Search result for 'S-chip'.


Michelle Malkin vs. Reality

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Obama Administration

It’s been awhile since I’ve written anything about Michelle Malkin, since I rarely run into her on the Web any more. We travel in different circles, apparently. But today I bumped into a column she wrote about Obamacare that shows she’s still the same toxic waste dump of stupid she ever was.

Here’s the story: Because she’s self-employed — a “self-employed small-business owner” in her words — she buys insurance on the Colorado state insurance exchange. But she is not happy.

Our most recent plan features a $6,000 deductible with a $1,000 monthly premium. It’s nosebleed expensive, but provides us access to specialists not curtailed by bureaucratic gatekeepers. This has been important for us because several members of my family have required specialized care for chronic illnesses.

Once again, however, I’ll soon be talking about our plan in the past tense. Choices for families like mine have evaporated in the era of Obamacare. In Colorado, UnitedHealthCare and Humana will cease selling individual plans next year. Rocky Mountain Health Plans is pulling out of the individual market in all but one county. Nearly 100,000 of my fellow Coloradans will be forced to find new insurance alternatives as open enrollment approaches on Nov. 1, according to the Denver Business Journal.

Here’s her punch line:

Every time we receive a cancellation letter, I recall President Obama’s big lie: “If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what.”

Now, that was an ill-advised thing for the President to have said; he probably meant to say that if you like the insurance you have the government won’t take it away from you. But that’s not what he said, so it’s been held against him, and the ACA, ever since.

But it’s not as if people didn’t have their health insurance ripped out from under them before the ACA was passed. It happens frequently enough to people who get their insurance through employment. It’s happened to me at least twice, when an employer decided to go with a different company for group insurance. I remember finding a co-worker weeping, because the new network didn’t include the trusted oncologist who had been helping her husband battle cancer. This was sometime in the late 1990s, long before the ACA.

I don’t know why Colorado or some other states are losing insurance companies, although see Sarah Kliff for one explanation. But this is nothing that a federal pubic option wouldn’t fix, I suspect.

And you’d think that health insurance costs had never gone up before the ACA was passed. The chart from Kaiser shows how employer-based health care has been going up all these years:

But now I want to go back to what Malkin wrote — she’s self-employed, and “several members of my family have required specialized care for chronic illnesses.” And it’s expensive, but it “provides us access to specialists not curtailed by bureaucratic gatekeepers.” I want to know what Malkin was doing for insurance before the ACA. Did she have any at all? If so, did it provide as much coverage? Does she realize that in most states before the ACA, if you had a chronic condition you could be denied coverage? Those pesky pre-existing conditions!

So, thanks to the ACA, she’s got insurance, in spite of the cancellations. Other policies are available in Colorado. She may not like her choices as well, but she’s got choices. Before the ACA, lots of people had no choices. And because so many states stubbornly refuse to expand Medicaid, lots of people who could have choices still don’t have them.

Are some of those family members with chronic conditions children? Remember the war Malkin waged against the S-chip program?

And if she hates Obamacare so much, why is she using it? Oh wait .. because there’s no other insurance available to her? Just a guess. Before the ACA, where you could buy private health plans at all, they tended to be ripoff plans with lousy coverage. In states that didn’t allow ripoff insurance to be sold, often there was little to no private insurance market. Complain to the insurance companies about that, toots.

And yes, health insurance is expensive because health care in the U.S. is expensive. That’s because it’s a mostly private, for-profit system, and there are few controls on price gouging. That was true before the ACA was passed, and it will still be true if the ACA is repealed.

And most of these problems would go away if we reduced or eliminated our dependency on a private, for-profit health care industry — which I’m sure Malkin opposes.

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Free to Die (Quickly)

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Obama Administration

Paul Krugman weighs in on Ron Paul’s “let ‘im die” sympathies.

The incident highlighted something that I don’t think most political commentators have fully absorbed: at this point, American politics is fundamentally about different moral visions.

Now, there are two things you should know about the Blitzer-Paul exchange. The first is that after the crowd weighed in, Mr. Paul basically tried to evade the question, asserting that warm-hearted doctors and charitable individuals would always make sure that people received the care they needed — or at least they would if they hadn’t been corrupted by the welfare state. Sorry, but that’s a fantasy. People who can’t afford essential medical care often fail to get it, and always have — and sometimes they die as a result.

The second is that very few of those who die from lack of medical care look like Mr. Blitzer’s hypothetical individual who could and should have bought insurance. In reality, most uninsured Americans either have low incomes and cannot afford insurance, or are rejected by insurers because they have chronic conditions.

Krugman goes on to argue that the “moralists” of the Right think it is more moral to allow the poor, even poor children, to die, than to subsidize any part of health care with taxpayer dollars. This include poor children, as witnessed by the fight over S-Chip.

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Sick of It

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conservatism, Financial Crisis, Health Care

Adventures in the land of the Best Health-Care System in the World™:

They borrow leftover prescription drugs from friends, attempt to self-diagnose ailments online, stretch their diabetes and asthma medicines for as long as possible and set their own broken bones. When emergencies strike, they rarely can afford the bills that follow.

The article is about how you get health care if you’re a 20-something living and working in New York City. However, I suspect this is true of vast numbers of 20-somethings throughout America. And I want to emphasize that we’re talking about children of the middle class. I’m not saying children from lower-class families don’t deserve health care as much. The point is that if this were a coal mine, the canary would be decomposed to a pile of bones and feathers by now.

Of course, some healthy young people who are eligible to get health benefits from employers choose not to do so because they are foolish. But many more, I think, either don’t get health benefits from their jobs or honestly cannot afford what they’d have to pay to join their company group insurance plan.

Today, the same people on the Right who fought S-CHIP expansion tooth and nail suddenly care about young people, although not about their health. Little Lulu and some of the other hysterical shriekers are pushing “porkulus” protests against the stimulus package. Lulu’s got photos of children and youths holding signs saying “I don’t want to pay for the ‘swindle-us’ package” and “Say no to generational theft.” But when Moveon produced videos like the one, for some reason the Right was not moved.

But as Steve M says, if the Right wants to waste its time with tactics that didn’t work for the Left, who am I to complain?

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More Suggestions

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Bush Administration, Congress, Republican Party

A couple of editorials in tomorrow’s New York Times that will get your heart pumping … first, “Playing Games With Toy Safety“:

With the holiday season approaching, there is more bad news about the federal agency charged with protecting children from unsafe toys. Nancy Nord, acting chairwoman of the Consumer Product Safety Commission, joined industry lobbyists in opposing a Senate bill intended to strengthen her enfeebled agency. That was followed by the revelation that Ms. Nord and her predecessor took free trips from the toy industry.

Second, “Republican Tricks on Children’s Health“:

For weeks now, the president and his Congressional allies have charged that the Democrats are unwilling to negotiate a compromise on expanding the State Children’s Health Insurance Program, or S-chip, because they want to use Republican opposition as a campaign issue. But it is the Senate’s Republican leaders who are doing their best to block any compromise.

They clearly would prefer to have no bill enacted — and provide ammunition for the president’s campaign to depict Congress as a failure — than do anything meaningful to help children.

Words fail.

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Where Next for Conservatism?

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big picture stuff, conservatism

Gary Kamiya has an excellent article in Salon that asks if American conservatism can heal itself.

American conservatism is at once absolutist and utopian, and reactive and aggrieved. Which state came first is a chicken-and-egg question, but they reinforce each other. Psychologically, conservatives want contradictory things — both pure freedom and an unchanging Golden Age. Pragmatically, they want things that are mutually exclusive — no social contract and an organic, connected community, untrammeled individual rights and a rigid moral code. The inevitable disappointment results in resentment. The reason that the American right always behaves as if it is an angry outsider, even when it controls all three branches of government, is that it is at war not with “liberalism” but with social reality.

When you’re talking about conservatism you’re supposed to clarify whether you are talking about libertarian conservatism, social values conservatism, America First conservatism, or some other critter. In a logical world, the libertarian get government out of my business conservatism ought to clash with social we’ll make you behave or else conservatism, but it’s not at all uncommon to find righties who take a libertarian view on some issues (e.g., taxes) and an authoritarian view on other issues (e.g., abortion; warrantless wiretapping). Untrammeled individual rights for me; a rigid moral code for everyone else.

Kamiya asks if “the conservative movement is foreordained to remain in its current debased form.”

There will always be substantive issues on which conservatives and liberals will have good-faith differences. It would simply be a more mature conservatism.

The history of American conservatism does not inspire much confidence, however. In spite of its moderate roots, it has succeeded mainly via absolutist, reactionary politics. This approach has enormous emotional appeal for Americans for whom the modern world is a source of confusion, anger and fear, or who simply disdain the social contract . And the Republican Party is now entirely in thrall to it. The current crop of GOP candidates hold uniformly hard-right positions, with the exception of the libertarian, no-chance Ron Paul. The leading GOP contender, Rudy Giuliani, is even more of a maniacal hawk than Bush on the Middle East and national security. These are hardly signs that the right is moving to the center.

FYI, Ron Paul is plenty far to the right on a great many issues.

But sooner or later, conservatives will have to change course or see their movement wither away.

The issues that have been winners for conservatives are fading. White resentment of federal civil rights laws is the ur-conservative issue, the engine that drove the right’s rise. Barry Goldwater, by reluctantly voting against the Civil Rights Act, permanently realigned the South and paved the way for Nixon’s “Southern strategy.” More recently, right-wing strategists successfully mobilized resentment over “values” issues like the “three Gs” — gays, God and guns. These issues still mobilize some conservative voters, but they aren’t nearly as effective as they used to be. Studies show that the electorate, especially younger voters, are moving left on these issues.

That’s the best one-paragraph summary of the past 40 years of American politics you’re ever likely to read. White resentment of federal civil rights laws, desegregation, Lyndon Johnson’s anti-poverty programs, and affirmative action were like a big boulder dropped in a lake, sending waves in all directions, and movement conservatism has been riding those waves ever since. “Values” issues like prayer in school and abortion and “security” issues like the communist threat (now the “Islamofacist” threat) made waves also, but IMO white racism truly was “the engine that drove the right’s rise,” as Kamiya says.

But, although racism is still with us, I think the racist wave is dissipating, and white voters don’t respond to the dog whistles the way they used to. And I think that’s because more and more whites are one missed paycheck away from disaster and barely hanging on to middle class status by their fingernails. A person facing potential financial ruin is not so likely to sneer about “entitlements” and “government handouts.” Pride goes before destruction, a haughty spirit before a fall.

In the end, conservatism will have to decide if it wants to be a real party of governance, moving beyond empty labels to engage with real issues, or if it wants to remain a party of reaction, in permanent rebellion against modernity, proffering emotionally satisfying but incoherent policies. Conservatism claims to be a politics of authenticity, but it is actually a politics of impulse and instinct. It is based on unmediated emotions, erupting from the individual ego — Get big government off my back! Keep those civil rights laws out of my white backyard! Lower my taxes! This is ultimately an infantile or an adolescent politics, a failure to come to terms with a world that does not do exactly what the omnipotent self demands. Does conservatism want to grow up, or stay an angry teenager forever?

Preach it, Brother Gary.

The new conservatism would not be liberal. It would still tilt toward small government and lower taxes, would reject policies aimed at equal outcomes, would oppose affirmative action and unrestricted immigration. That’s why it would be conservative (and, anticipating outrage from liberal Salon readers, why I wouldn’t support it). But it would abandon its facile government bashing and appeals to raw emotion. Above all, it would aim at working to build an America that, despite political differences, would pull together, would feel like a united country. It would take seriously that old saw about one nation, indivisible, with liberty and justice for all.

It’s hard to imagine the party of Karl Rove and Rush Limbaugh moving to the center. But if Americans turn away from the politics of resentment and fear, the GOP may be forced to follow them.

Just as an example of Why Conservatism Is Screwed, consider Jonah Goldberg’s column in today’s Los Angeles Times. Goldberg is an unoriginal thinker and pedestrian writer who got to be a big shot columnist promoting the virtues of taking care of oneself because he is Lucianne Goldberg’s son. Who needs government handouts when you’ve got nepotism? Anyway, today Goldberg writes,

The problem is that conservatism, even Reagan’s brand, wasn’t as popular as we often remember it. Government spending continued to increase under Reagan, albeit a bit more slowly. Today, the U.S. population is 30% larger but government spending is 84% greater (adjusting for inflation) than it was when Reagan delivered his 1981 inaugural address. That was the speech in which he declared: “In this present crisis, government is not the solution to our problem; government is the problem,” and vowed to “curb the size and influence of the federal establishment.”

In 1964, two political psychologists, Lloyd A. Free and Hadley Cantril, famously asserted that Americans were ideologically conservative but operationally liberal. Americans loved Barry Goldwater’s rhetoric about yeoman individualism, but not if it meant taking away their Social Security checks or farm subsidies. “As long as Goldwater could talk ideology alone, he was high, wide and handsome,” they wrote. “But the moment he discussed issues and programs, he was finished.”

The flaw was not necessarily Goldwater’s. As Gary Kamiya wrote in the Salon article linked above,

Conservative ideals are laudable: Who is against freedom, tradition or the preservation of community? The problem is that while they’re beautiful in the abstract, it is difficult to base a coherent governmental policy on ideals alone. Once these principles enter the real world of politics, governance and society, a world that requires compromise and the curtailment of individual freedom for the common good, they are useless as guideposts. If they are taken as moral absolutes, they cancel each other out: The apotheosis of the individual leads to the destruction of community and tradition.

When Kamiya writes “a world that requires compromise and the curtailment of individual freedom for the common good” I believe he’s using the word freedom in the sense of being unrestrained, as opposed to political freedom. But on the Right the word freedom has been drained of all meaning; it is merely ceremonial. We lefties who still care about the Bill of Rights are dismissed as “civil liberties absolutists.”

Goldberg continues,

Liberals have an inherent advantage. As long as they promise incremental, “pragmatic” expansions of the government, voters generally give them a pass. And every new expansion since FDR and the New Deal has created a constituency for continued government largesse. …

… “Liberals sell the welfare state one brick at a time, deflecting inquiries about the size and cost of the palace they’re building,” writes William Voegeli in an illuminating essay, “The Trouble with Limited Government,” in the current issue of the Claremont Review of Books.

Committed conservatives, meanwhile, find themselves at a disadvantage: They advocate smaller government for everybody — when Americans generally (including most Republicans) want smaller government for everybody but themselves.

In Goldberg’s view, people support liberalism because they are greedy. They want largesse. They demand entitlements. But notice that Goldberg defines “smaller government” purely in terms of domestic spending. He famously supports war, war, and more war, and the government spending that goes with war. He has advocated warrantless police strip searches of children. He is OK with criminalizing abortion. “Big government” is fine when it interferes with other people’s personal lives. Goldberg just wants to keep it out of his pocket.

Under all-Republican rule, the federal government got bigger and more intrusive even as it became more corrupt and less competent. I believe that is symptomatic of the inherent incoherence of movement conservatism. Right wingers want to control because they don’t know how to manage. The Bushies in particular seem to think that if they can just get enough control and operate without public scrutiny, they can force events and the world to bend to their will. Then to prove he’s against “big government,” Bush vetoes S-CHIP.

Just call ’em “totalitarians for freedom.”

Update: See also Busy, Busy, Busy.

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Override Fails

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Bush Administration, Congress, Health Care

The House failed to override Bush’s veto of S-CHIP. The Carpetbagger has details.

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Bush: “It’s All About Me”

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Bush Administration, Health Care

George Bush, on why he vetoed S-CHIP:

Q I wanted to ask you about S-CHIP and why you even let that get to a situation where it had to be a veto? Isn’t there a responsibility by both the President and congressional leadership to work on this common ground before it gets to a veto?

THE PRESIDENT: Right, as I said, we weren’t dialed in. And I don’t know why. But they just ran the bill, and I made it clear we weren’t going to accept it. That happens sometimes. In the past, when I — I said, look, make sure we’re a part of the process, and we were. In this case, this bill started heading our way, and I recognize Republicans in the Senate supported it. We made it clear we didn’t agree. They passed it anyway. And so now, hopefully, we’ll be in the process. That’s why the President has a veto. Sometimes the legislative branch wants to go on without the President, pass pieces of legislation, and the President then can use the veto to make sure he’s a part of the process. And that’s — as you know, I fully intend to do. I want to make sure — and that’s why, when I tell you I’m going to sprint to the finish, and finish this job strong, that’s one way to ensure that I am relevant; that’s one way to sure that I am in the process. And I intend to use the veto.

That certainly explains a lot. See also Dan Froomkin.

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Life, Liberty and the Pursuit of Happiness

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Health Care, Republican Party
    We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. — That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, — That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness. — Some historical artifact hanging in the Rotunda that Republicans might want to read sometime

Yesterday I linked to an NRO post by Mark Hemingway that attacked the parents of Bethany Wilkerson. Among other insinuations, Hemingway wrote,

While the debate around the Frost family at least initially centered around their relative wealth, the issue really at hand is one of bad behavior. While USAction and a labyrinthine maze of leftist activist groups prepare to rally around images of Tampa Bay’s Most Photogenic Baby holding up a crayon sign that says “Don’t Veto Me,” Dara and Brian Wilkerson are real poster children — for irresponsible decisions.

On the conference call, Dara admitted to me that she and Brian had been talking about having children since before they were married. She further admitted that after they were married she voluntarily left a job at a country club that had good health insurance, because the situation was “unmanageable.” From there she took a job at a restaurant with no health insurance, and the couple went on to have a baby anyway, presuming that others would pay for it and certainly long before they knew their daughter would have a heart defect that probably cost the gross national product of Burkina Faso to fix. But not knowing about future health problems is the reason we have insurance in the first place.

Blog reaction to Hemingway was, um, strong. Bill Scher:

In the conservative vision for America, the only people who should choose to have children are people that can afford health insurance. Or in other words: “Pro-Life (If You Can Pay For It).” …

… The honest conservative response to seeing the struggles of working class Americans is to mock them.

And the more honest conservatives are about their cold and callous vision for America, the easier it will be for American voters to make informed decisions about where we should go as a nation.

The Carpetbagger:

Hemingway left out a pertinent detail: Dara left that job seven years before Bethany was born. The implication in the National Review piece is that Dara should have stayed at her job in order to provide for her family. The reality shows otherwise. (And Hemingway’s decision to leave this fact out doesn’t reflect well on his argument.)

Digby:

Implicit in all of this is that every parent in this country has an obligation to either work for someone who provides health insurance for their families —- or be rich. The alternatives — entrepreneurial risk taking, working for retail employers like Walmart or restaurants which fail to provide health insurance, is something that no responsible parent would do. Therefore, that sector of the economy is completely off limits to middle class families. And that is the only sector of the economy that’s actually growing.

(Oh, and by the way, those health insurance providing companies which all responsible middle class should work for are under no obligation to these employees with kids who indenture themselves for the benefit. They are allowed to pull back this coverage any time they want, raise the contributions and fire the employees at will. That’s what Republicans call “liberty.”)

Today Hemingway is whining that he’s been misunderstood:

I suggested that the Wilkersons might have sacrificed by working less-desirable jobs, if that choice (or those choices) meant they could more adequately provide for their daughter. I said that a married couple that has been talking about having kids for years, but has failed to sacrifice financially or make basic economic preparations to pay for their first kid, is acting irresponsibly. That’s hardly “anti-life.” It’s common sense. How many people are in less than optimal jobs because of good benefits for their dependents?

Dude — we heard you the first time.

Life shouldn’t be something you put up with. Certainly, all of us deal with less-than-optimal situations every day; that’s life. But when the big stuff, the stuff that eats most of your time and concern — like your job or your marriage — become something you are just enduring year after year because you don’t have a choice, your life can seem like something you’re just waiting out.

I’ve had jobs that were so miserable I sincerely wondered if I wouldn’t be happier living in a cardboard box on the street. Once I bailed out of an insufferable work situation and found a new job that was even worse. And yes, I do ask myself if it’s me, but I have also had pleasant jobs that I’ve had to leave for reasons unrelated to the job. I think I have bad job karma.

We don’t know what Dara meant by “unmanageable.” Maybe the job required putting in unreasonable hours, which is not compatible with being a parent. Maybe the boss was hitting on her, or was abusive in some other way. I had one boss once who expected me to cheat the vendors and customers to save her money, which I found intolerable. There are some things nobody should have to put up with.

Let’s say Dara enjoys her current job and likes her boss and co-workers. What kind of “free” society would force her to choose between a job she likes and having children?

Freedom is about making your own choices, so let’s talk about choices. President Bush and other right wingers warn us that if we switch to “socialized medicine,” we’ll lose the freedom to choose our own doctors, which is bogus on two levels. First, citizens in most countries with universal health care can choose their own doctors. Second, under our current “system” workers all over America already have been forced to switch doctors by their employer’s managed care plan. And they can’t shop around for a new employer with a better managed care plan, because if they have pre-existing conditions they won’t be insured at all. So what choices do they have?

Even if you have insurance there’s no guarantee you’ll keep it if you develop a major medical problem. Get cancer, lose your home. Some choice.

In America, once upon a time, most people who weren’t slaves or servants were, in effect, self-employed. The whopping majority of free people were farmers. A young person might work for someone else for a while to learn a trade, with the expectation that he would strike out on his own when he was ready. In the 19th century, as the industrial revolution pulled people off farms and into factories, having to work for someone else was derided as “wage slavery.” Now, holding a job is not only respectable, it’s expected. A job isn’t slavery if you can walk away from it, right? But for growing numbers of Americans the system is rigged so that they can’t walk away from it. Call it “insurance slavery.” Road to serfdom, anyone?

John McG of Man Bites Blog writes,

That many people are in jobs they hate for the sake of insurance is a bug, not a feature. … Does the GOP really want to be the party of forcing people into life-sucking 40 hour a week jobs for huge companies for fear that they won’t have insurance? Seems like a loser to me.

I don’t care what the lyrics to the national anthem say; we’re not “the land of the free” if Americans aren’t allowed to make reasonable choices about how to live their own bleeping lives.

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Child Derangement Syndrome

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Bush Administration

This morning I posted a video featuring 2-year-old Bethany Wilkerson in support of S-CHIP. Now Faiz at Think Progress catches us up on the right-wing smear of the Wilkerson family. Read and be outraged.

Rightie Rick Moran had written,

I note that this time around, the Democrats were careful to push a family forward whose choices regarding health insurance couldn’t be questioned. In that respect, if they’re waiting for conservatives to attack the Wilkerson’s, they are going to be sorely disappointed.

Um, guess again.

John Amato reports
that even some of the talking heads on Faux Snooze are putting some distance between themselves and the attacks on the Frosts and Wilkersons. Neil Gabler and Jane Hall tried to talk some sense into Cal Thomas and James Pinkerton. As if.

Update: See also Hale Stewart.

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The Time Is Now

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Bush Administration, Congress, Health Care

Christy writes,

Please make those calls on SCHIP today. These kids are depending on all of us. Let’s get to work…

PS — In case you’ve missed it, we’ve flipped two Bush Dogs. Three to go — you can help us keep the momentum going by donating to Blue America PAC. Thanks to everyone for all the hard work and support on this.

Here’s another child Malkin will claim we liberals are abusing:

From Politico, about Bethany’s parents:

For the record, the Bo and Dara Wilkerson say they make $34,000 in combined income from restaurant jobs in St. Petersburg, Fla. They rent their house and the couple owns one car, which Bo calls “a junker.” Malkin and other bloggers have revealed over the past week that the Frost family owned two properties, as well as a couple cars, and had a $45,000 income. The accusation against Democrats, and by extension the Frost family, is that they are too middle class to be granted any subsidized health insurance for their children.

The Wilkersons said they are fully aware of the possibility that their finances and personal lives may be investigated by opponents of the SCHIP bill.

“We rent a house, we have one car that is a junker. Let them dig away,” Bo Wilkerson said. “I have $67 in my checking account. Does that answer your question?”

Righties might answer that they aren’t opposed to TRULY NEEDY children getting S-CHIP. They are opposed to middle-class children who already have insurance getting on the public dole. The response to this comes in an editorial in today’s New York Times:

First, nobody who enrolls in S-chip would be living on government handouts. The families would all be paying appropriate premiums and co-payments. It is also highly unlikely that a lot of people would drop private coverage to enroll in S-chip. States already monitor such substitution and take a number of steps to deter it.

New York estimates that only about 3 percent of the children enrolled in the program came from families that dropped employer coverage to obtain S-chip. Mathematica Policy Research, in a report prepared for the federal government, looked at states across the country and pegged the typical substitution rate at less than 10 percent.

Using a broader methodology and peering into the future, the nonpartisan Congressional Budget Office estimates that the bill vetoed by President Bush would increase enrollment in S-chip and Medicaid by 5.8 million in 2012. Of that total, 3.8 million children would otherwise be uninsured and 2 million would be children who could have gotten private insurance in the absence of S-chip.

Even if that 1-in-3 substitution rate should turn out to be accurate, it is still far better than denying insurance to millions of American children.

From the standpoint of a child’s health, it is often a good thing to substitute S-chip for private coverage. If the available private policy has skimpy benefits or is so costly it devours a family budget with large premiums and cost-sharing, the child may not get needed medical care.

Some critics of S-chip like to cite substitution estimates that are much higher. Mathematica found that so-called “population-based studies” estimated the substitution rate at 10 percent to 56 percent, depending on the approach and assumptions used. These studies capture not only families that dropped private coverage to go into the S-chip program but also families that had an opportunity later to take out private insurance yet stayed on the public program.

The problem with these studies is that they assume that all parents that dropped or decided not to go with private coverage did so because of the availability of S-chip. They ignore other very possible circumstances, such as when families lose their private coverage because a parent dies or loses a job. These studies also take no account of whether a private policy, though theoretically available, was too costly to be affordable for a low-income worker.

Richard Wolf reports for USA Today that House Republicans are getting heat from their constituents on S-CHIP:

On television and radio, in phone calls and e-mails, proponents of the five-year, $35 billion increase are pressuring about 20 Republicans to switch sides and help override President Bush’s veto. The full-court press includes preachers, rock stars such as Paul Simon and sick kids in an effort to sway the result — or the next election.

The odds are against us, folks. But if the veto stands, that doesn’t mean the fight is over. It means a lot of right-wingers are going to be clobbered by S-CHIP in the next election. Representatives need to think hard about who they represent — the military-industrial complex, or the people?

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