As far as it goes, I would have no real problem with a government health assistance program that helps those who really need it.

Unfortunately, in a system where one is allowed to vote benefits for oneself, or to be more exact, one votes for whoever passes out the most goodies, it is extremely difficult to avoid "benefit creep."

It would be interesting to see how much things like Social Security and Medicare would cost if they were handed out only to those poor enough to really need it. I might look at the numbers some day.

Political power is enhanced by dependency on the part of the electorate. And there aren't enough poor people to make a decent power base. That's why means testing goes out the window first of all in these things, and "universal" starts to be used.

There are some programs that seem to have managed to avoid this syndrome. The Food Stamp program allows the poor to shop at private food sources, without requiring a "nationalized grocery system" (farming is a whole new subject). Nobody runs around saying all food should be free because it's a necessity of life. And it all seems to work.

This is also sort of the idea behind school vouchers as well, but that is contaminated by schools already being largely socialized.

Could something like "medical vouchers" work, maybe combined with medical savings accounts? Don't know. Might be worth looking at.