Nothing the Bush Administration does surprises me any more, including this:
The Bush administration, continuing its fight to stop states from expanding the popular Children’s Health Insurance Program, has adopted new standards that would make it much more difficult for New York, California and others to extend coverage to children in middle-income families.
Of course they did this. What else did you expect? “Big government” is bad, so big government must reach out to save the states from falling into the error of big government.
David Sirota highlights two points of the Bush Administration’s argument:
The first is this passage:
“If a state wants to set its income limit above 250 percent of the poverty level ($51,625 for a family of four), Mr. Smith said, ‘the state must establish a minimum of a one-year period of uninsurance for individuals’ before they can receive public coverage.”
So basically, the pro-devolution and pro-“states rights” Republican Party is now on record saying that if a state legislature wants to extend coverage to a family of four making over $51,625, the legislature must insist that the family go without health insurance for a year. Wonderful.
The other nugget is this:
“In his letter, Mr. Smith said the new standards would apply to states that previously received federal approval to cover children with family incomes exceeding 250 percent of the poverty level. Such states should amend their state plans to meet federal expectations within 12 months, or the Bush administration ‘may pursue corrective action,’ Mr. Smith said.
This is threatening, deliberately intimidating Big Brother-style language. The federal government “may pursue corrective action?” Against who? In states that expand their CHIP programs, are federal agents going to swarm in and revoke publicly subsidized health insurance from working-class families and force those families to retroactively pay back the aid they received? Is that “corrective action?” If not, what is? I’m not even joking around here – these are very legitimate questions that we have to ask.
The most legitimate question that we have to ask, seems to me, is why is there government? In particular, what is representative, republican government good for? Do people really elect representatives to Congress so that their needs can be ignored in favor of special interests? Is the Constitution really all about limiting the power of people to establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity? If that’s really what government is all about, then I’d be tempted to throw in with the libertarians and do away with most of it.
However, I don’t think that is what government is all about. Call me a hopeless romantic or a loony liberal, but I still hold up government of the people, by the people, and for the people as the ideal.
What exactly do people reasonably expect from their government? Franklin Roosevelt explained,
The basic things expected by our people of their political and economic systems are simple. They are:
Equality of opportunity for youth and for others.
Jobs for those who can work.
Security for those who need it.
The ending of special privilege for the few.
The preservation of civil liberties for all.
The enjoyment of the fruits of scientific progress in a wider and constantly rising standard of living.
He was talking about “political and economic systems,” which may or may not mean government. He isn’t saying that government and government alone should provide those things, in other words. If private enterprise is providing “jobs for those who can work,” that’s fine. But if private enterprise is sending too many jobs overseas, what then? Does government have any role in seeing to it that enterprises incorporated in the United States are not using slave labor in the third world or importing toys covered in lead paint?
In fact, Kevin Hall of McClatchy Newspapers reports that
The Bush administration and China have both undermined efforts to tighten rules designed to ensure that lead paint isn’t used in toys, bibs, jewelry and other children’s products.
To which one might rightfully say, WTF?
The Bush administration has hindered regulation on two fronts, consumer advocates say. It stalled efforts to press for greater inspections of imported children’s products, and it altered the focus of the Consumer Product Safety Commission (CPSC), moving it from aggressive protection of consumers to a more manufacturer-friendly approach.
“The overall philosophy is regulations are bad and they are too large a cost for industry, and the market will take care of it,” said Rick Melberth, director of regulatory policy at OMBWatch, a government watchdog group formed in 1983. “That’s been the philosophy of the Bush administration.”
I’m sure all of America’s mothers and fathers who vote send their elected representatives to Congress to protect the profits of manufacturers over the lives of their children.
But let’s go back to what Roosevelt said back in 1941 about “The enjoyment of the fruits of scientific progress in a wider and constantly rising standard of living.” I would say “the fruits of scientific progress” include health care. One of the reasons health care is so expensive now is that science has opened many doors to new treatments that didn’t exist in 1941. So much of the high-priced stuff, like open heart surgery, chemotherapy, and MRIs, hadn’t yet been accomplished or invented in 1941.
So how will our political and economic systems provide these benefits of scientific progress to all citizens who need them? If private enterprise would do it, I’d be happy, but I think it’s apparent that private enterprise either cannot or will not do it, else it would be done already.
Essentially, the position of the Right is that it’s just wrong for government to use tax dollars to pay for citizens’ health care. I’m going to set aside why it’s wrong for the moment. Let’s just pretend, for arguments’ sake, that it is. Health care “solutions” coming from the Right these days mostly amount to using government programs to prop up the existing “private” system. Apparently government involvement in health care is OK as long as the involvement is indirect and the profit motive is not entirely eliminated.
Arguments against universal, taxpayer-paid health care coming from the Right vary. This one argues a single payer plan is not the same thing as risk pooling —
I think it’s a little misleading to talk about insurance pooling here. This isn’t really insurance we’re arguing about; insurance is voluntary. Single payer advocates are looking for the most politically palatable way to tax the young and healthy in order to pay for the health care of the old and sick.
And don’t you dare think of taxing the old to pay for children’s health care, either. This is not fair. It is not fair for healthy people to have to pay for the health care of sick people. (Exactly how this is different from risk pooling eludes me, unless the author thinks that healthy people never, ever turn into sick people.)
As for insurance being “voluntary” — the fact is that huge numbers of people in this country who want insurance cannot have it, either because insurance companies refuse to cover them or that insurance simply costs more than they can afford to pay. For many, health insurance isn’t something one can or cannot “volunteer” to have. It’s becoming more like a lottery, as Jane Bryant Quinn wrote last year:
America’s health-care “system” looks more like a lottery every year. The winners: the healthy and well insured, with good corporate coverage or Medicare. When they’re ill, they get—as the cliche goes—”the best health care in the world.” The losers: those who rely on shrinking public insurance, such as Medicaid (nearly 45 million of us), or go uninsured (46 million and rising).
To slip from the winners’ circle into the losers’ ranks is a cultural, emotional and financial shock. You discover a world of patchy, minimal health care that feels almost Third World. The uninsured get less primary or preventive care, find it hard to see cardiologists, surgeons and other specialists (waiting times can run up to a year), receive treatment in emergencies, but are more apt to die from chronic or other illnesses than people who pay. That’s your lot if you lose your corporate job and can’t afford a health policy of your own.
As I understand it, one of the reasons my ancestors (with some other folks, of course) fought the Revolution and established a republic was to allow ordinary folks to have a bigger say in their own lives and in their own government. But the Right seems to think this is not so. While it’s acceptable for corporations to get special favors and sweetheart deals from government, if ordinary citizens ask their representatives to make it possible for their children to receive good health care, the Right gets all worked up into a froth about it.
Others on the Right are complaining that the expansion of the Children’s Health Insurance Program would extend welfare benefits to middle-class families. But as Quinn writes, the shock of losing health insurance is rapidly becoming a middle class problem. Insurance has become so expensive — if you have to pay for it privately, you’ll probably find it costs a lot more than your mortgage — that even middle income families lose health insurance if they lose their benefits.
It is true that, as Gene Sperling explains here, some of the children who would be brought into the program already are covered by private health insurance.
But the White House well knows that every coverage-expansion plan — conservative or progressive — benefits some people who already have insurance.
In fact, the proposed S-CHIP expansions are highly efficient compared with the White House’s proposals. About 77 percent of the benefits of Bush’s plan to expand health savings accounts and 80 percent of his most recent proposal to subsidize purchases of premiums go to those who are already insured.
MIT economist Jonathan Gruber wrote to House Energy and Commerce Committee Chairman John Dingell, explaining that the House S-CHIP expansion was among the “most cost-effective means of expanding health insurance coverage.”
And as the Center on Budget and Policy Priorities points out, the disappointing rhetoric and name-calling about government-run health care is just a ruse. Seventy-four percent of children covered by Medicaid and more than three-quarters of children covered by S-CHIP are enrolled in private managed-care plans. And virtually all states contract with private providers to deliver health-care services. …
… This is the administration that was willing to finance a half-trillion-dollar prescription-drug benefit completely with borrowing and deficit spending. It is off the chutzpah charts for the White House to cry fiscal responsibility in regard to S-CHIP-expansion bills when the Democrat-controlled Congress is paying for its entire proposal with spending cuts and tobacco revenue.
What is most inexcusable about the White House stance is what they don’t say. They offer nothing — no better idea, no alternative, no plan — that has been shown to keep even a chunk of these 5 million to 6 million children from going to sleep every night without health insurance.
They are content to keep the status quo even with heartbreaking reports that uninsured infants with congenital heart problems are 10 times more likely to die because of delayed treatment than those with coverage.
I’ve got this crazy idea that when our “economic systems” are withholding fruits of scientific progress, especially fruits that might save the lives of our children, government is a tool that We, the People, may use to remedy the situation. But the Right says no; the Right says We, the People, have nothing to say about what government will or will not do for us. It’s up to government to decide what it will do for whom. Thus, we’ve got big government saving us from big government.