[corp-focus] A Heartless "Philosophy"

[robert weissman]

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A Heartless "Philosophy"
By Robert Weissman
July 25, 2007

After six-and-a-half miserable years, it is hard to tally up the worst 
abuses of the Bush administration.

Narrow the field, and focus only on abuses related to the economy. 
That's the universe of all the favors that the Bush-Cheney cabal has 
done for Big Business, so it is still a very competitive contest.

A case can be made that the administration's effort to block expansion 
of the State Child Health Insurance Program (SCHIP) should top the list.

SCHIP is a complement to Medicaid, and provides health insurance to 
uninsured children from low-income families, typically those making up 
to 200 percent of the poverty line ($34,000). It has had enormous 
success in its 10 years of existence. Four million children receive 
health insurance through SCHIP. It has reduced the number of children in 
families at or slightly above the poverty line who are uninsured by 
about a quarter.

This has very real and concrete meaning. As the Center for Budget and 
Policy Priorities has shown, children with insurance get more 
preventative care, get better treatment for chronic conditions like 
asthma, have far fewer unmet medical needs, and get better dental treatment.

SCHIP is now up for reauthorization. Because of medical inflation, the 
program needs more money to provide insurance to the same number of 
kids. Because the program has been a clear winner, members of Congress 
from both parties want to provide this needed funding, and to expand the 
program further.

But President Bush says no.

He has a "philosophical" objection to expanding SCHIP.

"I believe government cannot provide affordable health care," Bush said 
at a media event last week. "I believe it would cause the quality of 
care to diminish. I believe there would be lines and rationing over 
time. If Congress continues to insist upon expanding health care through 
the SCHIP program -- which, by the way, would entail a huge tax increase 
for the American people -- I'll veto the bill."

Here's what is most remarkable about this philosophical objection from 
the White House: It isn't shared by the for-profit insurance industry.

Last week, the Senate Finance Committee, by a 17-4 vote, approved a 
reauthorization of SCHIP that would enable the program to cover an 
additional 4 million children without insurance. Most of these children 
-- 85 percent -- would already be eligible under existing standards, but 
would not be covered for lack of funds. The Senate proposal is funded by 
a 61-cent-a-pack cigarette tax increase, which would have health 
benefits of its own: deterring almost two million children from taking 
up smoking, encouraging more than a million adult smokers to quit.

America's Health Insurance Plans (AHIP), the trade association for the 
health insurance industry, "supports the Senate package," says Mohit 
Ghose, AHIP Vice President of Public Affairs.

"Kids coverage come first" in the effort to get all Americans covered, 
he says.

Isn't it strange that the administration is trying to protect the 
industry, but your position is supportive of the Senate approach?

It's about a "philosophical point," not protecting the industry, says Ghose.

"I defer to the White House on what is government-run healthcare."

The Bush administration's position is that an expansion of SCHIP will 
mean that some covered children otherwise would have received private 
insurance, and that the government program will therefore "crowd out" 
private insurance.

It is true that, under the Senate program, about a third of kids newly 
covered would otherwise have had private insurance. But as the Center 
for Budget and Policy Priorities emphasizes, this is unavoidable (if you 
are in fact trying to avoid it): the patchwork nature of U.S. private 
health insurance makes it impossible to cover any group outside of the 
very poorest and not also provide coverage to some who would otherwise 
have some private insurance. Moreover, says the group's Matthew 
Broaddus, any parent switching their child from private insurance to a 
public program is doing so either because they have to pay too much 
out-of-pocket, or because they think they can get better care from the 
public program.

Where the private insurance industry does line up with the 
administration is in opposing a bolder plan moving forward in the House 
of Representatives. The House plan would cover more uninsured children, 
which does start to worry AHIP, and it would pay for the expansion both 
with a cigarette tax and by collecting excess payments to private 
insurers in the misnamed Medicare Advantage program. Medicare Advantage 
lets seniors opt for a private insurance plan in lieu of traditional 
Medicare. These private plans are collecting at least 12 percent more 
per covered person than it costs to treat a person under Medicare. The 
industry is adamantly opposed to efforts to stop these overpayments.

As against expanding SCHIP, the administration proposes a preposterous 
tax credit to help pay for individual insurance coverage. Because 
individual insurance coverage is both the least efficient component of 
the health insurance market and the one most rife with abuse, it is a 
certainty that the administration plan would be a failure.

One benefit of having already suffered through the long reign of 
President Bush is that he no longer commands the authority he once did. 
The vast majority of people in the United States oppose his position and 
-- in a change -- a strong majority in Congress oppose him, as well.

But will Bush veto SCHIP expansion? Will enough Republicans break from 
the administration to override (or prevent) a veto? That depends on how 
loudly the public insists its elected officials choose healthcare for 
kids over twisted philosophies.

Take action now via the Families USA website: 
<http://ga3.org/campaign/childrenshealth>.


Robert Weissman is editor of the Washington, D.C.-based Multinational 
Monitor, <http://www.multinationalmonitor.org> and director of Essential 
Action <http://www.essentialaction.org>.

(c) Robert Weissman

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