Children's Health Care in the Age of Bush

KANSAS CITY, Mo. — Let's design a children's health plan that President George W. Bush might like.

The State Children's Health Insurance Program serves working families not poor enough to qualify for Medicare. Bush is dead set against legislation that would raise the number of children covered by SCHIP from 6 million to 9 million.

In making a Bush-friendly plan, it's important to ignore his stated reasons for opposing the SCHIP expansion. That would start with his protests over the costs.

The $35 billion five-year price tag is a shadow of the projected spending on the Medicare prescription drug benefit, which Bush rammed through Congress in 2003. Medicare Part D will easily cost taxpayers $720 billion over 10 years. Bush was so intent on passing it in time for his re-election campaign that his henchmen threatened the Medicare actuary if he revealed the true numbers.

Bush and his allies have expressed much outrage that the SCHIP bill would "subsidize" rich families — that is, it would let children in households earning up to three times the poverty level — about $64,000 for a family of four — participate in the program. Well, try to raise two children in New York or San Francisco on $64,000, and also buy health coverage for them.

Funny, but the Medicare drug benefit (and Medicare in general) extends taxpayer-subsidized health care to retirees earning 2,000 times the poverty rate. Billionaires qualify if they're over 65. And that was just dandy with the president.

In a similar vein, one may question Bush's repeated worry that access to a government program will prompt some working Americans to drop their private coverage. Yes, that happened when the Medicare drug benefit went into effect, but the president didn't seem to lose sleep over it.

Given Bush's hearty support of the Medicare drug benefit, why won't he get behind expanding SCHIP? Sen.

Claire McCaskill, D-Mo., offered this short, clean explanation at a National Conference of Editorial Writers meeting here in Kansas City:

"The difference between the SCHIP program and Medicare Part D is the private businesses were cut into Medicare Part D."

Bingo.

You see, the writers of the SCHIP legislation worked on the simple-minded idea that the taxpayers could help uninsured children by just picking up their medical bills. They didn't understand the subtle thinking of the Bush administration, which can't support a government program that doesn't also enrich private interests.

The Medicare drug law gave insurers and drug makers a big piece of the action. In return, they a) supported a giant new government program that Bush wanted and b) generously rewarded obliging lawmakers with money, campaign and otherwise.

The Democrats writing the SCHIP legislation apparently forgot to hire their own Billy Tauzin to, so-to-speak, grease the wheels. Rep. Tauzin, the Louisiana Republican who wrote the Medicare drug law, did such a great job for the pharmaceuticals industry that its lobbying group immediately offered him a reported $3-million-a-year job — which he took.

Had Bush and his Republican Congress followed the Democratic proposal — that is, simply let the federal government negotiate drug prices on behalf of Medicare beneficiaries — the program could cost $300 billion less over eight years. SCHIP is really small change next to the Medicare drug benefit, whose price was clearly no object for the president.

So here's what Democrats must do to get Bush's blessings on children's health coverage: They should spend 30 percent more on it than necessary to keep private businesses happy. And once they have the corporate lobbyists on board, all the complaints about socialized medicine, subsidizing the well-to-do and big government would vanish.

That's how health care is done in Bush's Washington.

To find out more about Froma Harrop, and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate web page at www.creators.com.

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