Saturday, November 10, 2007

(S)CHIP Away At Excuses

"I'm sorry, Ma'am," said the police officer as he watched the woman getting beaten and robbed, "Helping you would be socialized law enforcement." After the robber had made off with her belongings, the cop advised her to hire Blackwater private guards for her future security needs. Though Blackwater would cost thrice as much as her taxpayer dollars he informed that she could get a 20% tax rebate under the Bush plan for Private Law Enforcement Savings Accounts.

This hypothetical scenario is not much removed from the logic being advanced by President Bush and his supporters to repeatedly torpedo the expansion of SCHIP. They mainly oppose expanding free health coverage from 6 million to 10 million poor kids because it would set us on the slippery slope of better healthcare for all. Of course they've a different name for it - socialized medicine. We already have "socialized medicine" for people above 65. It's called Medicare. Who (including Republicans) wants to do away with Medicare?

I earlier talked about SCHIP in my post of August 3rd. The Bush rhetoric against it hasn't changed, though some new angles have been added. Congress had already addressed initial objections by excluding the expansion to illegal immigrants and adults. Then after Bush's first veto they've lowered the family annual income cap for eligibility to $62,000 from $82,000. But that's apparently not enough.

On the eve of vetoing the second version of the Bill, Bush criticises the Democrats for not sending a Bill "that I can sign." His ability to sign is apparently not about merits but the imperative to keep his friends happy. Chief among these friends is the tobacco lobby since the additional funding for SCHIP is proposed to be covered by extra tobacco taxes. That's okay though there are alternatives to further milking the tobacco cow. I'd prefer SCHIP funding to come from rolling back the enormous giveaways resulting from the 2003 Prescription Drug Act. We can save more on drugs simply by allowing Medicare to negotiate drug prices. But that would widen the issues and give the Bushies additional excuses to resist SCHIP. Not wanting to be sidetracked, the Democrats wisely chose tobacco monies instead.

Also, private insurers worry about children currently insured by them being drawn away to the "free" government coverage. Some of this may happen but it doesn't change the overall benefits from a public policy perspective.

The Bushies' biggest ploy is pushing the requirement that no expansion be allowed till the states certify that 95% of the currently eligible kids have first been covered. This is a near-impossible hurdle as they well know. Moreover, an expansion of SCHIP does not reduce the opportunities for covering the poorer kids. It's like city police saying that they won't investigate any rapes or robberies until they've solved 95% of all past murders. If the Bushies were sincere in their concern about the poorer kids they'd seek simplified aplication procedures that would make it easier to cover such kids. Instead they insist on "safeguards" that make the task harder.

The Republicans' resistance to SCHIP is unpopular. I wonder whether some management gurus are being naive or deceptive in trying to spin this as simply a communications issue. Jack Welch in his BusinessWeek column of October 22, 2007 misses the mark in saying that Bush erred by not getting out in a big way to broadcast his detailed reasons for opposing SCHIP. The real reasons are that Bush wants to protect his cronies and fund contributors - hardly something that he can shout from the rooftop. The fake reasons he might give in campaigning harder against SCHIP are likely to get exposed during news analysis that would accompany such publicity.

There's a good graphic in an Oct. 17, '07 article in the New York Times (created by daughter Rubina, incidentally) that shows income limits and the number children and adults enrolled state by state. It shows one fifth of the states have a substantial number of adults included in the program. The pending SCHIP Bill will not expand adult coverage, but more importantly, note how just one state (New Jersey) has a family income limit above $62,000, at $72,275. So much for Bush publicity on how "rich" kids with family incomes of up to $82,000 will benefit from SCHIP.

As Bush is getting ready to veto a second SCHIP Bill, talks are reportedly proceeding on a third version that will be to Bush's liking. The man hath no shame. The Democrats may have little choice but to accede to this watering down in order to protect kids who are already covered, since the current legislation is about to expire. Still, it'll be a pity if any meaningful changes have to wait till Bush leaves office.