The Patchwork of SCHIP

Health care for kids, that’s good, right?

Modern American politics has become a practice in the art of spinning a catchphrase. In particular, by seizing onto a small portion of a piece of legislation, one party or the other has ramrodded through pork barrel spending, pet projects or banner bills that will play well with swing voters in the upcoming elections.

The State Children’s Health Insurance program (SCHIP), and the looming September 30th extension deadline, is one of the latest hot-button issues debated in all media. The majority of voices I hear on the left, even my friend the Swede, say “Hey, it’s medicine for kids, no-brainer!”

I support health care for kids, for everyone living in this country, but I do not believe that SCHIP is the answer to anything. However, I deferred posting on the matter as my lack for any ideas of a realistic alternative without the same damaging effects seemed to truncate any argument I could put forth.

Then I wandered over to visit my friend Thomas at the DragonFlyEye (DFE), someone who I have agreed and disagreed with, but for whom I have quite a bit of respect for running the best all-around progressive blog in Rochester in terms of layout and content. I wish the WBP looked half as good as the clean, interactive DFE.

I came upon his recent post on SCHIP and, after wading through the Amazon pop-up ads which I kept scrolling over expecting past posts on the legislation, this little nugget was unearthed:

…there’s your constituency: poor or nearly-poor working-class families who are out to reap revenge on the Welfare State.

-snip-

…it’s angry, frustrated, jealous middle-class men . . . They’re pumped full of resentment, pumped full of a naive, foolhardy sense that they could be the Investor Class if only they had that twenty dollars of FICA money back.

Well, I certainly do not consider myself to fall into the above description. I feel no desire to reap revenge on the “welfare class” nor a belief that I would even be able to define who that would fall into that class.

I am a middle-class white male and according to the guidelines I and my family of three, with one year old son, would technically qualify for SCHIP. We fall into the 250% poverty level, and certainly well within Spitz’ plan (which backfired) that expanded coverage to families within 400%; one catch – my child has not been uninsured for one year.

However, my wife and I have my own health insurance through my job. It is here that, under the hypothetical that I were to enroll in SCHIP, that the first dangerous standard is set: the enrollment of parents and children in different health care programs with different coverages and different physicians. Even if my wife and I were to enroll in SCHIP only in a perfect scenario would my entire family be in the same program, from covertheuninsured.org:

To the extent possible, parents would be enrolled in the same program as their children.

The logical thing to me in this situation would be to establish a system that aids enrollment of my child in my employee insurance such as vouchers or tax credits to cover the difference in cost.

You will probably be as surprised as I was to learn then that such a practice exists. Under state law the SCHIP funds can be used to fund the cost of adding a child to an existing policy through a “premium support” clause.

According to the Congressional Budget Office this situation:

…applies to half of the children living in families that earn between 100 percent and 200 percent of the federal poverty level and 77 percent of children in families that earn between 200 percent and 300 percent of the federal poverty level

Unfortunately the “premium support” option is rarely employed due to stringent enrollment policies. Various members of Congress proposed amendments to ease enrollment in and expand the “premium support” option but neither the House nor the Senate version of the bill contain such an amendment.

Another dangerously divisive standard established by SCHIP exists when pregnancy comes into play. While the unborn child is covered:

For pregnant women, SCHIP coverage would be limited to pregnancy-related services and other conditions that may complicate the pregnancy

Following the birth mom is only covered by SCHIP for two months for conditions directly related to the pregnancy. Again parent and child exist in two separate realms of coverage and, oh mom, SCHIP will not be covering that pain medication you needed.

Rather than working to put an effective program in place the kneejerk reaction kicks in, “it’s for the kids,” and we extend this dual-system enrollment precedent to more than half the children who would qualify for the program; all while having the government decide where and by whom a child will be seen as opposed to the parents.

I am also not under the impression that “twenty dollars of FICA” money will bump my bracket. I am aware that study after study reports New York state has one of the highest tax burdens in the country yet one of the most ineffective delivery systems of government services.

I am also aware that one of the reasons for this is the exorbitant per capita cost of health care and Medicaid, a program whose shortfalls are made up for via SCHIP funding. Despite spending so much on health care and Medicaid we again fail to deliver an effective system that covers those who were the original intent of the program.

All this would seem to indicate to me that throwing more money at the problem through an extension of a government run health care system is not the answer to ensuring affordable and accessible care for all, especially in a state already facing an ever-increasing multibillion dollar budget gap.

See someone, these very kids who we are supposedly out to help with this SCHIP extension, is going to have to pay the tab someday for all our spending. The Feds are proposing to pay for the added spending with, what else, a tax increase. And not just any tax increase, a cigarette tax increase. That’s right – cigarettes, the use of which is supposedly a public health issue and likely drives at least a small percentage of users into the very program it is supposed to pay for, is going to give Kids their medicine.

Um, sure. According to the Heritage Foundation:

To produce the revenues that Congress needs to fund SCHIP expansion through such a tax would require 22.4 million new smokers by 2017.

Bring back Camel Joe, we need to sign ‘em up young.

Additionally:

When the projected costs of an expanded SCHIP and other entitlement programs are combined, the total value of unfunded debts and entitlement obligations that must be paid down the road is equivalent to imposing a $170,000 mortgage on every child in America at birth–but without the house.

SCHIP is a band-aid at best and does nothing to address the real issues of health care costs climbing to unreasonable heights and the influence of the health care industry in our government. I do not believe this because I am jealous or angry, I believe this because I am truly concerned about doing what is right “for the Kids.”

I do believe that there are more sensible alternatives and even under-utilized programs already in place that would improve on the current situation. But I suppose the election is coming up and who doesn’t want to campaign on kids?