by Paul Krugman
Published on Monday, July 30, 2007 by The New York Times
When a child is enrolled in the State Children’s Health Insurance Program (Schip), the positive results can be dramatic. For example, after asthmatic children are enrolled in Schip, the frequency of their attacks declines on average by 60 percent, and their likelihood of being hospitalized for the condition declines more than 70 percent.
Regular care, in other words, makes a big difference. That’s why Congressional Democrats, with support from many Republicans, are trying to expand Schip, which already provides essential medical care to millions of children, to cover millions of additional children who would otherwise lack health insurance.
But President Bush says that access to care is no problem – “After all, you just go to an emergency room” – and, with the support of the Republican Congressional leadership, he’s declared that he’ll veto any Schip expansion on “philosophical” grounds.
It must be about philosophy, because it surely isn’t about cost. One of the plans Mr. Bush opposes, the one approved by an overwhelming bipartisan majority in the Senate Finance Committee, would cost less over the next five years than we’ll spend in Iraq in the next four months. And it would be fully paid for by an increase in tobacco taxes.
The House plan, which would cover more children, is more expensive, but it offsets Schip costs by reducing subsidies to Medicare Advantage – a privatization scheme that pays insurance companies to provide coverage, and costs taxpayers 12 percent more per beneficiary than traditional Medicare.
Strange to say, however, the administration, although determined to prevent any expansion of children’s health care, is also dead set against any cut in Medicare Advantage payments.
So what kind of philosophy says that it’s O.K. to subsidize insurance companies, but not to provide health care to children?
Well, here’s what Mr. Bush said after explaining that emergency rooms provide all the health care you need: “They’re going to increase the number of folks eligible through Schip; 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.”
Now, why should Mr. Bush fear that insuring uninsured children would lead to a further “federalization” of health care, even though nothing like that is actually in either the Senate plan or the House plan? It’s not because he thinks the plans wouldn’t work. It’s because he’s afraid that they would. That is, he fears that voters, having seen how the government can help children, would ask why it can’t do the same for adults.
And there you have the core of Mr. Bush’s philosophy. He wants the public to believe that government is always the problem, never the solution. But it’s hard to convince people that government is always bad when they see it doing good things. So his philosophy says that the government must be prevented from solving problems, even if it can. In fact, the more good a proposed government program would do, the more fiercely it must be opposed.
This sounds like a caricature, but it isn’t. The truth is that this good-is-bad philosophy has always been at the core of Republican opposition to health care reform. Thus back in 1994, William Kristol warned against passage of the Clinton health care plan “in any form,” because “its success would signal the rebirth of centralized welfare-state policy at the very moment that such policy is being perceived as a failure in other areas.”
But it has taken the fight over children’s health insurance to bring the perversity of this philosophy fully into view.
There are arguments you can make against programs, like Social Security, that provide a safety net for adults. I can respect those arguments, even though I disagree. But denying basic health care to children whose parents lack the means to pay for it, simply because you’re afraid that success in insuring children might put big government in a good light, is just morally wrong.
And the public understands that. According to a recent Georgetown University poll, 9 in 10 Americans – including 83 percent of self-identified Republicans – support an expansion of the children’s health insurance program.
There is, it seems, more basic decency in the hearts of Americans than is dreamt of in Mr. Bush’s philosophy.
Paul Krugman is Professor of Economics at Princeton University and a regular New York Times columnist. His most recent book is The Great Unraveling: Losing Our Way in the New Century.
© 2007 The New York Times
HR 676 Universal Healthcare: Don’t Stop Believin’ (video; Kucinich; 35 percenters)
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Ok, so you want me to have a debate with someone that has a “pink rabbit” coming out of their head…….I don’t think soooo……..got better things to do……
Read the questions again, then think before you type…..kind of like taking your foot out of your mouth OR the “pink bunny” off your head …….
“i’m late..i’m late for a very important date…no time to stay and chat you see,…i’m late”……BYE……t
and you didn’t say for children, you said for all people…the same heathcare for all people
and its a rabbit, nothing coming out of his head…that is his head…what is that on your avatar? a floating tampon?
i guess being serious doesn’t include making sense. cool by me…btw, your mailman likely as not has better insurance than you as well.
Hmmm….Criminyjicket….I ususally try to be serious when I’m talking about important subjects like..uummm “healthcare for children”, but then I don’t have bubbles coming out of the top of my head on “MY” avatar…..t
i just have to ask..since we should all have the same insurance, should we all get the same pay? and what about entertainment? should our cable be the same? what about our hard drives? should everything in life be the same for everybody, or justi nsurance?
Oh, and please don’t assume that I’m for “THE OTHER CORPORATIONS ARE US ” party. Its just that i hate fascism. PERIOD…..t
I just love Krugman…..hhmmm what an interesting idea ..health care for people and as usual Bush (of the “CORPORATIONS ARE US” party) won’t support such a concept…..go figure …so what else is new……!
Change the debate….
Question….Why is it that Congress (the employees of the American People ) have better insurance than we do. There sould be only one policy for all people and it should be the exact same policy as our president and all the members of Congress…..now start asking all your friends that ….Change the Debate….t
I believe that the assumption that President Bush has any of his own thoughts is kind of presumptuous to begin with. I think that everyone except the people who are caring people believe that should there be universal health care for everyone. England has it Canada has it and of all things even the French have figured out and have it as well. Why isn’t the supposedly greatest country on earth able to figure it out and have universal health care coverage even for the Heroine addict?
Namiste and peace to you my friend,
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Too bad you feel that way about addicts.
i can almost agree with you, but then I think, why the hell should i pay for some heroin addicts methadone? Sure, his addiction created a circumstance where he can’t afford health care, but that isn’t reallym y problem. I’m for health care for the poor, the genuinely disabled (not addicts), and the elderly. Those who can work should, and should not be granted free healthcare if they are unwilling.
Oh, I agree with you on that completely. Health care for all the citizens, paid for by all the citizens (who can afford it). Singling out only tobacco users is ridiculous. It unfairly taxes the poor.
i’m all for schip, but I think the burden for paying for it shouldfall on all tax payers, not just people who use tobacco products.