, in his late 80s, he needs this care.
And then there are the veterans cared for through the Veterans Health Administration, which runs the most efficient health care system in our country and cares for 5.6 million veterans across the country.
The state government supports the Basic Health Plan, which provided health coverage for 100,000 residents last year. The state and the federal governments combine to provide health care for an additional 1.2 million very low income disabled people, retirees, children and their parents. Another 17,000 lower-income children get their health coverage through the State Children’s Health Insurance Program. Add to that more than 500,000 federal, state, and local public employees, such as firefighters, teachers, the state patrol, park rangers, naturalists, community college faculty, safety and health inspectors, doctors and nurses, meteorologists, and throw in their dependents, and we have at least another 750,000 residents benefitting from government health care.
That’s a lot of people — about half of our total population, all direct beneficiaries of government provided, sponsored or paid-for health care.
We should also factor in the government incentive for employers who provide health insurance. While this is definitely part of the package of compensation for employees, it is not taxed like wages. It is not taxed at all. So employees don’t pay income tax on this benefit, and employers and employees avoid payroll taxes — totaling 15 percent of wages — that they both pay on earned income. That adds up to a hidden subsidy from the federal government in excess of $1.25 billion a year in our state alone, to encourage employers to provide health coverage. My family benefits from this subsidy, as do half of the families in our state.
We can also add in the $300 million hospitals in our state receive from the federal government for uncompensated care, the federal and state support for medical training for doctors and nurses, state and federal support for community health clinics, the $625 million that the state provides for mental health services, the investment by our state in home health care … the list goes on and on.
Any way you cut it, our government provides health coverage that none of us would want to have taken away. But the problem is that this is such a patchwork system that more than 700,000 people have fallen through the cracks of our network of public financing and private provision of health care. That must be fixed, something Congress is struggling with right now.
But in the debate, let’s not fool ourselves that our government, in this representative democracy, has no place in the provision of health care. On the contrary, without government, millions of us in the Northwest would be deprived of what should be our right to health care.
We do not have the moral dilemma of being in a lifeboat with no more room, fending off people left in the water. We can all fit into this lifeboat, as long as we realize that health coverage should be a right that extends to all citizens of our state. And that our government is the means to make sure that happens.

John Burbank is executive director of the Economic Opportunity Institute ( His e-mail address is

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