Wednesday, October 03, 2007

"I Believe in Private Medicine"

So said Pres. Bush after vetoing the State Children's Health Care Insurance Program legislation, which included an extra $35 billion (over five years) to cover more children whose families do not have health insurance.

Speaking in Pennsylvania, Bush said he vetoed the bill because it was a step toward "federalizing" medicine and inappropriately expanded the program beyond its focus on helping poor children.

"I believe in private medicine, not the federal government running the health care system. I do want Republicans and Democrats to come together to support a bill that focuses on the poorer children," the president said, adding the government's policy should be to help people find private insurance.

Democrats quickly took to the floors of the Senate and House of Representatives to condemn the veto of the bill that received bipartisan support. Video Watch the Democrats slam Bush's veto »

"I think that this is probably the most inexplicable veto in the history of the country. It is incomprehensible. It is intolerable. It's unacceptable," said Sen. Edward Kennedy, D-Massachusetts, who pleaded with Republicans to help overturn the veto.

I disagree with Sen. Kennedy. It's not inexplicable at all. It's unconscionable, but not inexplicable. The explanation is that we have a president who would rather play politics and advance his own narrow, partisan, ideological agenda than safeguard the health of American children.

Two days ago, Bush declared October 1 to be "Child Health Day." The creation of a day marking the importance of children's health just before he vetoed legislation containing more funding for children's health insurance is insulting and hypocritical enough. Bush, though, heaps more insult onto injury by explicitly mentioning his "support" for the SCHIP legislation:
On this day it is also appropriate to recognize the important role the State Children's Health Insurance Program (SCHIP) has played in helping poor children stay healthy . To preserve that role and ensure that poor children can get the coverage they need, SCHIP should be reauthorized.

Note that Bush says "poor children," not "children without health insurance." This is the tactic the right uses to frame their opposition to the expanded SCHIP. The implication, of course, is that "poor children" and "children without health insurance" are synonymous -- or, put another way, that children who are "not poor" (i.e., children who are "middle class") either have private health insurance or live in families that can afford private health insurance.

Paul at Powerline provides another example of this ploy. In a response to Bush's veto titled "Well Done, Mr. President," he writes:
President Bush has vetoed the SCHIP legislation passed by Congress. Currently, SCHIP is a targeted program that provides health insurance for children of low income families. However, the legislation Bush just vetoed would expand the program by providing it to children in middle class familes. In the process, the legislation would increasingly substitute government programs and taxpayer dollars for private coverage and funding.

Put this way, opposition to an expanded SCHIP makes perfect sense. Why would children who have private health insurance or whose families can easily afford private health insurance need a government program like SCHIP?

Maybe because private health insurance has become prohibitively expensive for almost anyone who isn't insured through an employer:
The president and opponents of the expansion say that it is an end-run toward nationalized health insurance and would cover children whose family’s incomes put them squarely in the middle class although today in America it’s not just poor people who need a leg up to get access to health care.

But acknowledging this reality would require Bush conservatives to be honest about their true priorities: insurance companies' profits rather than the health of American children.

Better to have folks think you're an idiot or a liar than have them think you are heartless:
The veto threat stems from a one-two punch of silly excuses. The first being that it costs too much. By the time we finally manage to extricate ourselves from Iraq, the total loss of treasure alone will reach into the trillions. Compared to this, $35 billion is mere chump change. But even funnier is the fact that unlike most Republican proposals which simply go off the assumption that money grows on trees, or in the case of Iraq that by attributing the money directly to the national debt the problem fixes itself, this expansion comes with a means to pay for it. A considerable $.65 tax on tobacco products would generate a considerable amount of revenue to pay for the program expansion, while at the same time having a net positive effect on the nation’s smoking habit. Win-win (unless you are in the tobacco industry).

The other prong in Bush’s reasoning, oddly enough, has absolutely nothing to do with the proposal at all. Bush is claiming that the expansion would make SCHIP available to families that make as much as $80,000 a year. But this isn’t based on the proposal, but instead by a failed appeal by New York to raise the limit up to the $80K mark, and has already been rejected.

Bean, blogging at Lawyers, Guns and Money, sees a pattern in Bush's vetoes:
... [H]is first veto was of a stem cell bill, and this (his fourth) is of a health insurance plan for kids. Seems to me that though Bush talks a big game on supporting a culture of life, his vetoes speak otherwise: they portend sickness and suffering for millions more Americans. He talks the talk, but in this (and so many other areas) he just doesn't walk the walk.

Shaun Mullen sees a break from pattern:
President Bush this morning quietly vetoed a bill with broad bipartisan support that would have expanded the State Children’s Health Insurance Program. Unlike previous vetoes on federally-funded stem cell research and Iraq troop withdrawals, this veto was executed without ceremony or television cameras and behind closed doors.

The shyness of a president who seldom misses a photo-op stems from the reality that his veto is a liability for Republicans already facing an uphill fight in the 2008 election.

McClatchy reporters Steven Thomma and Tony Pugh have more on that:
President Bush is putting his fellow Republicans on a collision course with the American people, forcing them to choose between guns and butter.

In this newest example of a historic clash over priorities, Bush is asking Congress for $190 billion to keep financing the unpopular war in Iraq for another year and vowing to veto as early as Wednesday a bipartisan plan to spend an additional $35 billion over five years on health insurance for children.

Polls suggest that Bush's budget battle could be a loser for his party. Two new polls — one nonpartisan and one sponsored by a labor union — showed that solid U.S. majorities want to cut the financing for the war and increase spending on children's health insurance.

Christy Hardin Smith makes some important points about middle-class families and health insurance:
How, exactly, are people working two or three minimum wage jobs and barely paying rent on top of their bills going to afford that extra $600 or more a month, let alone the $2,000 or more deductible, for a basic family health insurance plan as things stand currently? And is that the fault of these children that their parents are barely scraping by? Should we just say “screw the poor kids” even if it has a long-term cost-benefit for every taxpayer to have intervention early through preventative medicine instead of reactive worst-case care?

In fairness, though, you can't really expect that kind of nuanced thinking from a man who believes that all Americans can get affordable health care when they need it by going to an emergency room -- which is what Bush told a Cleveland audience back in July:
“The immediate goal is to make sure there are more people on private insurance plans. I mean, people have access to health care in America. After all, you just go to an emergency room.”

In the same speech, Bush informed the audience that "the best health care policy is one that emphasizes private health." He did not explain what "private health" was, but if there is such an animal, you might think its opposite would be "public health." But "public health" is actually a real concept that has meaning, and we can't have that. Anyway, Pres. Bush does not believe in public health -- that's unacceptable interference with the free market -- so the opposite of "private health," in the Bush dyslexicon, is "government control of health care":

Zuzu at Feministe has an interesting take on why Bush opposes expanding SCHIP's coverage -- and why he's tightening eligibility rules even for those children SCHIP already covers [emphasis mine]:
One thing that I found very interesting was that while Zycher kept touting Health Savings Accounts and tax credits for the purchase of private insurance, Benjamin kept pointing out that each of those alternatives would wind up costing the government MORE than simply expanding S-CHIP to cover children from families up to 400% of the poverty line (which, incidentally, is not adjusted by cost of living. So a family of four can live quite well on $80,000 somewhere like Mississippi, not so much in New York City). Moreover, Benjamin pointed out that the HSA option would result in a higher percentage of people abandoning private insurance than would S-CHIP. Which is what they’re supposed to be concerned about, right? Though I suspect that someone with a connection to the administration would be making some money managing those accounts; that has to explain why they push them so much.

So, when it comes right down to it, this isn’t really about the expense. But I think it *is* about making sure that government health insurance remains something that poor people get. Not because Bush wants to help poor people, but because he and his crowd, who would love nothing more than to dismantle all of FDR’s social programs, want to be sure that government health insurance maintains the stigma of being something, like welfare, that poor people — and in particular, poor brown and black people — get and middle-class people don’t. Because we’ve seen with Social Security what happens when you get middle-class people used to the idea of entitlement to social programs. And they sure as hell don’t want middle-class people getting used to the idea that they deserve to have government-provided health insurance in exchange for their taxes. Unfortunately for them, momentum for this very idea is building.


Chief said...

I was listening to NPR while Mrs. Chief was in the grocery store this evening. I am sure there are a lot of horror stories about tragic outcomes that could have been avoided if the person had health insurance.

But here is the one that was on NPR:

A 12 year old boy in the Baltimore area vad an abcessed tooth. Tho he qualified for Medicaid, his mother could not find a dentist who would fix the abcess for the amount Medicaid would pay. Eventually, the infection spread to the boy's brain and he died. This was in 2007.

Kathy said...

Yeah, I know about that story. It was widely publicized after it happened. And you're right; it IS horrifying.