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Posted by on Aug 2, 2007 in At TMV | 21 comments

Health Care: Good vs. Evil

This should be just the kind of battle the President loves, right against wrong, no nasty little nuances to fog the mind, but here he is on the side of darkness, threatening to veto a bill passed by the House that would extend health insurance to five million more children of the working poor.

The proposal, according to the Washington Post, is backed by “Republican and Democratic governors, the American Medical Association, AARP, the March of Dimes, the Catholic Health Association, the American Academy of Pediatrics, and even cyclist Lance Armstrong. And the prospects are good in the Senate, where a key Republican, Orrin G. Hatch (Utah), said, ‘It’s difficult for me to understand how anyone wouldn’t want to do this.’”

George Bush doesn’t–on “philosophical” grounds. “When you expand eligibility,” he argues, “you’re really beginning to open up an avenue for people to switch from private insurance to the government.”

In his opposition, the President may be opening the wider debate on American health care and what some of his loyal supporters yesterday denounced as the first step toward “socialized medicine.”

If so, it would only be a baby step, but the discussion is long overdue. If “socialized medicine” is the only alternative to lining the pockets of HMOS and health insurance companies at the expense of sick kids, so be it. If “socialized” means humane rather than rapacious, what’s so scary about it? Socialized doesn’t mean Socialist.

Even doctors, the presumed victims, seem to be in favor of scrapping the current system. A recent survey by the Minnesota Medical Association found that “64% favored a single-payer system, 25% HSAs, and 12% managed care. The majority of physicians (86%) also agreed that it is the responsibility of society, through the government, to ensure that everyone has access to good medical care. Less than half (41%) said that the private insurance industry should continue to play a major role in financing health care.” (Source: Sustainable Middle Class blog.)

It’s time to talk frankly about what’s good and what’s evil in our health care system, and President Bush may just be leading the way.

Cross-posted from my blog

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Copyright 2007 The Moderate Voice
  • Strange coincidence. I just finished reading an AlterNet interview with Noam Chomsky, who talked about healthcaqre, too, among other topics. He is making the case that the strange reluctance of the Dems to serioulsy stomp for national healthcare is based on their candidates dependency on HMO and Pharma money:

    “Take, for example, take your pick, say for example health care. Probably the major domestic problem for people. A large majority of the population is in favor of a national health care system of some kind. And that’s been true for a long time. But whenever that comes up — it’s occasionally mentioned in the press — it’s called politically impossible, or “lacking political support,” which is a way of saying that the insurance industry doesn’t want it, the pharmaceutical corporations don’t want it, and so on. Okay, so a large majority of the population wants it, but who cares about them? Well, Democrats are the same. Clinton came up with some cockamamie scheme which was so complicated you couldn’t figure it out, and it collapsed.

    Kerry in the last election, the last debate in the election, October 28 I think it was, the debate was supposed to be on domestic issues. And the New York Times had a good report of it the next day. They pointed out, correctly, that Kerry never brought up any possible government involvement in the health system because it “lacks political support.” It’s their way of saying, and Kerry’s way of understanding, that political support means support from the wealthy and the powerful. Well, that doesn’t have to be what the Democrats are. You can imagine an opposition party that’s based on popular interests and concerns.”

    Read it all, many very good points, especially on Iraq:
    http://www.alternet.org/story/30487

  • Are we really defining “working poor” up to $40,000+ a year? I get skeptical when I see advocates calling an entitlement program for the middle class a program to help the “poor.”

    I realize that foks making $40,000 can experience real financial hardships if their children develop serious chronic medical issues, but this program goes WAY beyond helping folks in those situations.

    Couldn’t we have a more narrowly focused program to help those in the middle class deal with catastorphic costs?

  • Lynx

    the strange reluctance of the Dems to serioulsy stomp for national healthcare is based on their candidates dependency on HMO and Pharma money

    Did you ever seriously doubt this? Lobbyists are not partisan, they donate to whom they think will win. The biggest lobbies donate to everyone, to a greater or lesser extent, to make sure that no matter who is in power, THEY are in power.

    Yes socialized medicine, ohhhh scary! We wouldn’t want to be like those smelly Europeans, never mind they have better systems. lower infant mortality (hell even Cuba has lower infant mortality!) and life expectancy.

  • Lynx

    that should read and HIGHER life expectancy. I miss the “preview” button 🙁

  • Rudi

    IC says:

    Are we really defining “working poor” up to $40,000+ a year?

    Where did this number come from? I didn’t see it in any of the posts links. IC, please provide a link for verification.

  • egrubs

    In Orange Couny, 40k annually -is- working poor. It’s barely enough to afford rent. Definitions based on strict numbers fail to identify how varried the economic situations are within our own country.

    That said…um…I can’t understand how this is a “philosophical” issue without immediately proposing a “philosophical” way for those same kids to be covered just as effectively.

  • Rudi,

    Here is a good place for info from a SCHIP advocacy group: On page 14 it has a story that sums the program up thusly:

    SCHIP (or just plain CHIP, as most know it) is the state Children’s Health Insurance Program, operated separately from Medicaid. Created by Congress in 1998, it now covers 68,000 children of low-income Mississippi families whose
    employers do not provide medical coverage or who earn just enough to not be eligible for Medicaid.

    Medicaid is an entitlement program, funded 83 percent by federal dollars, that now covers some 605,000 Mississippians, including 130,000 children, who live below the poverty level (now $40,000 for a family of four).

    The entire point of SCHIP is to cover people who cannot qualify for Medicaid. I’m not saying there should be no program of any sort. I just think it is disingenuous to call it a program for “poor people” when it is clearly designed for people who make $40,000+.

    And yes, egrubs, $40,000 won’t go as far in the OC, but it quite middle class in Mississippi (and most other areas.) That is one reason the states run these programs, so they can be implemented with an eye to local conditions.

  • $40,000 is not middle class for a family of four.

  • domajot

    The focus here should not be on how much a family earns but on what kind of insurence for the children it can afford. to buy. Private insurance is prohibitively espensive, while only bare bones benefits are often in the affordable range of even middle class families. Insurance for a child with a chronic disease if out of the question.

    It is soooo discouraging to see how focused the public is on making sure no struggling individual or family gets away with one cent of undeserved assistance. It would be ever so much more fuitful to engage in counting up the public dollars saved by investing in good health care for all.

    We all pay, one way or another, sooner or later, for a low health level in the nation. Our health statistics are going down, down, down. Pay a penny today, or pay a dollar tomorrow, the bill for this neglect will come due.

  • People making $40,000 to $50,000 a year are poor?

    What a crock. That’s people making $19.25 to $24.00 an hour. Sure, in some places where housing is extraoridinarily expensive it is a stretch, but most areas of the US simply are not that expensive. (Believe it or not most people do not live in NY, DC, Boston, SF and LA.)

    It is soooo discouraging to see how focused the public is on making sure no struggling individual or family gets away with one cent of undeserved assistance.

    It is a matter of priorities. By “selling” this as a program for the “poor” it avoids the fact that it is really offering a helping hand to the middle class. Too many government program get sold in such a way. “Oh you dont want to help the poor children! You brute!”

    Or, “You don’t want to help those poor family farmers, you bully!” When those “poor” family farmers are making a million bucks a year.

    Lets talk honestly abut what this program is, who it is designed to help, what it costs, and where it should rank in our list of priorities. The cheap emotionalism gets us nowhere, and is meant more to obfuscate than to clarify anyway.

  • Pay a penny today, or pay a dollar tomorrow, the bill for this neglect will come due.

    Good point.

    There may be problems with this specific program, but the general idea is a good one.

  • domajot

    “cheap emotionalism gets us nowhere”

    Emotions are only cheap to those who don’t share them.
    Mostly, emotions can motivate people to do great things.

    I would not misrepresent in aid of pursuing my emotional goals. However, what is middle class and what is poor depends on whether a family can or can not afford to buy private insurance,, not on the dollar amount of their income.

    Investing in the health of its citizens is the most
    unemotional, and fiscally prudent thing this nation could do.
    Should we ever manage to do it adequately, I’ll be very emotionally glad.

  • C Stanley

    Robert Stein asks us to talk frankly, so OK:

    Does that mean we can talk frankly about how the bill pays for the additional coverage by reducing Medicare payments for seniors?

    And is it OK to talk about whether or not there might be a better way to handle the problem of uninsured kids, or am I simply a heartless SOB if I don’t have a kneejerk reaction to support this?

  • egrubs

    You’re only a heartless SOB if you oppose health care for kids on philosophical grounds.

    You’re fractionally a heartless SOB if you want to deny them the health care for half a decade while a better plan gets worked out.

    Though if this truly is rob Peter to pay Paul, that does sound kind of shady.

  • domajot

    “whether or not there might be a better way to handle the problem of uninsured kids,”

    I’m not at all convinced this is the best bill possible; There was an odd thing about suddenly dropping a tabacco tax for funding, for example.

    However, if looking for a better bill was the answer, then the talking should have started years ago. One way to kill bills, practised increasingly, is to claim support for the iidea, but deny a vote for the bill because it’s just not good enough. That argument can be used in perpetuity.
    Politicians use this method cynically to milk approval from both sides of the issue. In the meantime, the bill dies, often without being resurrected..

    I’d rather go for the bird in the hand than the two in the bush liable to fly away.

  • C Stanley

    Equally bad in my opinion though is the tendency to just get something passed so that the politicians can claim that they did something about a problem, when their solution could actually lead to no improvement in the situation or marginal improvement in one area with unforseen negative consequences in another (or foreseen ones that they chose to ignore).

  • domajot

    CS-
    I wouldn’t call passing a flawed bill equally bad vis-a-vis no bill at all.
    All bills come up for renewal.
    In the meantime, a program is nlace to privide for shilcren.
    There will be time to collect data about how this bill is bad as well as good Next time around, then, maybe the arguments will be of higher quality..

  • domajot

    PS My bottom line is that, no matter how much I hate how things work in Wadhington, I care about providing health care more than I care about our elected officials.

  • Rudi

    IM – I couldn’t find the current income levels for Mississippi, but I doubt that it’s $40K today. I think your group is using disinformation to push their point. I did find a document from 1999 and the income level for 1999 wasn’t even $20K back then.
    http://www.hhs.gov/news/press/1999pres/991217b.html

    Mississippi is eligible to receive as much as $55 million in new funds for fiscal year 1999. SCHIP is historic, bipartisan legislation signed in 1997 by President Clinton. The SCHIP law appropriates $24 billion over five years to help states expand health insurance to children whose families earn too much for traditional Medicaid, yet not enough to afford private health insurance. Mississippi, like all states with SCHIP plans, will receive federal matching funds only for actual expenditures to insure children.

    Together, the 56 state and territorial SCHIP plans anticipate providing health insurance coverage for more than 2.6 million currently uninsured children over three years.

    “The Clinton Administration and the states are working together to give children the health care they need to live longer, healthier lives,” said Secretary Shalala. “It’s a pleasure to approve Mississippi’s amendment and I look forward to more states expanding their programs in the future.”

    SCHIP gives states three options for devising a plan to cover uninsured children: designing a new children’s health insurance program; expanding current Medicaid programs; or a combination of both strategies. HHS must approve any amendment to a state’s SCHIP program.

    Mississippi’s initial SCHIP plan, a Medicaid expansion, was approved by Secretary Shalala on March 31, 1997. In February 1999, the state had an amendment approved that created a separate SCHIP program for children below age 19 in families with income levels between 100 percent and 133 percent of the federal poverty level (FPL). The current FPL for a family of four is $16,700.

    So tell me how $16,700(1999) becomes $40,000 today. Something doesn’t smell right here, I wonder how you feel about corp welfare for ADM?

  • Rudi

    IM You are correct about the link using $40,000 from a local news article. However, this has to be a typo. The CURENT level in 2007 from HHS is just over $20K.
    http://aspe.hhs.gov/poverty/07poverty.shtml
    2007 HHS Poverty Guidelines
    Persons
    in Family or Household
    48 Contiguous States
    and D.C. Alaska Hawaii
    1 $10,210 $12,770 $11,750
    2 13,690 17,120 15,750
    3 17,170 21,470 19,750
    4 20,650 25,820 23,750
    5 24,130 30,170 27,750
    6 27,610 34,520 31,750
    7 31,090 38,870 35,750
    8 34,570 43,220 39,750
    For each additional
    person, add
    3,480 4,350 4,000
    The curent value is $20,650, not $40K. Wanna live on $21K with a wife and two children?

  • Rudi, I think there is some confusion here. I’m sorry if I wasn’t clear.

    The $40,000 refers to the level of income that defines the upper limit (?) of the proposed SCHIP expansion, not something on the books now.

    And the group I linked to is PRO the SCHIP expansion, not Anti. The collection of articles and editorials is the spin the advocates give to the program. Any bias in it isn’t indicitive of my own view.

    I’m not against the current SCHIP program, and maybe some expansion of it is in order, but at some point it becomes something other than a helping hand to poor people. Were if to become a middle class entitlement the costs could be enormous.

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