The University of Washington Bothell has a new master of arts in policy studies program. The program is for those people who are balancing family and work while striving for higher education.

The graduates have managed to succeed in graduate school while shuttling children to soccer practice, throwing together a quick meal in the evening and earning enough money to keep house and home together.

That striving is the first and finest foundation for citizenry in our democracy. I have the honor of speaking at the commencement celebration for these graduates. Here’s an excerpt.

The motivation to go back to school in policy studies is to develop public policy for the greater good for our society. This leads to the dilemma we face any time we as responsible citizens try to “fix” something we think is broken in our society. We are faced with the inertia of the status quo. This inertia resists systemic change.

Let’s apply this inertia to one social problem that we all face: health care.

It used to be that employers would provide health coverage as a fringe benefit for their workers. But the emphasis for many employers has become the short-term bottom line, not the long-term prosperity of the organization. On top of this, each year it becomes more expensive to provide health coverage. As an employer, I know. Our health coverage amounts to more than 13 percent of payroll.

So the incentive is to cut benefits and let the employee figure out how to make do. First you cut dependents, then spouses, then shift costs to the employee, and then just curtail coverage. As a result, more than 50,000 fewer people in our state have employer health coverage now than three years ago. That’s about the total population of Olympia and Gig Harbor combined eliminated from coverage.

Today, 15 percent of our fellow Washingtonians have no health insurance. That includes 165,000 children. Twenty percent of kids in poverty lack coverage. Almost 20 percent of adults – close to 800,000 – go without. Of these, more than four out of five are in households with at least one worker, and seven out of 10 are in households with at least one full-time worker. More than 40 percent of people without health insurance are in households with incomes greater than $39,000 for a family of four.

But the fact that 15 percent of citizens don’t have health insurance means that 85 percent do. When you talk about providing coverage for all, you also have to begin talking about redesigning benefit packages, selection of providers and type of care for those who currently have coverage. You take on the health care complex that benefits from the status quo.

So universal coverage might mean that my neighbor might not be able to get his chiropractic manipulation covered by insurance. It might mean we have to pay $175 a month, when some of us think we pay nothing for coverage now. It might mean that doctors’ salaries might be lidded and that insurance company profits would be regulated.

Health insurance pools risk. That is, it throws together those of us with good luck and good health, and those of us with bad luck and bad health. We hope we will have good luck, but we want to know that if our luck fails, our insurance won’t.

This seems to make sense, but it runs counter to the social Darwinism of what is now being labeled the “ownership” society. So the impulse for universal health coverage founders against the entrenched interests of the health care complex, the rhetoric of the “ownership” society and the health insurance arrangements for that 85 percent of the population that includes me!

When you have a big and growing problem, the solution demands changes in business-as-usual. The incentive is to avoid these changes and to just make do. So we replace “can do” in policy formation and social progress with “make do” in just getting by.

But the make-do looks like a Rube Goldberg contraption held together with duct tape as more and more people lose their health coverage. Sooner or later, we are going to have to find a way out of this trap and realize that the insecurity of our current “system” of health coverage is not acceptable in a democratic society.

I am hoping for sooner. And I am hoping that these new masters in policy studies from the Bothell campus will be part of figuring out the solution. They are not make-do people. They have shown that they can do.

John Burbank, executive director of the Economic Opportunity Institute (www.eoionline.org), writes every other Wednesday. Write to him in care of the institute at 1900 Northlake Way, Suite 237, Seattle, WA 98103. His e-mail address is john@eoionline.org.