Socialized medicine through the back door

By Wes Vernon

The Senate has been wrestling with legislation that the media echo chamber has framed as "helping sick kids," but which in reality is a step toward universal government-run health care. Furthermore, there is every reason to believe that those who are enabling this slow train to socialized medicine know exactly what they are doing.

In England, there are people who have been waiting in line for so long to get vitally needed medical attention from the government-operated National Health Service that some have actually taken to threatening physical harm to doctors and nurses.

In Canada, where seeking private medical care is a criminal offense, the backup is so severe that while government-favored political backers of the public health system can get an MRI in 24 hours, the rest must wait or become physically worse beyond the possibility of recovery. According to a report in the Washington Times, Canada's health minister labeled a lawmaker as "disgusting" for daring to suggest a constituent get emergency treatment. As a direct result of the wait, that constituent had to endure day in and day out pain and misery. As a result of infection from a long use of a catheter, that 32-year-old woman had to have her bladder removed and must go the rest of her life with a bag on her abdomen to capture the urine her only kidney produces. The other kidney has already been removed.

Yet the pressure mounts for America to "join the world" and turn over our very lives to bureaucrats who would deal with our health problems in a government-mandated impersonal assembly-line fashion.

Heaven knows, our health system is not perfect, and yes, we do need to contain costs. But the U.S. health system can be defined in much the same way Winston Churchill once described democracy — i.e., the worst in the world "except for all the others."

Foot-in-the-door politics

After Hillarycare met its ignominious defeat in the mid-nineties, Congress passed the State Childrens Health Insurance Program (SCHIP) — a federal/state plan to cover kids from lower income families who make too much money to qualify for Medicaid.

It did that, although it took the federal-state program all of ten years just to enroll between 5 and 6 million kids. But it has also had some (perhaps) unintended consequences. And the Democrat majority in Congress wants to expand SCHIP without dealing with those same unintended consequences.

Congressman Joe Barton, a Republican from Texas, has been trying to stop the bulldozing process by which the majority wants to expand SCHIP in the House Energy and Commerce Committee. In a committee hearing, he said that some states "have [through a loophole] begun to expand the program to adults and children who are hardly needy, much less poor, leaving the poor and needy behind." He offered an alternative that would "cover poor and sick kids, not adults pretending to be children and not families making more than $100,000 a year [yes, the abuse is that bad]."

The choices

The Bush administration wants to boost the $25 billion SCHIP budget by $5 billion over five years. Democrats on Capitol Hill want to hike that by $50 TO $60 billion and make it easier to cover more affluent families. They are carrying on the legacy of Lyndon "Great Society" Johnson, who once remarked that every time the Republicans send up a budget, "we just add a couple of zeroes to it."

The Washington Post spiked an article June 28 in which it was pointed out that 71 percent of all children in families of four making as much as $82,000 (or 400% of the poverty level) would become eligible under the original Democrat plan in this Congress — the Clinton-Dingell bill. The current ceiling is 200%.

However, a Senate bill presented as "compromise" would expand SCHIP eligibility to 300% above the poverty line which would be $62,000 annual income on average. In New York the figure would be $82,600 per year. This measure is known as the Baucus-Gassley bill — so named for Senate Finance Chairman Max Baucus, a Democrat from Montana, and the committee's ranking member, Iowan Charles Grassley, who provides a Republican fig leaf for what essentially is Democrat legislation.

In the House, Chairman John Dingell — a Michigan Democrat — is sticking to the provisions of his Clinton-Dingell bill in the Energy and Commerce Committee.

Delicious irony for the Dems

Coincidentally enough, the prime Democrat sponsors in both the House and Senate must be salivating over the history involved in this stealth attempt to the put the government in charge of your health care.

First, the Clinton in Clinton-Dingell is, of course, Hillary — junior Senator from New York — who went down in flames when she tried to foist socialized medicine on Americans all at once in 1994. If this current expansion plan goes through, she will be well on her way to having lost the battle, while winning the war.

As mentioned above, the Dingell in Clinton-Dingell is the powerful chairman of House Energy and Commerce. His father was the Dingell in the 1943 Murray-Dingell-Wagner bill — the first serious — but failed — attempt at all-out socialized medicine for all Americans. If the current legislation becomes law, perhaps the younger Dingell (now age 81) can — quietly in the privacy of his chambers — communicate with the old man and say, "We're getting there, Dad."

Then there is the Baucus in Baucus-Grassley. Max Baucus has the Senate seat once occupied by the Murray in the forties Murray-Dingell-Wagner. The late Senator James E. Murray of Montana was a crusty old New Dealer whose immersion in the ways of Washington was never better illustrated than the way in which he announced his retirement. When a young reporter in Billings phoned him to say that he had heard rumors the senator was stepping down, Murray's response was, "I didn't authorize those rumors." He made the "authorized" announcement the next day.

The consequences — intended or not

Baucus-Grassley would allow new adults to be added to the program at the expense of kids. So it starts out as a bad deal for the very people it purports to help

The measure uses the most disingenuous budgeting gimmicks in an attempt to hide the ultimate cost and technically abide by the majority's own "pay as you go" rules. (Those rules are enforced in a manner comparable to the old practice of stopping the clock so that legislators can claim there are in sinc with a legislative mandate to adjourn by a designated date and time.) In so doing, Baucus-Grassley would shift many covered individuals into Medicaid. The net effect is that millions of kids will lose health care coverage, while costs in the years 2013-2017 alone would total $130 billion, and a 10-year total of $160 billion. Those numbers are carefully hidden by the budget gimmicks.

Baucus-Grassley would also needlessly shift billions of dollars of health care coverage from private insurance to government-run health care.

Moreover, the Congressional Budget Office finds this "crowd-out" effect will result in 600,000 losing their coverage for every 600,000 who are newly insured. Part of the budgeting gimmick is to transfer resources from SCHIP to Medicaid.

Baucus-Grassley is cited here as one example of the kind of stuff that is floating around Capitol Hill in the name of "health care for kids." There are several versions, and legislation is constantly being rewritten or amended in committee or — sad to say — in backroom midnight deals behind closed doors. By the time you read this, there may be multiple changes. But the general thrust of the above outline still applies. SCHIP must be re-authorized by September 30, and thus the flurry of activity.

Alternative approaches

A GOP alternative in the Senate, the Every American Insured Act, provides "refundable, advanceable tax credits ($2000-individual/ $5,000 family) to everyone in America regardless of income or employer" and would do so in a truly "budget-neutral manner" — no cutsie gimmicks.

Moreover, this measure (with Oklahoma Senator Tom Coburn — an MD obstetrician — as lead sponsor) equalizes the tax breaks between those who have employer — provided health insurance and those who do not; gives Americans the right to choose the health insurance that meets their needs; eliminates the current cost shift in the market that drives up the cost for everyone; and provides Americans with the ability to save for future health care costs by putting some of their tax credit money into a health care spending account.

President Bush has proposed a $15,000-per family tax deduction to enable the uninsured to buy health insurance on the open market with rival insurers competing to offer the best coverage at the best price. It was to be offered on the Senate floor during the SCHIP debate, but given the anti-free enterprise majority in that body, it was expected to die.

Columnist Morton Kondracke says while the Bush plan may well be "meritorious," it will not become law in part because it "would move America away from employer-based health coverage — a huge policy shift that has not been adequately debated."

There's a dab of the disingenuous and some code language involved in that observation. We have had about 65 years to "debate" the advisability of employer-based health coverage, a "temporary" practice that began in the forties to get around wartime price and wage controls during World War II. Prior to that time, it was considered absurd that your employer was obligated to provide you with health care coverage any more than he was responsible for keeping your refrigerator stocked with cold cuts and cheese. Secondly, the assertion that moving away from that practice has not been "adequately debated" is liberalspeak for "We haven't had enough time for the George Soros-funded think tanks to gin up their demagogic multi-million dollar ad campaigns to scare the booboise (a la AARP on Social Security reform)."

If you're really serious about reform

In their study of the problems afflicting SCHIP in particular, and health care in general for that matter, Heritage Foundation scholars Nina Owcharenko and Robert E. Moffitt (Ph.D.) recommend the following:

(1) Include budget-neutral tax reform for health insurance. Either the president's bold proposed universal tax deduction for the purchase of private health insurance, or the Coburn standard non-refundable tax credit should be considered.

(2) Allow SCHIP to supplement tax relief for lower income families. Almost three-quarters if the uninsured choose to decline employer-provided health coverage because of high costs. Tax relief can't do much for many of these families, because they already pay little in taxes. So the Heritage study proposes improving on premium assistance "by subsidizing lower-income individuals and families to purchase the private insurance of their choice."

Owcharenko and Mofitt argue that "[t]ackling the fundamental problems in the health care system would have a broader, much longer-lasting impact" than band-aid back-doors to all-powerful government control now being proposed by Senators Baucus, Grassley, and Clinton and Congressman Dingell. We don't need a Trojan horse for Hillarycare.

As the Gipper would put it

Ronald Reagan used to say Congress does not really solve problems. It only re-arranges them. Here is a chance for Congress to use the SCHIP debate to do something serious — for a change.

© Wes Vernon