President Bush has demonstrated that he is not the compassionate conservative he claimed to be in 2000, but on the other hand you have to admit that he takes a back seat to no one in his admiration for private greed.
If the choice is taking away a little profit from insurance companies or leaving hundreds of thousands of children without medical care, he will run with the insurance companies every time. How many poor kids ponied up enough in 2000 or 2004 to be Bush Rangers or Pioneers?
What else accounts for Bush’s promise to veto any appreciable increase in funding for the children’s health insurance programs, including the one that presidential hopeful Mike Huckabee claims as his greatest achievement in public life? Bush’s threat followed a bipartisan vote of the Senate Finance Committee to reauthorize the 10-year-old State Children’s Health Insurance Program (SCHIP) and expand it to cover an additional 3.6 million children of low-income families over the next five years. Another 50,000 or so Arkansas children would be guaranteed medical care.
The president’s principal reason is that quite a few of those children may be covered now by their families’ private insurance and that making them eligible for the state-run Medicaid program would induce the families to take them off their private insurance plans and switch to SCHIP. Insurance companies, alas, would have to reduce or forego premiums.
Let’s consider the morality of Bush’s position, which his poor Health and Human Services secretary, Mike Leavitt, has the awful job of articulating. Far better, they say, that we force a few kids to stay with private companies, instead of the cheaper and better Medicaid coverage, even if it means keeping millions of other children out of the health-care system.
The children’s health insurance program is one of government’s undiluted success stories. Children’s health care produces a lifetime of rewards, for the children and society. Mike Huckabee, the self-styled most conservative governor in Arkansas history, is moved almost to tears talking about it. He and Mike Beebe, then a state senator, teamed up in 1997 to make Arkansas one of the pioneers with the ARKids First program. Congress, on President Clinton’s initiative, followed with SCHIP a few weeks later.
The bill that the Senate Finance Committee recommended last week by a vote of 17-4 would continue to cover the roughly 6.6 million children who benefited last year and expand it over time to cover some 3.6 million others, mostly the very poorest who are eligible now but do not participate. It would expand eligibility upward to cover more children of the working poor. Cigarette and tobacco taxes would be raised to pay for it, which would drive more young people not to smoke. Bush is against that, too. Haven’t the tobacco companies suffered enough?
Bush has a tiny bit of truth on his side when he says the expanded SCHIP would cause some people to drop their children from private plans and enroll them in SCHIP. But the administration says those would be the primary beneficiaries and that the number of uninsured would not be reduced. The studies, even one by the health economist whom the administration likes to cite, show that the switchovers would be relatively small.
But so what if a few switch to a cheaper plan with better benefits? Bush’s own plan for expanding health coverage would do the same. He would give tax deductions to families for premiums to encourage them to buy from the insurance companies. The benefits would go almost entirely to people who already have coverage, and the president’s favorite health economist says that the individual tax credits would be simply another inducement for employers to end their group plans.
Here is the biggest irony. Remember Bush’s generous acceptance speech at the 2004 Republican Convention, when he sought to return to the compassionate conservatism of 2000 by talking about the desperate need to give Americans health insurance?
“In a new term, we will lead an aggressive effort to enroll millions of poor children who are eligible but not signed up for government health insurance programs,” he declared, to applause. “We will not allow a lack of attention, or information, to stand between these children and the health care they need.” That is exactly what the SCHIP reauthorization and the extra money propose to do. Eighty-five percent of the children who would be added are those already eligible. Either Bush didn’t mean it, or Dick Cheney told him he couldn’t do it.
The administration has one other argument. The expanded SCHIP program is a foot in the door for a single-payer national health insurance plan like the one Michael Moore espouses in the movie “Sicko.” Bush called it “a Washington-run, government-owned plan where government makes the choices, where government sets the prices, where government then taxes people to pay the bill.”
That would be a good strategy but, too bad, it is not. SCHIP is run by the states, private doctors and hospitals provide the care, and private carriers administer benefits.