The debate over government-run health care has roiled for decades. Today, we’re at the tipping point.

Incremental growth in public health programs has brought us to the brink. Today, almost half of America’s children — 45 percent — have their health care paid for by taxpayers. The children’s health bill (SCHIP) now before Congress would boost this to 55 percent. And that’s the tipping point.

Once most children are covered by taxpayers, the remaining children will shortly follow. Then their parents. Then those with no children at home. Eventually, the whole country would be under Washington-run health care, using tax dollars to pay the bills.

Even without a megabillion-dollar SCHIP expansion, taxpayers already pick up the tab for almost half the health care in America, via Medicare, Medicaid and the Veterans Administration. The SCHIP expansion could tip that, too, so the majority of all health care — not just kids’ care — is government-paid and therefore government-controlled.

If Congress overrides President Bush’s SCHIP expansion veto, the full and final federal government takeover of medicine in America becomes inevitable. With that would come lower quality health care, long waits and explicit government rationing of care. That’s the story wherever countries have nationalized their health systems.

SCHIP stands for “State Children’s Health Insurance Program,” but most of the money really comes from federal taxpayers, not from state coffers. Politicians are using kids’ little feet to wedge open the door to national health insurance. That’s just fine with many members of Congress, such as Rep. John Dingell (D-Mich.), who have been pushing for government-run health care for years.

The SCHIP bill claims to cover kids in families earning three times the level of poverty — $62,000 for a family of four — but it goes further, because states are free to disregard huge chunks of income to make more people eligible. This “free” health care for the middle class mostly substitutes government coverage for existing private insurance, because more than three-quarters (77 percent) of the kids who would be newly eligible are already covered by private policies.

Boosters of a bigger SCHIP often claim it’s a “private insurance program,” even though government pays the premiums. It’s true that private carriers are sometimes used as intermediaries — for now. He who pays the piper calls the tune. Plans are already afoot to eliminate the insurance carriers as middlemen, leaving total government control. The Children’s Defense Fund — a liberal group and prime movers behind the SCHIP expansion — is promoting a bill, HR 1688, to “simplify and consolidate children’s health coverage under Medicaid and SCHIP into a single program.” Hello, National Health Care!

As noted in documents from Hillary Clinton’s 1993 Health Care Task Force, the goal of government-controlled universal health care can be stealthily reached if “phased in by population, beginning with children. Kids First is really a precursor to the new system.”

Says now-Sen. Clinton in 2007: “We're going to have universal health care when I'm president — there's no doubt about that. We're going to get it done.”

If liberals succeed in turning SCHIP into a new entitlement for middle-class kids, the heavy lifting will have been done before President Hillary sets foot in the Oval Office.

Bush doesn’t want to kill SCHIP. Indeed, he’s already signed an extension to keep the program going — and focused on helping poor kids. But he’s right to oppose expanding it from a safety net program for the truly needy.

SCHIP expansion also distracts from efforts to make health care more affordable. That would require a reversal of the Washington-dictated bureaucracy that is pandemic in American medicine and drives up costs — as illustrated by 135,000 pages of federal regulations that hog-tie doctors and hospitals. Reduce the bloated bureaucracy, and you reduce the costs.

This political fight isn’t just about kids; it’s about all of us in America. It’s about the kind of health care we are going to have. Bit by bit, we’ve reached the tipping point where Washington-run, taxpayer-financed and government-controlled health care becomes the rule and not the exception. When those dependent on tax money for health care outnumber those who aren’t, you can say goodbye to personal freedom and high quality care.

Ernest Istook, a former U.S. congressman from Oklahoma, is a distinguished fellow at The Heritage Foundation.