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You make a very good point, John. The word “poor” in this kind of policy context does have a particular meaning, and it’s important to understand that SCHIP is for kids who aren’t poor, but whose parents nonetheless cannot afford to insure them.

This is an important point to understand about the uninsured in general. Those without health insurance in America are generally not the poor—who are eligible for Medicaid. About 75% of the uninsured are above the poverty line, and (though these more detailed data are harder to pin down and remain somewhat in dispute) it appears that the bulk of those uninsured who are below the poverty line are non-citizens, and therefore have trouble qualifying for Medicaid, as they would (one imagines) to any new benefit. The great bulk of the uninsured are, rather, in the lower middle class, and in many cases employed by small companies, or self-employed, and so are not given insurance by their employers and can’t afford it for themselves.

This is why the Republican proposals to use the tax code to help the uninsured make sense. These proposals have been ridiculed by some on the left for letting the poor deduct health insurance they can’t afford from taxes they don’t pay. But the people who are actually uninsured are generally employed, not poor, do pay taxes, and would benefit a great deal from deducting $15,000 for health coverage—or in other words getting the same benefit that those who get coverage from their employer do. That’s not a complete solution to the problem of the uninsured (and it’s also not the only solution Republicans are offering, as I argue in the Weekly Standard this week), but it’s better suited to the actual needs of the uninsured, and of everyone else, than an effort to dismantle our insurance system and replace with one even less responsive to economic realities and the needs of American families.

Health care is a perfect example of the kind of Democratic group-think or echo chamber effect Jonah referred to yesterday. Because Republicans have too often been absent from the argument, the Democrats have persuaded themselves that the public wants a government-financed (and managed) solution, and that the problem to be solved is more or less everything about our health insurance system. This seems to be a vast overreaction to the public’s actual concerns. If Republicans seriously make the case for their own emerging approach, and highlight what the Democrats seem to have in mind, they might find an unexpected opportunity on health care.


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