Some people cite fiscal concerns as a reason to oppose expansions of the health safety net. This chapter develops and examines those fiscal concerns. The opening sections lay out some information on government debt and the fiscal risks it can create. After that the chapter analyzes how considerations about fiscal risk could most plausibly figure into assessments of universal health insurance. It is argued that in some instances, there are legitimate fiscal objections to expansions of the health safety net but that fiscal objections cannot ground opposition to well-designed universal health insurance systems.
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