Democrats & Liberals Archives

Save SCHIP for Children's Sakes

Nearly everyone professes a desire to renew the State Children’s Health Insurance Program (SCHIP), set to expire in September. Disagreement persists on funding levels & sources, qualification thresholds, and state discretion for variances. Is this a healthy policy debate, or a platform for ideological grandstanding? For the sake of children’s health, let’s hope SCHIP is funded at levels to protect the truly vulnerable.

There is a policy debate here worth having, but hold on there and look at the scope and the big picture before allowing the ideologues to drag us into minutiae. SCHIP (pronounced ess-chip) is a program which America's governors agree across party lines has benefited the hard working families most deserving of health insurance for their children that they otherwise simply couldn't afford. Everyone agrees that renewing the program for five years at the current level of $25 billion for five years is not enough. The White House wants to limit the expansion to an additional $5 billion, the Senate's bipartisan version expands the program by $35 billion and the House version (HR 3162) by $50 billion. Co-author and conservative Republican Senator Orrin Hatch's made this statement on the floor in favor of the Senate version (S 1893).

The White House is attempting to don the garments of fiscal restraint in threatening a veto of excessive Congressional expansion of SCHIP. Ahem...

In 2003, Bush famously signed into law the most expensive health bill in our nation's history. That bill with a stated price tag of $400 billion over 10 years, almost didn't pass, as Tom DeLay had to coerce one fiscal conservative with a political threat against his son to get the necessary vote. Later we learned that the administration already knew that the price tag was being understated by over $100 billion, but the actuary with that information was being muzzled by his boss, so Congress might pass it. Never mind that the biggest beneficiaries of this bill were the pharmaceuticals and HMOs, much more than the seniors it was supposed to benefit, who in spite of all that government spending were actually going to have their out of pocket costs increase. Multiple sources now tell us that the actual cost to taxpayers of this gargantuan largesse to big pharma and HMO will exceed $1 trillion dollars, though the White House denies them. Note, however, the quiet admission that the cost is over $500 billion.

Yes some perspective is in order.

So this administration wants to trim $30-45 billion off of a program which directly benefits the underinsured in the name of fiscal responsibility, when four years ago it was willing to lie about the cost of a program it supported to the tune of $135 billion, when many of those dollars are an indirect benefit, which simultaneously lined the pockets of the executives who really have Bush's ear.

Yes I understand that the 2003 program is showing a 10 year cost, whereas the 2007 SCHIP graph is showing a 5 year cost - but still look at the difference between columns 5 and 6, which the Administration is declaring a willingness to veto over, compared to the difference betwee columns 2 and 3 which the Administration was willing to LIE over. When it comes to cost control this administration has no credibility whatsoever. It simply says whatever it wants for political reasons, with no apparent regard for the public good.

When all is said and done, this war the President started will likely cost us over $2 trillion dollars, dwarfing further the bars on the graph above - and that doesn't even attempt to assign a value to the lost lives of soldiers and civilians, or the damage to our national image across the globe.

Yes there is a policy debate worth having about SCHIP. From Kaiser to the AARP to pundits to policy journals, folks are weighing in with the specifics. Maybe the House version needs to be scaled back or includes earmarks which don't belong there. I'll take Orrin Hatch's word for it that in the Senate version, "my Democrat colleagues made sacrifices in endorsing this bill and in sacrificing program expansions they so dearly advocated". I personally might prefer the House version, but this President ought to be convinced to sign some compromise - perhaps close to that bipartisan effort in the Senate. I would urge my Congressman to work to present a bill that can be quickly approved, but one which accounts for the realities that the working poor and the working lower middle class must face in health care. Some states have already run out of funds, and in instances children may be literally dying because their parents can't afford the procedures they require.

Posted by Walker Willingham at July 31, 2007 2:34 PM
Comments
Comment #227986

Good article, Walker.

Bush is going to veto the renewal of this program no matter what. It doesn’t matter that it has worked extremely well, and doesn’t cost very much, and hasn’t proven to be fiscally irresponsible. He is going to veto this because it’s totally against his political ideology.
If the public can grasp that this has worked for these children, then they might start thinking that it could work well, and not cost much, and prove to be not fiscally irresponsible for everybody. And we can’t have people thinking that. That’d be way too commie-pinko.

Here’s what he said in Ohio recently about this program:

“S-CHIP is now aiming at encouraging more people to get on government health care. That’s what that is. It’s a way to encourage people to transfer from the private sector to government health care plans. I strongly object to the government providing incentives for people to leave private medicine, private health care to the public sector.”
“I mean, think of it this way: They’re going to increase the number of folks eligible through S-CHIP; some want to lower the age for Medicare. And then all of a sudden, you begin to see a — I wouldn’t call it a plot, just a strategy — to get more people to be a part of a federalization of health care.”

So in other words: Screw these uninsured kiddies. Free market ideology is much more important than their health and welfare.

Culture of Life? What a joke.

Posted by: Adrienne at July 31, 2007 7:11 PM
Comment #227989

Walker,

Absolutely excellent article. I had actually mentioned something about this briefly on another thread today.

Just doing away with the extra costs associated with privatized Medicare programs (aka: Medicare Advantage plans) would free up $54 billion over five years and $145 billion over 10 years. And ————— this is the real kick in the teeth ——————- Advantage Plans are not really a good deal for the consumer.

Sure they sound great. Most provide improved dental and eyeglass coverage, but a bit of close studying reveals that they do not work with traditional Medicare supplement plans, so the consumer will ultimately pay more for lengthy hospitalizations, etc. Recently both my local doctors office and the local hospital stopped accepting Advantage plans because they don’t pay in a timely manner.

The real advantage of Advantage plans goes almost lock, stock and barrel to the insurance companies. Just another example of corporate welfare!

OTOH SCHIP is a vital program to safeguard the health of future generations of Americans. Of course you need look no further than the deficit spending since 2001 to realize that our nations future, and the future of our children and grandchildren, don’t mean a thing to Bush & Co.

Luckily a number of Republicans are even siding with the children to save SCHIP. I hope that number will be enough to shove Bush’s veto right down his throat (or elsewhere).

Posted by: KansasDem at July 31, 2007 7:48 PM
Comment #228001

KD…you had mentioned in another thread the other day that you were looking for some earlier data on this subject. I had found this, and now it seems appropriate to show you. This is dated 1997, but don’t know if it has what you might be looking for.
http://www.westgov.org/wga/publicat/schips.htm

Posted by: Sandra Davidson at July 31, 2007 9:15 PM
Comment #228010

Walker, yes, save SCHIP. But, Democrats are taking absolutely the wrong approach toward trying to use SCHIP to broaden universal health care coverage.

They should have used this opportunity to offer Americans currently buying private insurance, a discount premium for signing onto SCHIP. That is the direction a single payer plan has to go. But, the Democrats blew it, giving the Republicans the ammunition they need to blast Democrats as tax and spend socialists trying to give away health care to people purchasing it today while passing the expense onto all taxpayers.

Democrats have really blown this opportunity to advance the single payer universal health care coverage combining premium payers with those falling under the 200% of poverty line, into one system. DUMB! MAJOR DUMB! Going directly for a socialized approach instead of a hybrid approach, just made the flat road ahead of them into a steep mountain rise uplifted by Republican resistance with appeal to many voters opposed to socialized health care outright.

Posted by: David R. Remer at July 31, 2007 10:01 PM
Comment #228046

DR
Lets get our terms correct. Schip,medicare and even single payer universal plans are NOT socialized medicine. We do have a large socialized system,the VA,but these proposal are not the same. In a socialized system the facilities belong to the government and the healthcare workers work for the government. Many of the drugs and products used may also be manufactured by the government depending on which system you look at. With Medicare,Schip and any proposed single payer plan the the government pays the bills to private healthcare organizations. They are not the same thing.
I tell you this as one that believes that services everyone must use should be socialist,that is collectivly owned. We have some of that already and they work reasonably well. Examples: the highways,postal,sewer systems ect. Fire and police depts. You get the idea. Most 1st world countries have socialized healthcare systems. What is being proposed as single payer plans ARE the compromise position and not “socialized medicine.”

Posted by: BillS at August 1, 2007 3:02 AM
Comment #228054

I am very tired of this type of argument. Personally, I thought the article was terrible. I am the most liberal person I know and don’t like red herrings from Democrats any better than the ones offered by Republicans.

SCHIP has some fundamentally good motives behind it and as someone who believe we should have a single payer healthcare system, I am in favor of moving in this direction. But to dismiss the funding debate as “a platform for ideological grandstanding”, ignores the fact that the funding ideas being suggested by this legislation are irresponsible and unfairly targeted at particular segments of the population.

But since I would not want to “drag us into minutiae” (one of the most condescending statements I have read on this site), I will just point out that the funding debate, IS the real debate. The comparison between two completely different healthcare packages in an attempt to destroy the credibility of George Bush is ridiculous. He has no credibility on any subject. This is not about his credibility, it is about who we take the money from to pay for this program.

I urge my fellow democrats to at least look at where the funds will come from a little closer before you support it. Just because Walker has a flair for skewering Bush, does not mean his blind support of this legislation is correct. There are many ways to skin a cat, this would be the wrong way.

Posted by: John Lewis at August 1, 2007 9:08 AM
Comment #228061

John Lewis,

I always welcome comments which suggest alternative ways to see things, point out flaws in logic, or reveal new information that I failed to uncover. I do not appreciate being misrepresented. Reread my article, because I certainly did NOT dismiss the funding debate as a platform for ideological grandstanding. On the contrary, I wrote TWICE “there is a policy debate worth having”, and linked to multiple sources of information for those who were interested in finding out more. I simply asked a rhetorical question and proceeded to make a comparison to point out a very striking difference in scale between these amounts and those which this Administration was willing to lie about a mere four years ago. Of course they are different programs with different aims, and yes I like to take opportunities to remind or educate folks about past misdeeds of this administration.

A couple of comments above yours, David Remer made a substantive comment about a different tact Democrats could have taken in lieu of expanding SCHIP in the manner that they have. Frankly I would prefer to see a single payer system which eventually results in the total dismantling of private health insurance in favor of a government plan. Incremental steps like this may indeed make the best later steps more difficult.

Nonetheless, there is a current effective program which is about to expire, and renewing it in some fashion expeditiously is important for the well-being of children around the country.

I’m not saying details (or minutiae) are not important. As always the devil is in the details. All I claimed is that it makes sense to FIRST look at the big picture, because there are those who will rush to details in order to obscure the big picture.

Your comment made some vague suggestions without being specific. Is your biggest problem with the funding sources of more cigarette taxes or diversion of funds from other health care providers? By all means, let us know - give us links.

Posted by: Walker Willingham at August 1, 2007 10:08 AM
Comment #228065

Bill, like you I too would like us to move to socialized medicine like many other western nations have (and very successfully too). But S-CHIP is a program that has proven to be very effective for not very much money, so until we get to socialized healthcare, I’d like to see it continue. There is no excuse for Bush to pull the rug out from under these children and their health for the sake of his ideologies.

Walker, I’m not one in favor of raising the taxes on cigarettes to pay for S-CHIP. In my state, people who smoke are already taxed several dollars higher per pack of cigarettes, and pay for plenty of state services as a result. I think it’s time to start taking some funds from the Pentagon. From Star Wars for instance, or maybe just not build a single stealth bomber.

Posted by: Adrienne at August 1, 2007 10:44 AM
Comment #228072

Sandra,

That wasn’t quite it, but your reminder got me looking again. The following pretty well says it (notice the print date - April 8, 1999 - so this was during Bush’s tenure as governor of Texas and leading up to the 2000 Presidential election:

“While Bush and his staff were pushing the oil-and-gas tax bill through the legislature, they were also fighting to hold the line on health insurance for children whose families earn too much to qualify for Medicaid but too little to purchase private health insurance. There are 1.4 million children in Texas who have no health insurance. If eligibility were set at 200 percent of the federal poverty level, more than 500,000 of them would qualify to purchase low-cost insurance policies. Bush insisted, however, that the line be set at 150 percent, eliminating 200,000 children in a state second to California in the number of uninsured children and second to Arizona in the percentage of uninsured children.”

http://www.thenation.com/doc/19990426/dubose/2

The entire article is worth reading for nostalgic purposes, but my point then and now is that Bush has never been “compassionate” about the poor, the working poor, or the middle class. The only reasons he expanded Medicare were to line the pockets of Big Pharma and the insurance industry while also pushing Medicare closer and closer towards unsustainability.

Beginning with Reagan the social agenda of the GOP has been to “starve the beast” and replace the remnants of the New Deal with their new Raw Deal! The so-called conservative mantra should read “you’re on your own bucko”. They could care less about people going without healthcare, going hungry, or even dieing.

BTW I found that story through the Daily Howler under the headline: “DENY THE CHILDREN WELL! Bush philosophizes about health care—and we recall the history”. It’s also well worth reading.

http://www.charm.net/~somerby/dh071907.shtml

Posted by: KansasDem at August 1, 2007 2:29 PM
Comment #228082

KD…doesn’t sound to me like his “no children left behind” applies to much of anything. Of course, he never did tell us what they would’nt be left behind.
Well I’m sure that the twins always had the best that booze and drugs (perhaps a bit of bribery) could buy, so poor and/sick children are of little consequence.
I’m sorry, I am just about of fight against this imbecile, and it frustrates me, because it enforces the fact that I’m getting old and slow and tired. There is just something all the time that demands attention and a fight against the pompous insanity that abounds in the White House today.

Posted by: Sandra Davidson at August 1, 2007 5:04 PM
Comment #228092

Sandra,

NCLB is a perfect example of building from the top down. It’s created a lot of new bureaucratic jobs and even fed the pockets of private contractors, including his own brother Neil (under the guise of Ignite! Learning) who’s best known for his involvement with Silverado Savings and Loan.

http://en.wikipedia.org/wiki/Ignite%21

Most of our countries educational problems need a “bottom-up” fix rather than the other way around. More teachers, better teachers, improved school security, etc. All middle class jobs……….not more six digit earners cooking up impossible quotas.

Only a fool builds from the top down!

Posted by: KansasDem at August 1, 2007 7:29 PM
Comment #228095

John Lewis,

IMHO your comments to Walker, which I’d missed earlier, are exemplary of the “all or none” attitude of the far left. I do believe we’ll eventually achieve our goal of true universal healthcare for all Americans, but we don’t stand a snowball’s chance in hell right now.

In the mean time we must do everything we can to cover as many Americans as possible ……….. especially the children. Partly out of compassion, but also because our children and grandchildren are our future. We must squeeze Bush as hard as possible, but we must also be practical.

I personally think Walker’s article was absolutely top notch! Especially the effort of putting a successful program (SCHIP) in perspective to a failed program (the GOP Medicare reform). And I don’t take that lightly because I am a Medicare recipient.

Posted by: KansasDem at August 1, 2007 7:49 PM
Comment #228231

BillS, sorry, but your objection is wrong. Medicare and Medicaid is socialized, it collects from everyone and distributes to those with the need. Socialized has multiple meanings. You are correct that Marxian socialism calls for ownership of the infrastructure by the state. But, modern socialism is also defined as collective payment from all for services rendered by law to all in need of the service.

There are 3 main proposals in debate in Congress. One is the GOP proposal for an all privatized health care system, (libertarian view), another is for a hybrid system of single payer which underwrites legally mandated health service to the needy, while maintaining the privatized system for those who can afford it (the moderate Republican and conservative Democrat view). The last is an entirely government funded non-profit health care system which pays for basic and preventive health care for all, leaving private elective health care to those who can afford to support its continuance. (The liberal Democrat view.)

None of these proposals consider the Marxian government ownership of health care practitioning infrastructure. The latter two views however, seriously curtail the for-profit health care insurance industry, which I think is a good thing.
The liberal Democrat view however, does inevitably move us toward a non-profit dominated health care delivery infrastructure, which could be the salvation of the economy in 2040 IF handled and designed properly. (By non-profit, I mean clinics and hospitals will morph through competitive bidding for government contracts, into non-profit privately owned competitive operations in urban and suburban areas, rural areas won’t be able to support competitive operations, which is also the case under our current system.)

But, the politics of GOP opposition will not permit such handling and design to take place, and thus, it runs a real risk of bottlenecks and inefficient delivery of health care (the Republican’s self-fulfilling prophecy for a universal single payer system.) This of course presumes Republicans can maintain a sufficiently large minority status in Congress to impede and force compromises to the universal single payer system to make their prophecy come true.)

We must overhaul though, the hierarchy of medical delivery personnel if we are to make health care affordable. America must license LVN’s, RN’s, Physician’s Assistants for limited scope independent practices and outpatient non-profit treatment centers. This would relieve doctors of their overburdened work loads, and drive down the cost of safe and routine procedures that can be administered by non-doctors under doctor review and availability for consultation.

Of course, this also implies that America must install a rigorous quality control system and oversight system, which can insure a minimum of malpractice occurrences, now running rampant in our overburdened system motivated by maximum patients per hour for maximum profitability. In turn, that will require a retooling of our laws regarding malpractice suits, with limits imposed which both provide just compensation for victims while preserving the social benefit of affordable cost delivery systems.

Trying to contemplate our politicians from the Duopoly parties embarking upon such a plan, gives me a headache and grave reservations about whether our political system even can address the health care crisis now growing and peaking with the boomer retirement peak.

Posted by: David R. Remer at August 3, 2007 1:53 AM
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