An op-ed in the NYT discusses the big argument against expanding S-CHIP: that parents will drop private coverage in favor of S-CHIP (or substitution).
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.
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.
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.
Bush says it would be irresponsible to expand S-CHIP beyond it’s original intent, as the legislature has proposed. Me thinks Bush is the wrong person to be lecturing anyone about being responsible.
Just off the top of my head…
In 2000 and early 2001 (just before and after he was elected), George pushed big tax cuts with the stated intent of “giving people back their money,” due to large budget surpluses. What happened when those surpluses turned into large deficits shortly afterward?
In 2002, Colin Powell went before the U.N. to explain why it was necessary to remove Sadaam Hussein from power in Iraq, citing the need to destroy his advanced WMD programs. I wonder how that worked out?
Let’s see, what’s the worst that happens in these examples of “irresponsible” excess?
In the case of tax policy, the worst that happens is we ring up big budget deficits.
In the case of foreign policy, the worst that happens is we destroy our credibility in the world, virtually print the terrorist recruitment flyers for them (the terrorists), get a bunch of people killed, and ring up huge budget deficts.
– Woo hoo… big check baby!
In the case of providing health care for poor kids without health insurance, the worst that happens is we add a few billion dollars to the budget (congress is asking for an increase that amounts to a fraction of what is being spent in Iraq), and a few more needy kids get health care.
Now that’s going too far.
Consider that the original intent of S-CHIP was to provide health care to poor kids who didn’t have health insurance; and the intent of the expanded SCHIP is to provide health care to kids a little less poor, who also don’t have health insurance. That’s not a big leap.
I remember when George was running against Al Gore, and later John Kerry. Both were famously chided for being “flip-floppers,” based on their changing views on certain topics. The Clinton’s were also occasionally brought into the discussion, pointing out an alleged patern of indecisiveness on the part of his Democratic opponents. What I’d like to ask you is this: what trait would you prefer in a president: someone who changes their position as circumstances change, or someone who invents new justifications (as circumstances change) for the same position? I’ve had a little experience dealing with people suffering mental illness, so I’m familiar with people who shape their perception (either consciously or unconsciously – creating justifications on the fly) to match their world view.
I would suggest to Mr Bush that in the case of S-CHIP, circumstances have changed. The ranks of the uninsured are on the rise, and many of them are our most vulnerable… our children. Many of them come from families known as the “working poor.” They have income, they own property, and they still can’t afford health insurance. My family makes considerably more than 4x the poverty rate for a family of four, and I can tell you that we could not afford the $1000/month premiums that an average policy would cost. I would further point out that it’s unlikely anyone would give us a policy at the average rate, due to our long list of pre-existing conditions. Hell, just having leukemia in remission probably puts a big, bold asterisk next to my family’s name. We’d be priced right out of the market – if anyone would give us a policy at all – if our employer didn’t provide coverage.
You can probably guess which way I’m hoping the vote goes in the House tomorrow.