“But it’s difficult to foresee the entire population accepting Medicaid or something like it, because it’s a poverty program with all the attendant problems in obtaining access to quality care. “
I can see your point but it can morph into something else and be shoved on the public at large. How many times has that happened before with a government program. Social Security wasn’t supposed to be a retirement program either but that’s what it has become to millions of Americans.
SSI/SSD wasn’t supposed to be a catch all for disability but that has what they have become. Including kids.
A historical note: Social Security was a cleverly designed and packaged name for a program instituted by the Franklin D. Roosevelt administration, sold on the false premise that workers would be buying an "insurance policy" that would provide them with supplemental income for their retirement years to allow them to be "secure". (Of course, in no other insurance policy agreement could the "insurer" make unilateral changes in the terms and conditions without the policyholder's consent.) The true purpose of it, as admitted to later by some politicians who were in on its start, was to lock in the senior vote for the Democrats forever via a monthly government check. On that alone, they turned out to be wrong, but they gradually added a whole spate of "entitlements" for selected demographic groups, in return for which the recipient is expected to reciprocate at the voting booth. Problem is, as life expectancy increased dramaticaly, SS and other entitlements became actuarially unsound and unaffordable in their existing state - hence the debt and deficit situation the government is facing now.