Tuesday, 31 July 2007

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.

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