It's no secret that health care costs are blowing holes in the national system of financing decent care. Now, as The N&O's Thomas Goldsmith reports, federal and state governments are trying to hold down the costs of one of the system's main components, Medicaid, by going after people who could pay for nursing care themselves. While there may be a few who game the system that way, regulating transfers of funds could easily cause unwarranted mischief.

Granted, some savings in nursing care costs that are charged to the taxpayers may result. But this crackdown doesn't address the fundamental problem: Health care for Americans of all ages is becoming a luxury that fewer and fewer can afford. The lack of government attention to that issue is a national scandal.

When Medicaid was created in 1965, it was intended to provide care for men, women and children who qualify as poor. The lifespan of the average American was shorter back then.

Now, with life expectancy reaching an all-time high of 77.6 years, more people qualify as poor by the time skilled nursing care becomes a life-or-death matter. Many such patients are unable to walk, speak or feed themselves, and the cost of round-the-clock nursing is high.

Research has shown that most nursing home residents pay some of the cost. The trouble is that costs, now averaging $74,000 a year nationally, are overwhelming for middle-class people. About 10 percent of those who enter a nursing home stay five years or more. Medicaid will cover the cost when patients have just $2,000 worth of assets left.

It's not unheard of, though, for some people to shelter assets with gifts to family members or charities, expecting Medicaid to pay for their care. Their numbers, thankfully, are small. Drawing down resources that way so Medicaid can be tapped risks leaving too little for the poor whom the program is supposed to help.

The danger lies in administering the state's proposed restrictions on asset transfers within five years prior to applying for Medicaid. For instance, a patient who had exhausted his own resources paying nursing home bills could be forced out if Medicaid wrongly frowned on his having helped a grandchild with college. Clearly, such rules have to be applied with intelligence and compassion.

Those are two qualities missing from the U.S. health care system as it has evolved. Financing care through private insurers has led to layers of extra costs. Millions of people can no longer afford insurance during their healthy working years, let alone their final years in the grip of illness.

The 1776 claim to unalienable rights of life, liberty and the pursuit of happiness should entitle every American to decent health care. It's time that fulfilling such a promise becomes the passion of anyone aspiring to national leadership.