Setting the Record Straight on S-CHIP
As a parent of now-grown children, there perhaps was nothing more terrifying than wondering if they would be able to get health care should I lose my job.
That thankfully never occurred. I had health insurance through my employer and could not be considered to be poor. But it is something that parents have to confront today who also are not poor but whose children are among the 9 million in the U.S. who are uninsured.
That is the rub of – and a central misunderstanding in — the debate over expanding the popular federally-funded State Childrens’ Health-Insurance Program and yet another instance in which the so-called compassionate conservatism of the Bush administration is nothing less than an attack on a beleaguered middle class.
Opponents of expanding S-CHIP tirelessly point out that the program would cover children whose family’s incomes put them squarely in the middle class as if that were some budget-busting giveaway – pork for parents, as it were – whereas the reality is far different:
Today in America, not just poor people need a leg up to get access to health care.
Please click here to read more at Kiko’s House.
40 Responses to “Setting the Record Straight on S-CHIP”
Far be it for me to defend President Bush, but I’m surprised how quickly you jump to the conclusion that opposition to S-CHIP must be attributed to nothing less than attack an a beleaguered middle class. Isn’t it possible, Shaun, that opposition to S-CHIP could be attributed to the concept of federalism, in which certain functions of government are left to the individual states and not the federal government?
Granted, Bush has hardly been one to follow the letter of the Constitution (i.e. signing statements, electronic surveillance program, and ignoring Habeas Corpus in the case of Jose Padilla), but there are principled conservatives and libertarians who oppose S-CHIP who have nothing to do with an attack on a beleaguered middle class.
There’s nothing in the Constitution that grants the federal government to implement insurance programs. If fiscal progressives insist on having an elastic intrepretation of the Constitution on fiscal matters, then they really shouldn’t be so surprised when neoconservatives insist on having an elastic intrepretation of the Constitution in carrying out their War on Terrorism.
Nick:
Your argument is just fine in the abstract but collapses under the weight of reality.
While there is nothing in the Constitution that grants health-insurance companies the right to set the rules in the health-care system, there indeed also is nothing that demands that the federal government bankroll health-car programs.
But as it is, health-insurance companies (who represent one of the largest D.C. lobbies) have been allowed to be the tail that wags this particular dog while the White House has been adamantly opposed to expaning federally-funded health-insurance programs with the conspicuous exception of Medicare, which it had no choice but to do because of the political consequences.
A reality check, my friend: America’s middle class is in dire straits as the soaring level of home foreclosures, auto reposessions, credit card debt and diminishing employe health-care and pension programs well show. Then there is the fact that the median hourly wage has risen a little less than 10 percent in the last 25 years while productivity has grown by more than 70 percent.
That is not entirely the fault of the federal government, or the Bush administration in particular.
Some of that has to do with long-term trends. the vagaries of the financial markets, poor decision making on the part of some members of the middle class, and so on and so forth.
But the fact of the matter is, except for enormous tax cuts for the rich and piddling cuts for the middle class, the Bush administration has done nothing over the past six years to give a leg up to middle class American families.
Bush’s expected S-CHIP veto will keep that sorry record alive. Please don’t give him a free pass on principle.
Shaun, shame on you. Our government needs the extra money so that they can give tax breaks to large oil companies.
But don’t worry, that’s not welfare so it’s okay.
There are principles, but there are also higher principles.
States rights, personal responsibility, etc are admirable principles.
But when a patient, or a nation, is sick, the highest principle should be to find a cure. There is nothing to admire about a doctor who refuses to give a patient medicine because a federal truck, instead oa a state-owned truck delivered supplies.
I don’t see how these counter my orginal argument, which was that many people oppose S-CHIP on the basis of federalism.
I’m not arguing that things are not as bad as you say they are. I’m not disputing your statistics. You could cite all the statistics in the world, but that doesn’t change the fact that there’s nothing in the Constitution to grant the federal government the power to implement S-CHIP or any time of insurance program. That you wan’t it to exist or that there is a need for it to exist does not make it Constitutionally legal.
As to giving President Bush a free pass, Bush has been one of the most reckless and prolifrogate spenders of American taxpayer dollars in American history. You’d have to go back to Lyndon Johnson to find a president who spent money as quickly as Bush did during his first term in office. The easy thing for Bush to do would be to do the politically popular thing and support S-CHIP, the way he supported the boondoggle of a prescription drug plan that he signed into law (and ended costing hundreds of billions more than what the administration said it would cost–kind of like the Iraq War).
Sorry, but the fact that Bush is being a bit more fiscally responsible (and not signing every single bill that comes across his desk the way he used to) isn’t something that I find myself growing upset about.
That’s the whole point, not only with this program but with 2/3 or more of what the federal government does, where the federal government encroaches into what correctly are and always ought to be state and local issues only. (Amend the Constitution if you want to grant power to the federal government to do what you want it to do.)
Certainly that has been claimed by many over the years who have trashed the Constitution and made our federal republic more and more like a unitary state (with power concentrated in, as it is arrogated by, Washington). Not that your argument is valid, but it was on firmer ground in the past when FDR engineered our nation’s third revolution (the Civil War was the second). Back then there was a “need” to “do something” about the Great Depression, a true crisis, nothing like hyped “crises” we hear of now.
Since then federal growth has been such that many no longer question the impropriety of encroachment into state and local affairs (many of you in fact have contempt for federalism) and, perversely insofar as our constitutional system is concerned, you look first, foremost, and sometimes only at the federal government to find solutions to all problems. “Higher principles” in practice is merely a means to feel better about demanding whatever you want even though it violates the letter and the spirit of the existing law. Perhaps it helps to assuage the guilt you really ought to be feeling.
This is where you go wrong, in seeking sympathy with your position. The real issue here is that S-CHIP was intended to help the poor, so it should not be expanded to benefit those who are not poor. This is an underhanded growth of an entitlement to distort the character or nature of the program itself, just as you have distorted the situation with the program and opposition to the bill that changes it.
Nick, I’m sad to say I disagree with this; federalism has incrementally vanished since the 1930s (there were violations of it in earlier years as well) and few people today care about, even respect, the concept (and by implication, our constitutional system, though they’d resent facing such a cruel fact).
If I appear not to be as strong a defender of federalism as you are, it’s because the anti-federal, Washington-can-do-whatever-it-wants belief and values underlying it are commonplace and in fact could be argued to have been the mainstream since at least the 1960s. I’m resigned to continued flood waters going beyond the bridge (and more such; I suspect we’ll have federal health care within 10-20 years with the odds skewed toward earlier rather than later), because the numbers are strong behind expansion of government, especially entitlements (followed by regulatory fervor), in Washington.
Anti-federal (and anti-constitutional, though such a charge would be resented by the guilty) expansion of Washington and accepting the notion that Washington can do whatever it wants to do (a worse threat than any concern a rational person can have about the Bush administration here or abroad) is and for decades has been the norm; I disagree with your statement because there simply just isn’t a lot of defense of federalism, and I suspect much ignorance about it. (Contempt for federalism, as well, is seen by those who seek to misuse the courts to legislate whatever goals they wish to seek. They don’t care about respect for law and rule of law and they don’t care about federalism.) The numbers are heavily on the side of having Washington Do Something about any and every problem that needs a solution.
DSL:
I am preparing for hell to freeze over as you and I are essentially in agreement here.
The time-honored concept of federalism has served the states — and the republic overall — well down through the years, but like so much else, the Bush administration has merely paid lip service to it.
Exhibit A: The referenda passed by a majority of the citizens in at least a dozen states permitting physician-supervised and state-controlled use of medical marijuana for gravely ill people were cast aside by the Supreme Court which bought into the Bush administration’s specious and scientifically unsupportable argument that marijuana is bad all the time for all the people and its classification as an illicit substance trumps easing the pain and suffering of a few individuals.
Nick,-
Your argument is cohesive in that you start with a certain interpretaion of the Consiturion and end with the conclusion made inevitable by the premise.
In modern times, however, the strict states rights approach does not work in the same way it did 200 years ago. To take advantage of more favorable laws a short drive across a state border, people will take that drive to take the advantage. What one state does, directly affects the residents of other states. That’s precisely how local problems become national problems needng national solutions.
Strict adherence to the letter of the law at the price of ignoring the spirit of the law leads to a false clarity IMO. It bypasses the messiness of trying to understand and deal with problems by simply turning away from them.
In understand your principles.
I don’t endorse them in this case.
If SCHIP is opposed on the basis of federalism, what about the federal govt’s recent actions to prevent California from instituting stricter standards for carbon emissions? Why is it ok for the federal gov’t to be involved in setting environmental standards but not in health care?
Federalism can’t be expected to operate in the same way that it did, because TIMES HAVE CHANGED.
When what’s illegal in one state can be had 20 minutes away in another, borders are not he same borders they used to be.
Problems are transported across state borders as readily as advantages. . Fpr example, environmental regulations in one state can be sabotaged by a neighbor state when water flows and air moves.
There is a natural tension between federal and state authority. Just don’t say it can every be absolute one way or the other.
Principles are great guiding stars. One has to look down to see what one has steppen in while following a star, though.
Krit -
I think there are those who abide by strict federalism regardless of outcome on particular isseues. I think they are few, however.
What I see is people whipping out the federalism principle when it would prohibit that which they sislike or enhance that which they do. It’s a principke of convenience for many.
Nick–
As a proponant of Federalism, are you in favor of all the individual states creating their own S-CHIP type of programs?
Doma- My feeling exactly. We’re seeing a lot of it in the presidential campaign, where thorny issues are being avoided by exhorting the principled stand of letting the states decide. Its a copout, really.
krit,
Especially on the issue of abortion. If you really really think it’s murder, then how can you let states decide and maintain your morality?
Mr. Sorwell and Nick:
Please note that part of the appeal of the S-CHIP program has been that states, as has been much the case with reform of the Aid to Families With Dependent Children (AFDC) welfare program, have great discretion over how to spend federal dollars to suit their own particular needs based on their own particular populations.
Now the Bush administration is undermining that, which has prompted the lawsuits by New Jersey and other states.
Chris- You can’t. I haven’t trusted that argument since it was used by the Dixiecrats to avoid integration. If the principle held, we’d still have Jim Crow in the South. But, we’d have our principles, LOL!
I wonder if that satisfies the requirements of Federalism?
The fact remains that there are many children that have to go without health coverage because it is simply out of reach of most americans. Also, this isnt’ limited to strictly poverty level familes, but also to those in the $30-60k range, which aside from healthcare can get by. What sort of solutions do we have for this? What good is the “greatest healtch care on earth” if large amounts of folks can’t use it, or are bankrupted/have their savings wiped out by doing so?
The fact is costs like these are simply not included in inflation stats, if they were I think more people would be pissed off about them. We keep inflation low by ignoring some pretty important costs like healthcare, education, and property. But if you do that, you can’t expect the private sector to magically fix the issue via “the invisible hand” of the market. Its simply not taken into acct.
The Bush administration has dishonored federalism (and constitutionalism) far less than the Democrats; FDR, not Bush, replaced our constitutional system with a Washington that can do whatever it wants unless forbidden (turning the Constitution backward) and converting it largely to a service agency. FDR and LBJ are the main offenders, by far.
However,
Refererenda are fine because this involves more than the dishonest activists who are simply seeking a novel, beginning-incrementalist way to decriminalize drugs. The problem of the Drug War does not consist only of federal encroachment where it does not belong. Certain practices, first and foremost, civil asset forfeitures are blatantly unconstitutional (confiscation of property; there is no compensation).
This is a non-argument, often advanced in support of judicial activism (saying “red” now means, and better, red should mean, green now). (Hypocritically, it typically addresses only selected parts of the Constitution, like the Second Amendment, while leaving others such as the First Amendment, as old as the Second, alone.)
If times change, then the law can be changed. In fact, the Constitution has a built-in process so that it can be changed, and it has been amended several times. The Constitution has been changed as times have changed.
Complaining that it is too difficult to amend the Constitution, so the federal government “should just do it anyway” is anarchic as well as childish and disrespectful of law and rule of law.
As far as “destruction of distance” (improvements in transport and communications) and externalities (air pollution from one state into another, for example), the simplicity of one standard or one bureaucracy rather than fifty, the ability to make it impractical for people to escape onerous taxes by “voting with their feet” to a state where the high taxes in your state aren’t levied, there may be a desire for a federal role. But to make it legitimate it has to be made legal, not simply sought because you want it, you want it, you want it!
In addition you’re wrong because states’ rights has ceased to be honored for decades, to the extent that with no relevent experience for ages it is impossible to claim (honestly) that it does not work.
No, more like a rationalization, to the extent that such people are selective in applying the argument.
The federal dollars shouldn’t exist in such cases. That’s the central issue here. What you describe is an improvement over having no discretion whatsoever, obviously, but the real issue is that there is a federal presence where there shouldn’t be.
Incorrect. This was remedied, ironically by what is seen as a legitimate federal legislative solution. Were it left to the states alone in this instance, of course it would have taken much longer to see the end of segregation.
I believe California should be able to institute those more strict standards, or even wacky, politics-rather-than-science standards associated with global warming. (Presumably Californians could change the laws through their initiative process if they found the laws silly or otherwise objectionable.)
Jackpot. Read and learn.
Recognizing that all government programs are imperfect, I think it makes more sense for individual states to tackle some of the more popular government programs (such as S-CHIP) and for those states that implement these programs successfully to serve as models for other states.
Implementing government programs at the federal level, with Washington making decisions for all fifty states has had extremely limited success. No one in their right mind could argue that our educational system is better off today with involvement from Washington than it was when state and local governments had exclusive control over education.
Shaun:
George Sorwell:
It doesn’t. Using federal taxpayer dollars to pay for federal programs–even those in which the individual states have a great deal of control over how those dollars are allocated–is incompatible with federalism.
I’m amazed with regard to how quickly some of you are to make excuses for ignoring the Constitution based upon such arguments as “times have changed.”
I doubt very many of you would also make the “times have changed” argument with regards to Bush violating the Fourth Amendment with his electronic surveillance program. Some of you are being as selective in your reading of the Constitution as the Bush administration–the only difference being that you’re using an extremely elastic interpretation of the Constitution to justify social programs while the Bush administration is using an extremely elastic interpretation of the Constitution to justify his prosecution of the War on Terrorism.
DLS might seem like a bit of an alarmist, but he has a point. If you interpret the Constitution as having an extremely elastic definition as to what is in the scope of the federal government, then there is no end to what the federal government may do. Any government program–no matter how expensive or how inefficient or how unfair–can be justified as long as 50.1% of the politicians in Washington vote for it.
I don’t think some of you appreciate the fiscal situation our country is in. Our government spends and spends and spends, driving up the national debt higher and higher and higher. We can’t sustain this kind of spending forever. We have to exert some financial responsibility. That means we can’t knee-jerk support every single government program that politicians in Washington bring forward.
I’m not suggesting that we dismantle every federal government program and return to 19th century standards. But, at the very least, we should stop expanding the federal government further and learn to live within our means.
DLS- Now we see it as legitemate. At the time, the Southern states saw it as an incursion upons state authority. Remember, Barry Goldwater didn’t support forced integration, not because he was a racist-he wasn’t, but because he believed in states’ rights. (It was actually the beginning of the Southern strategy- and he very shrewdly wanted to take advantage of Democratic voters who were furious with LBJ’s civil rights legislation). This is what I mean when it just seems to me that politicians use the argument whenever its convenient.
I appreciate your willingness to concede that, in fact, times have changed.
Oh, yes, and were it left to them, progress (the progression to justice) would have been much more slow. I’m guessing that Jim Crow would have remained in effect or in operation through the 1970s.
In cases where they are inconsistent, you may have a reasonable suspicion, definitely.
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I don’t consider myself to be one, just a times more forceful — or immoderate — than others. (Not in any position, but in expressing it.) In fact, I’m very realistic, I don’t see a return to constitutional federalism ever, and so I have to rely instead on the more realistic Plan B, which is to address the merits and demerits of what the feds are going to try to do anyway, and view it all with an eye toward fiscal and other forms of damage control.
Imagine something else long sought by activists, often transparently (not so much a collectivist agenda but just to get the tax revenues), for older central cities in metro areas — namely metro area unification (where the city annexes all the suburbs).
Imagine entire metro areas run like Detroit, Philadelphia, or other bad-government, party-machine-style cities.
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In the past, the law (Constitution) was changed as well. That’s the part that’s missing nowadays.
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Ah, but that is precisely what many want (and many more simply to have it also do what they happen to want currently). They want a general, unrestricted grant of powers (except perhaps to regulate or to set standards for individual behavior).
And they often add disparaging remarks, old-guys-in-powdered-wigs, etc., even though they express reverence for (while sometimes abusing) parts of that same “old, outmoded, quaint” document such as the First Amendment that are themselves old.
So true.
THIS COMMENT POSTED 3 TIMES – I DELETED THE OTHER 2. – HOLLY FOR TMV
What the writers of the Constitution never foresaw was the automobile, the federal interstate system, the airplane, telephones and other forms of telecommunications that basically shrank the nation. The concept of the industrial revolution and the green revolution and the change in the very nature of the United States that they combined to create never entered their minds.The problem with the concept promoted by DLS and Nick that all we have to do is amend the Constitution is that it was made to be purposefully difficult and time consuming because the founders could never have foreseen what kinds of demands would be placed on a government by a modern society and two other things about our times. The absolutely amazing rate of change and the political environment. It is a rate of change that demands the ability to adapt faster than a constitutional amendment could move, especially in our modern political environment. Is it hypocritical to give a different weight to some parts of the constitution than others? I don’t believe so. Some parts are more a statement of core belief than others. I consider the Bill of Rights among these and I will agree with those who say that any major changes to how we treat the 2nd Amendment needs an amendment even though that aspect of our lives has changed too since the 18th Century.
Re: if times have changed, change the leaw:
This argument, again, skirts the issue
There is the letter of the law, and the spirit of the law
Like the Bible, sections of the Constitutuin are ‘read’ differently by different folks and there are different philosophies of Constitutional law
The Federalist arguments on many issues are circular, just like the debates about religion. If you accept a certain premise, then the rest of the argument follows. There is an attempt in both areas of contention (the Bible and the Constitution) to prove the premise by referring back to the conclusions from the premise Thus the magic circle kind of thinking.
At the very least, one should be able to accept that there is more than one way to read the Constitution, just like there is more than one way to read the Bible.
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Articles of the Constitutuion are “stretched’ constantly to accomomodate new conditions that ariise over time. The laws passed under the commerce clause are often way, way beyond anything the FF could have imagined. The commerce clause has simply become a handy odds-and-ends drawer in many ways.
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The country would stop dead in its tracks if a Cosntitutional Amendment would need to be added every time a law was needed for a situation not specifically spelled out in the Constitution
There is a practical element to this, The Sandra O’connor approach is one I endorse. You can’t evaluate a law (or a Constituional article) without examining how it affects the people that are subject to it. The law does not exist for its own sake. It is there to serve and protect the people subject to it.
A principle, like a law, is there to guide and protect. Becoming so enamored of the words and letters that make up laws, that one neglects its impact on the lives of tis subjects, is a rather fundamentalist view of written text.
Fundamentalism, as we see, can lead to trouble.
“No one in their right mind could argue that our educational system is better off today with involvement from Washington than it was when state and local governments had exclusive control over education.”
Oh, yeah, The segregated schools of the south worked to much better when they wete under state control = NOT.
The knee-jerk reaction to any problem in the country is now, in many circles, to say that it’s caused by federal intervention, Bad wather ? – it’s the government! Local weather presents no problems.
It’s the equivalent of believing that if only you had taken the other fork in the road, you’d now be in the land of milk and honey.
In real life, nothing is so simple. There is a tension between state and federal authority that is sometimes resolved well and sometimes the results are bad. But State supremacy in all things is not a fool-proof, or even a desirable, primary reaction.
in every instance. It’s no better than looking to the Federal government to solve all pwesonal problems without looking to see what one can do for oneself.
ItS two sides of he same bad coin of thinking.
SChIP is a very good example. For wealthy sates, there would be no need to get the federal government involved. If, however, there is a cash poor state right next door, borders would be crossed a lot to find relatives and friends whete to establish ghost residency for children of the poor state. If you understand why immigrants come to the US illegally, then you will understand the effects of a strict state-by-state policy.
Besides, would it be conscienable to watch children in a cash poor state suffer because their state can’t fund its own SCHIP?
Can a nattion really survive without a sense of common cause, without the feeling that the children in ine next state are also ‘our’ children?
It so amazes me that people are surprised at the lack of patriotism in times of war or national crises.
Where can patriotism be planted if everything we do and say points to loyalty restricted to one’s self, family or locality? The circles of self-ientity grow ever smaller,and, IMO, that’s the best way for a society to come apart and self destruct
A good case in point is the abortion controversay.
The band-aid now offered ts that each state should decide. That sounds good to those for whom an abstract formula is worth more than what happens to real people.
Wealthy women would simply travel to other states to take care of the problem. Porr women woudl either bear children they can’t support or resort to unsavory means of ending pregnancies.
That’s exactly what was the case before abortion became legal in the US, and I see no reason why human nature would have changed in the interim.
Those states banning abortion punish poor and vulnerable women only.
Think about that effect of federalism and formulaic thinking.
I’ve mentioned “destruction of distance” before — and will note that it doesn’t matter what was not foreseen then, because the Constitution and federal laws can be changed now, by today’s legislators. Also, in many instances, existing laws and their intent plus, often, legal precedent cases can guide today’s decisions.
… it should not be able to be easily changed on the whim of the moment.
Also, the impatient shouldn’t seek instead to distort the meaning of what exists now to mean what they want it to mean, ideally in a judge’s ruling.
If it’s important enough, and has sufficient merit, an amendment can be had. And of course not everything (but more than most would admit) that is sought for the federal government to do would require amending the Constitution.