This week’s health-care debate previews the fall 2008 election, if today’s presidential frontrunners win their respective party nominations. Senator Hillary Clinton (D., N.Y.) and former mayor Rudolph W. Giuliani (R., N.Y.) are promoting reforms that contrast like midnight and high noon.
As Clinton cheers, Congress moves to reauthorize the State Child Health Insurance Program. Launched modestly in 1997, SCHIP was targeted at kids whose families were too prosperous for Medicaid, but too poor for private coverage. Like nearly every federal scheme, SCHIP is metastasizing. Clinton, her Democratic comrades, and some weak-kneed Republican appeasers are widening SCHIP into a self-contradictory contraption, complete with a tax hike and a fiscal blunderbuss.
“It is one of our most important national priorities to cover all Americans, and that should start now with all of our children,” Clinton said July 16. Of course, it depends on what the meaning of the word “children” is. Washington already lets 14 states cover 670,000 “boys” and “girls,” up to age 25, some of whom have been drinking legally for four years and voting for seven. Ninety-two percent of Minnesota’s SCHIP budget insures adults.
Clinton’s proposal, like the House Democrats’ bill, would cover children in families up to 400 percent of the Federal Poverty Line (FPL), double today’s target. Thus, a family of four making $82,600 could receive federal-government medicine. Meanwhile — the Heritage Foundation’s Rea Hederman estimates — 70,000 “American families are both poor and high-income — simultaneously.” They qualify for SCHIP and the Alternative Minimum Tax.
Madder still, 77 percent of children between double and triple FPL and 89 percent between 300 and 400 percent of FPL already have private health insurance, notes Cato Institute scholar Michael Cannon. Nonetheless, the Democratic House Wednesday night approved $47 billion for SCHIP through 2012, 88 percent above its current $25 billion, five-year budget.
Senate Democrats would fund this extravaganza via a 156 percent cigarette-tax hike — from 39 cents to $1 per pack. Heritage forecasts that 22 million new smokers would have to light up by 2017 to keep SCHIP afloat. So, SCHIP promises to improve children’s health while exploiting adult tobacco addiction. And if those smokers never materialize, future Congresses simply will invoice smoke-free taxpayers.
“The Left is pretty blatant about this being their vehicle to move to universal coverage,” one health-policy expert told me. “Make kids think you get health insurance from the government, and in less than a generation, you’re there.”
While Democrats and some lily-livered Republicans ceaselessly invoke “the children” to impose government medicine, Giuliani does the reverse. His just-unveiled health plan rejects public entitlements and tax hikes and embraces private property and tax incentives to extend health coverage overall — beyond just kids.
“America’s health-care system is being dragged down by decades of government-imposed mandates and wasteful, unaccountable bureaucracy,” Giuliani told New Hampshire voters Tuesday. “To reform, we must empower all Americans by increasing health-care choices and affordability, while bringing accountability to the system.”
Giuliani specifically would grant uninsured families $15,000 tax exemptions, and singles $7,500, to help them buy private coverage that they, not their bosses, would own, control, and transport throughout their careers — much like car, home, and life insurance. Funds remaining after insurance purchases could be deposited tax-free into Health Savings Accounts for routine medical expenses.
He also would let Americans acquire health plans across state lines, as they now do with non-medical insurance. For instance, unmarried New Yorkers, who currently must buy such unneeded mandatory benefits as fertility services, would be free to secure no-frills plans from insurers in, say, mandate-light Ohio.
Giuliani also would curb malpractice costs by capping lawsuit damages and requiring frivolous plaintiffs to cover victorious doctors’ legal bills.
“If a person gets injured, he should be compensated, but he shouldn’t get the brass ring or win the lottery,” Giuliani explained.
Unlike President Bush, whose happy talk fuels Leftist disdain, Giuliani describes Democrats’ ideas with bracing candor. He calls their health proposals “heavily influenced by Marxism.”
“We’ve got to solve our health-care problems with American principles, not the principles of socialism,” Giuliani says. “I know Democrats will say this is unfair, I know they’ll squeal…But I am a realist. I face reality, which is: If you take more people and have government cover them, it’s called socialized medicine.”