Is it ironic that the push for universal health insurance is NOT being driven primarily by concern for the poor? The truly poor already have Medicaid. In other words, this is not a safety net issue.  It's about the relationship between citizens and the government. Should government guarantee health care for people other than the very poor?  (It already does so, of course, with Medicare, and that might be part of the story too).

As I understand it, What's the Matter with Kansas suggests that lower-middle class whites in rural America ought to vote for liberals who will give them hand-outs, rather than conservatives with whom they agree on social issues. By the similar logic, shouldn't the AFL-CIO support reducing or eliminating immigration into the U.S.? On the other hand, in The Road to Serfdom, Hayek wrote, "the erroneous belief that there are purely economic ends separate from the other ends of life. Yet, apart from the pathological case of the miser, there is no such thing."

Is it possible that the tax on "Cadillac health plans" if it goes into effect will be, ultimately, a way of means testing the health care hand-out, rather than making it an entitlement of all Americans? In principle it could, over time, create a situation where a certain, basic items are covered for all Americans, but, above that line, individuals and families (other than the truly poor) have to pay, either out of their own pocket, or through insurance for which they pay themselves. Given bracket creep, and some inflation, in time most health insurance will be in the "Cadillac" category. I know this seems unlikely, and probably is, but more ironic things have happened.