If America is ever to realize its goal of equal opportunity, every citizen must have access to two things: a good education and sound medical care. With these, every person can go as far as his ability and his energy will take him. A taxfinanced system of health care such as Medicaid goes far toward meeting our obligation to ensure adequate medical care for all. Good medical care for everyone is sound social policy for everyone. No one should be denied decent medical care because he is unable to afford it.
But a great failing of publicly paid medicine like Medicaid is that it contains no self-restraining force to curb abuse and excessive expansion. Beneficiaries make no direct financial contribution to the system, and consequently, have no personal stake in its fiscal health. Medicaid, therefore, can be no more than a "second line" of defense.
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