The veto by President Bush of funding for children's health insurance underscores the difficulties in having a patchwork system of private and public funding for health care rather than following a more consistent approach.
In this country, we have Medicare and Medicaid programs to give coverage to the elderly and the indigent. The government provides little else besides tax deductibility as far as government assistance to the middle class and the working poor for health care.
Health insurance coverage for children has been part of that "little else," using a variety of private insurance providers through a variety of state programs. Now this program is under criticism because it may help children from middle class families, even upper middle class families and because it may be used by illegal immigrants. The latter concern was the primary reason Congressman Steve King gave for supporting Bush's veto.
As far as illegal immigrants, there needs to be a better employee identification system and aggressive deportation to eliminate issues regarding the cost of social services to immigrants.
Families with incomes well above the poverty level might not have adequate health insurance or any insurance at all. A serious medical condition can result in bankruptcy. The idea that such a family could afford to pay for private insurance is not necessarily true. Insurance will not generally cover a preexisting condition and the small print can often carry exclusions for unexpected situations that arise.
The whole concept of insurance is based on spreading the risk among many people in order for the risk to be shared. When an individual family or an employer with only a few employees has to purchase insurance, the cost of the insurance is based on the financial risk created by those few people, defeating the idea of insurance.
The only way that all citizens can be part of a large pool is to have universal health insurance for all Americans.