Wednesday, October 17, 2007

SCHIP Is About Uninsured Children


George Will shares his thoughts on SCHIP,
SCHIP is described as serving "poor children" or children of "the working poor." Everyone agrees that it is for "low-income" people.
It is described this way... by whom? Because when I look at the U.S. Department of Health and Human Services SCHIP website, I read this:
CMS Administers the State Children's Health Insurance Program (SCHIP). Program benefits became available October 1, 1997 and will provide $24 billion in federal matching funds over 10 years to help states expand health care coverage to over 5 million of the nation's uninsured children.

The State Children's Health Insurance Program (SCHIP) is jointly financed by the Federal and State governments and is administered by the States. Within broad Federal guidelines, each State determines the design of its program, eligibility groups, benefit packages, payment levels for coverage, and administrative and operating procedures. SCHIP provides a capped amount of funds to States on a matching basis for Federal fiscal years (FY) 1998 through 2007. Federal payments under title XXI to States are based on State expenditures under approved plans effective on or after October 1, 1997.
Not one mention of the word "poor". Perhaps what offends Will then is that states are actually afforded the right to share in the determination of who qualfies to participate in the SCHIP program? He lauds Bush's veto because it pares back the rights of states? And he has to "make stuff up" to make his argument more compelling?

Will whines about families who he believes to be too wealthy to be in need of help obtaining health insurance for their children:
Under the bill that Democrats hope to pass over the president's veto tomorrow, states could extend eligibility to households earning $61,950. But America's median household income is $48,201. How can people above the median income be eligible for a program serving lower-income people?
Well, Gee, George - perhaps you have forgotten your years of prattle about how employment-based benefits are part of a "welfare state" that should be eliminated, and the resulting rise of the working uninsured. Perhaps you have totally overlooked what decent health care coverage costs these days - and how if you're not part of a decent group plan you can pay an extraordinary amount of money while getting very little actual coverage. And no matter how much you keep repeating "low income", while nobody has disputed that the SCHIP program has income limits which lead to that result, that does not appear to be among the program's actual goals or elements.

During my last period of being between employment-based insurance plans - during which I was paying COBRA benefits to maintain coverage probably inferior to that Will receives for free from his employer - I priced out "group" plans available through the State Bar. For my family, I found plans which charged $1,200 or more per month, and offered very poor coverage with significant deductibles. I paid my COBRA premiums quarterly, and they were rising several hundred dollars each quarter. The last bill, right before my wife obtained coverage through a new employer, was not far off from $20,000.00 per year.

Will has a lot more concern for the financial plight of the rich, but those are "his people". When do you suppose was the last time he spoke to somebody who works for a living, other than perhaps to explain to his cleaning lady, "Next time I want this toilet bowl to sparkle."

6 comments:

  1. I think his argument could go something as follows: All children should have health insurance. In families where the parents are not poor, those families should purchase health insurance for their children with their own money. For those families that cannot afford it, the government should provide it.

    I have no clue what health insurance for a child costs. So I can't say how much someone should to make before becoming eligible for SCHIP. I can say that I have seen many people without health insurance fritter away their money on things like cable television, Doritos, beer, and other luxuries. If those people value their luxury items more than their child's health, why should I be required to pay for their child's health insurance?

    SCHIP, like all government programs, require me to give up something so that someone else can have something. Why should I be required to make sacrifices when many lower- and middle-class families refuse to make similar sacrifices?

    Now, some would say, "Mike, you have no business telling people they can't have cable TV, eat Doritos, and drink beer." I would say, "That's exactly my point. I shouldn't be able to tell them they can't have cable television. And you shouldn't tell me that, because of taxes related to SCHIP and other programs, I can't order a box of cigars this month." But that's exactly what SCHIP supporters are doing.

    They are not telling the beneficiaries of SCHIP to not sacrifice anything. But they are making me sacrifice much.

    Now, show me a family eating generic brand name foods who doesn't have cable television, and even my libertarian self would say, "The government should insure the kids." But that has not been my experience. At all. And I grew up and worked around enough poor and middle class people to know how they spend their money.

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  2. To me, that sounds a lot like a call for a nanny state. In my opinion, if the family meets the income requirements for a program, the government shouldn't be prying into how they spend their discretionary income.

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  3. Poor kids are covered by Medicaid, whether or not they are permitted to snack on Doritos. SCHIP primarily benefits kids whose parents work for a living, but still don't make enough money to pay for health insurance. I'm not one to impose a requirement on penury on working parents who want to insure their kids.

    If this dispute could be resolved by creating a reasonable sliding scale for SCHIP premiums based on parental income, with higher earning families contributing toward the cost, I would have no problem with that. But that would probably be even less acceptable to the White House. Based on their actions and statements, the Bush Administration doesn't want more kids in this program, even if their parents pay 100% of the premium.

    Everybody reading this would probably "benefit", in the sense of having a greater amount of immediate, discretionary income, if taxes were eliminated. But we don't get to pick and choose like that (well, perhaps with "sin taxes" we do, but that's a subject for a different day), we all have different priorities, and the government cannot function without funding.

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  4. It should probably also be noted that the tobacco tax element was introduced to the bill to appease Republicans. The original proposal was to fund the expansion with a cut of the subsidy to private insurance companies who (otherwise apparently can't) compete with Medicare. But for Republican obstructionism, there was no need to include a tax increase in this bill.

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  5. I have no clue what health insurance for a child costs

    That's blatantly obvious, if you think that giving up Doritos and cable TV makes the difference between being able to afford health insurance or not. (And Doritos are a luxury?)

    You also assume that buying insurance is like buying a car; you just walk in and pay for it. Clearly, you've only had insurance through your employer, where you're automatically eligible. Private insurance is a lot harder to get, because you're not part of a risk pool the way a group of employees at a company would be.

    Why should I pay for it? I'm going to pay for it one way or the other. Subsidized insurance is a hell of a lot cheaper than emergency-room visits.

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  6. http://www.census.gov/prod/2007pubs/p60-233.pdf

    That's the link to the report where Will got the 48,201 figure. That figure is the average of ALL households. The same chart shows that the median household for "married couple households" (the closest thing the census has to "family of four") at $70K. And the $70K figure that corresponds to the $62K SCHIP cap for the family of four.

    So now, an SCHIP cap of $62K doesn't seem as ludicrous.

    Will was including "non-family households" to make his point seem stronger. ("Non-family" means NO KIDS, and this is legislation about health insurance for kids.)The median household income for *nonfamily* households is 29K.

    No amount of obfuscation by George Will can get around the fact that the average cost of health insurance premium for a family of four has gone up 78% since 2001--to over $12,000 in 2006--while wages only rose 19%.

    Will says households making more than that "median" $48K should be able to pay for their own health insurance. But, after they did so, that would mean raising a family of four on (pre-tax) income of... $36,000! Guess what, that's friggin impossible.

    Sometimes I actually like George Will, but today I loathe George Will.

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