health care – Page 15

Take that, you obstreperous children

Seven years in and the president has vetoed four bills — including one today that denies health coverage to about 10 million children of low- and moderate-income families. The bill would have reauthorized and expanded the State Children’s Health Insurance Program, to cover an additional 3.4 million kids (from 6.6 million).

But according to our fearless leader, this was not about denying coverage but about a “philosphical divide.” The nearly two thirds of House members and more than two thirds of Senators apparently believe their responsibility was to cover as many children as they could; the president believes in private insurance.

The policies of the government ought to be, help poor children and to focus on poor children. And the policies of the government ought to be, help people find private insurance, not federal coverage. And that’s where the philosophical divide comes in. I happen to believe that what you’re seeing when you expand eligibility for federal programs is the desire by some in Washington, D.C. to federalize health care. I don’t think that’s good for the country. I believe in private medicine. I believe in helping poor people — which was the intent of S-CHIP, now being expanded beyond its initial intent. I also believe that the federal government should make it easier for people to afford private insurance. I don’t want the federal government making decisions for doctors and customers.

Customers. Apparently patients are no different than car buyers — except that many are sick and most are scared and confused.

The president’s answer, as it has been for most issues, is to play with the tax code:

That’s why I believe strongly in health savings accounts or association health plans to help small business owners better afford insurance for their workers. That’s why I believe we ought to change the federal tax code. You’re disadvantaged if you work for a small business and/or an individual trying to buy insurance in the marketplace — disadvantaged relative to somebody working for a large company. If you work for a large company, you get your health insurance after tax. If you buy insurance you have to pay — no, you buy your insurance after taxes as an individual; you get your insurance pre-tax when you’re working for a large corporation. You’re at a disadvantage if you’re an individual in the market place.

So I think we ought to change the tax code. I — my view is, is that every family ought to get a $15,000 deduction off their income taxes, regardless of where they work, in order to help people better afford insurance in the marketplace.

Nothing wrong with altering the tax code to make medical expenses an automatic, pretax deduction. But that won’t fix the problem.

Providing coverage and getting the insurance companies out of the mix just might.

South Brunswick Post, The Cranbury Press
The Blog of South Brunswick

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Corzine steps upand applies Band-Aid

New Jersey, at the direction of Gov. Jon Corzine, is ready to take on the president over health care.

The state is suing the federal government over new rules that would cut thousands of children off from state health-care subsidies — a move the Corzine administration rightly calls “incomprehensible.”

The program — the State Children’s Health Insurance Program, or SCHIP — is jointly funded by the federal and state governments and is designed to provide health care coverage to families who earn too much to qualify for Medicaid, but no more than 200 percent of the federal poverty level.

States have some flexibility under the program that allows them to raise the income threshold and cover more kids — which is where the lawsuit comes in. The Bush administration wants to place limits on this expansion, either through legislation or via administative order.

But Congress in a bipartisan vote is preparing to extend the program and allow for greater flexibility at the state leve — a move the administration is threatening to veto. An override is likely, but shouldn’t be necessary. Read my Dispatches column on SCHIP from Sept. 20 to see why .

In the end, as I write here, SCHIP is just a Band-Aid and should be made redundant by a single-payer, universal health care system. That should be the goal, because it is the only way to ensure that every uninsured and underinsured American, child and adult, get a baseline of care.

South Brunswick Post, The Cranbury Press
The Blog of South Brunswick

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One health care system, not 50

The national political class doesn’t have much stomach for comprehensive health care reform (i.e., universal coverage, single-payer), so it has fallen to the states to try and expand coverage to a greater number of Americans.

The success of these efforts, however, is rather illusory. The number of uninsured Americans is growing despite plans like those in Vermont and Massachussetts, which should not be a surprise given that most of them rely to at least some degree on private insurers.

A column in today’s Boston Globe by Benjamin Day, executive director of Mass-Care: The Massachusetts Campaign for Single Payer Health Care, offers a pretty good explanation for the pitfalls that state plans face.

Massachussets, he writes, has three classes of plans — full-cost plans, partially subsidized plans and fully subsidized, free-coverage plans. It also fines state residents — $1,000 in 2008 — “who are deemed able to afford health insurance but fail to enroll in a public or a private plan.” The state had hoped that the program would extend coverage to hundreds of thousands and that the full-cost and partially subsidized plans would minimize the number of people taking advantage of the free plans.

That hasn’t happened. So the state is proposing a change.

The administration’s reforms would refuse eligibility for this safety net to everyone who is eligible for the state’s subsidized health plan, Commonwealth Care, along with anyone offered “affordable” insurance by their employer. The proposal would also, for the first time ever, impose cost sharing — deductibles and copayments — on many of the exclusively low-income patients who rely on the pool for medical care they can receive nowhere else.

This, Day says, would “cripple the state’s only program that guarantees that low-income, uninsured residents have a place to land when all else fails” in an effort to boost enrollment of other plans. He says the plan will punish the poor without accomplishing the goal of providing health care to all.

There is a long and unfortunate history to this line of thinking, which has led to the erosion and, at times, the vilification of our economic safety net institutions. From the Work Relief programs of the Great Depression through Welfare to Workfare, attempts to erode income security have been proposed as a way to corral the unemployed into the workforce. In the United States, the only developed nation without a national universal health plan, the health safety net is targeted as a means of corralling the uninsured into traditional insurance plans.

There is little evidence that eroding safety net programs actually helps improve participation in the labor market or the healthcare market. This does, however, succeed in punishing the poor, throwing low-income communities back on their own resources, and increasing the stigma upon safety net recipients.

The answer, then, is not to rely on state plans that are nothing more than Band-Aids and do what Michael Moore, U.S. Rep. Dennis Kucinich (a Demcoratic presidential candidate) and others advocate: Create a national system of universal coverage, administered by the government and paid for out of our taxes.

Will this be simple? No. But health care needs to be treated as a right and not as an economic benefit of employment. The current system is expensive, inefficient and detrimental to our economy — as General Motors.

It is time we joined the world’s other industrialized nations on this.

South Brunswick Post, The Cranbury Press
The Blog of South Brunswick

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Finally, someone notices Dennis

I’ve written before about Boston Globe columnist Derrick Z. Jackson, so everyone who reads this blog knows I think he’s one of the best columnists going.

Today’s column is a case in point. He writes about the only presidential candidate on either side of the aisle offering a real plan for fixing the mess of a healthcare system we have in the United States, Dennis Kucinich.

On healthcare, he says what Americans believe, even as his rivals rake in contributions from the industry.

In a CNN poll this spring, 64 percent of respondents said the government should “provide a national insurance program for all Americans, even if this would require higher taxes,” and 73 percent approve of higher taxes to insure children under 18. Those results track New York Times and Gallup polls last year, in which about two-thirds of respondents said it is the federal government’s responsibility to guarantee health coverage to all Americans.

Such polls allow Kucinich to joke that, far from being in the loony left, “I’m in the center.

Everyone else is to the right of me.” More seriously, in a recent visit to the Globe, he accused the other Democratic candidates of faking it on healthcare reform.

“One of the greatest hoaxes of this campaign — everyone’s for universal healthcare,” Kucinich said. “It’s like a mantra. But when you get into the details, you find out that all the other candidates are talking about maintaining the existing for-profit system.”

Jackson goes onto explain why the rest of the candidates seem willing only to nibble around the edges — if at all.

The hold of the healthcare industry on the top candidates is already apparent. According to the Center for Responsive Politics, the top recipient of campaign contributions so far from the pharmaceutical and health products industry is Republican Mitt Romney ($228,260). But the next two are Democrats Barack Obama ($161,124) and Hillary Clinton ($146,000). The top recipient of contributions from health professionals is Clinton ($990,611). Romney is second at $806,837, and Obama third at $748,637.

The top recipient of cash from the insurance industry, which includes health insurers, is another Democrat, Connecticut’s Christopher Dodd, at $605,950. Romney and Republican Rudolph Giuliani are second and third, with Clinton and Obama fourth and fifth. Even though Obama is in fifth place, he still has collected $269,750 from insurance companies.

In a category that is relatively small in money thus far, but huge in terms of healthcare morality, Democratic presidential candidates occupy four of the top six spots in receiving money from death-dealing tobacco companies. After Giuliani’s $69,500 from tobacco companies, Dodd has received $45,400, Clinton $32,300, Romney $31,400, Obama $7,885, and Democrat Joe Biden, $4,000.

When the top Democratic candidates take tobacco contributions, it is hard to see them truly believing, as Kucinich says, that healthcare “is the single-most important domestic issue. . . a defining issue in the presidential race.”

The top recipient from lobbyists by far is Clinton at $406,300. She is still so badly smoldering from the torching of her healthcare efforts as first lady that she recently asserted to the National Association of Black Journalists, “I have never advocated socialized medicine. That has been a right-wing attack on me for 15 years.”

Her comment is telling, of course. True liberals would not fight a right-wing attack by retreating, as Clinton does, they would follow Kucinich’s lead and fight for real reform.

That assumes they believe in universal health care and are not behold to the folks with the cash.

***

Here are my two most recent columns on health care from The Progressive Populist — here and here — and a link to a radio interview I did on America’s Work Force Radio (click on Archived shows, go to August and click on the show for the 8th).

South Brunswick Post, The Cranbury Press
The Blog of South Brunswick

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On your radio

I’ll be doing an interview on universal health care tomorrow on an Ohio radio show. It’s based on some recent columns I’ve written for The Progressive Populist (here and here).

You should be able to find the show on a Web stream here.

I’m hoping not to embaress myself.

South Brunswick Post, The Cranbury Press
The Blog of South Brunswick

E-mail me by clicking here.