Thursday, October 04, 2007


Last week Congress sent a bill to President Bush that would have provided an opportunity to secure comprehensive health insurance coverage for an additional 4 million uninsured American children. Currently in the United States, 9 million of our children have no health coverage. This legislation would have cut that number almost in half.

The President's plan for funding the State Children's Health Insurance Program (SCHIP) calls for an increase in funding of $5 billion over the next five years, an amount that will not cover the costs for those currently enrolled in the program. The administration's plan is a step backwards.

Congress envisioned an increase of $35 billion that would have been funded by a 61 cent increase in tobacco taxes. Sort of a "Win-Win" for those concerned for real gains and long term savings in public health costs and outcomes.

On the Senate side enough votes are in place to override the Presidential veto, but such is not true in the House of Representatives.

I'll leave others to debate the details relative to cost, those who would be eligible for coverage, speculation about intentions and competing philosophies.

But this I know. Every child in America needs health care that is high-quality, accessible and affordable to their families. Further, if improved public health is our real goal, health care should not be bought and sold like a market commodity.

The way we've been delivering health care options to low-income and middle-income families just doesn't work. The time has come for bold change. In the long run reform that leads to universal coverage will be the very best investment for the nation. Every cost benefit analysis I've seen makes this case very clear.

Here in Texas for every $1 the state invests in CHIP, we receive $2.64 in matching funds from the federal government. Bringing tax dollars back home helps everyone in Texas.

No doubt, the legislation will return to Congress for a vote to override the President's veto. One of our Senators, Kay Bailey Hutchison voted for the bill. Unfortunately, Senator John Cornyn voted against the legislation. I hope everyone reading here will contact their Representatives in the House and urge a vote for SCHIP.

I pray the President will reconsider his veto for the sake of our children and for all of our communities.

Everyone needs health care, and emergency rooms don't count.



Politics & Culture said...

I don't agree with you on a lot of things, but I'm with you on this one. I really think the President should have signed the bill.

Anonymous said...

I agree with just about everything you said. And Bush's position is stingy. However, this bill was not perfect. It would have allowed some families making $60k to qualify, and was funded by a tax on cigarettes, which are now bought largely by people of low income. So, while I'm certainly not endorsing cigarettes, having a poor person (making say $18k a year) subsidize a middle class person's income seems wrong.

Larry James said...

Anonymous, 10:02 AM, you are correct--no bill is perfect. Allowing a family at 300% of the federal poverty benchmark to enroll and pay something for this health coverage is very realistic, given what it costs to raise and care for a family. The 300% is a gross income standard and many of these children aren't covered, but in fact, they are only a small % of the total who would be newly covered by the legislation.

As to the poor subsidizing the middle class, this is a public health effort that is designed to help lots of folks stop smoking--a choice that is in everyone's best interests.

osipov said...

This administration . . . a step backwards? What a surprise.

dan said...

There are a lot of disadvantages of this SCHIP health care plan for "children." Allow me.

1. Many of the "poor" children are actually adults already covered by private plans.

2.It is a middle class handout and a gateway to an upper class handout-creeping socialism.

3.Last year 700,000 adults were in this program. Adults outnumbered children in 3 states.

4.14 states already cover adults, six of them childless adults.

5.6 states cover pregnant women, fetuses count as children when it comes handy.

6.States have the option to check for proper documentation or not, since many local authorities turn a blind eye, it is easy for illegals to get into the system.

7.Doctors tend to opt out of the program because payment rates are considerably lower than private insurance. Fewer doctors plus more children=hugh wait times, typical socialized medicine.

8.Today 89% of all children in families making 300-400% above the poverty line have private insurance. Because the program appears to be "free," millions of chidren will flood the government program--with a shrinking pool of doctors and much more limited "doctor choice." Canada anyone?

9. The current funding for this program is 5 billion--Democrats are asking for a 50 billion expansion over 5 years. They say the increase to a dollar a pack on cigarette tax will pay for it. Of course government never goes over budget.

10. By 2017 we will need 22.4 million new smokers just to keep SCHIP funded.

11. With smoking increasingly stigmatized, and cigarettes too pricy, where are these new smokers supposed to come from?

12. If new smokers don't materialize who will foot the bill for millions of now privately insured "children?" Answer--YOU

13.This bill is designed to entice the middle class and the affluent to ditch their private plans for the government dole. Once folks get the taste of federal "assistance," there is no going back. (hello, Social Security)

14.It creates an incentive for states to enroll as many people as possible. The bill offers "bonus payments" for enrollments over 'baseline' levels.

15. Congress never has to review or renew the program, unlike the one in 1997--it's there for eternity.

Mrs. Clinton's SHIP bill is complicated, dry, muddled in bureaucratic language, and dressed in noble-sounding code phrases like "for the children." Let's hope the veto stands!

Janet said...

Your facts startled me. I found it hard to believe that adults were being allowed on the SCHIP. I also found it hard to believe that people are "turning a blind eye."

My experience with people I know is that it would be near to impossible for an adult to get on SCHIP. My friends have enough trouble keeping their eligible children on SCHIP with the paperwork and every 6 month (I think that's right) re-enrollment requirement. I've had friends get kicked off the roles and it has taken months for them to get back on. Some of them are adults who do not have insurance themselves. I'm sure they would be happy to know if there were an opportunity for them to receive health care as well!

When I looked up SCHIP information, I saw the fact sheet where you found the statistics. It's a White House fact sheet. So I *suppose* it's not propoganda. However, nowhere in the fact sheet did it say how old the "adults" were. When I looked up other sources, I could only find programs that offered SCHIP to 0-18 year olds--including Arizona, Minnesota, and Wisconsin, the three who have adults on their SCHIP count. Are they counting 18 year olds as "adults" to get their statistics? Personally, I have no problem with an 18 year old...or a 21 year old, for that matter, receiving health care. A college student I know was removed from the opportunity to have medicaid once she turned 21. Her adopted mother didn't have insurance for her (because she was too poor herself), but then she passed away. So is a 21 year old college student expected to find her own privatized insurance because she goes to school full-time and has a part time job that doesn't offer benefits?

Oh, and of course 89% of people at the 300-400% poverty level have privatized insurance for their children. They don't want something to happen to them! It doesn't mean they can afford it. I am probably in that range. I don't have children, but I often wonder what would happen if I did. I have live a pretty basic lifestyle with very few luxuries. I'm fine with what I have, but if I had a child, I wonder how I would be able to afford school supplies, school activities, health insurance, clothes, food, saving for college, etc. I'm sure something would have to give. And since I don't have many luxuries to cut out, it would probably end up being some necessities.

Anonymous said...

I am a grandmother raising an orphaned grandchild with special needs. The Texas Chip program has been a God send for us. Yes I could have covered him on my employee plan. The cost was well over $300. monthly and would have driven us into poverty with huge co-pays on services and medicines. When you have to make a choice between putting food on the table or healthcare the obvious choice is made. Chip was the only realistic way to go for his care and is the case for other families who find themselves caught in the high cost of health care dilemma.

Although I don’t agree with all of the bill Bush vetoed, especially with the cigarette tax, I don’t appreciate his lack of concern for the need now or in the long term. A good compromise needs to be made and a stronger bill passed than what he is proposing.

If we can finance his ridiculous war in Iraq we can find a way to improve the quality of life for so many in need right here at home. Too many people fail to recognize the true cost of failing to do that. We are already paying for it in more ways than one and it is time we demand better care for all of our citizens. Recognize the crisis for what it is and demand proper action from both sides!

dan said...


The way I understand it is that SCHIP funds are a block grant to each state. Some states follow the guidlines as originally intended which is for health care for childrren from low income families. Other states do not follow the guidlines and allow adults in the program. Then when these states run out of money, they go asking for more.

Larry James said...

Undeniable bottom line: SCHIP covers millions of children who have no health insurance. States who extend benefits to "adults" do so for reasons they have determined to be reasonable and acceptable. No matter how much negative propoganda one throws up on the wall, this program is excellent, utilizes private providers and covers more of our children. It should have been signed into law for the benefit of us all.

Anonymous said...

The socialized medicine of Europe and Canada is on life support. We should learn from their mistakes.

Anonymous said...

The reasonable and acceptable reason that states started covering adults is that they had to give back money that wasn't used in 2003. Now many children cannot be covered because the money is tied up in adults.

I think it's a shame that the original intent, to cover poor children, has been lost.

Karen said...

Infant mortality rates are not the only indicator of public health, but they are a good one. The United States is 37th in the world, behind most European nations and Canada, so I question the assumption that socialized medicine is on life-support in these countries. I have relatives in France, and their health care system is rated highly.

I have a feeling this one is, again, about many of us being afraid that people living in poverty are going to 'get some of our stuff.'

1. Singapore 2.30 deaths/1,000 live births
2. Sweden 2.76 deaths/1,000 live births
3. Japan 2.80 deaths/1,000 live births
4. Hong Kong 2.94 deaths/1,000 live births
5. Iceland 3.27 deaths/1,000 live births
6. France 3.41 deaths/1,000 live births
7. Finland 3.52 deaths/1,000 live births
8. Norway 3.64 deaths/1,000 live births
9. Malta 3.82 deaths/1,000 live births
10. Czech Republic 3.86 deaths/1,000 live births
11. Andorra 4.03 deaths/1,000 live births
12. Germany 4.08 deaths/1,000 live births
13. Switzerland 4.28 deaths/1,000 live births
14. Spain 4.31 deaths/1,000 live births
15. Macau 4.33 deaths/1,000 live births
16. Slovenia 4.35 deaths/1,000 live births
17. Denmark 4.45 deaths/1,000 live births
18. Austria 4.54 deaths/1,000 live births
19. Belgium 4.56 deaths/1,000 live births
20. Australia 4.57 deaths/1,000 live births
21. Liechtenstein 4.58 deaths/1,000 live births
22. Canada 4.63 deaths/1,000 live births
23. Luxembourg 4.68 deaths/1,000 live births
24. Netherlands 4.88 deaths/1,000 live births
25. Portugal 4.92 deaths/1,000 live births
26. United Kingdom 5.01 deaths/1,000 live births
27. Ireland 5.22 deaths/1,000 live births
28. Monaco 5.27 deaths/1,000 live births
29. Greece 5.34 deaths/1,000 live births
30. San Marino 5.53 deaths/1,000 live births
31. Taiwan 5.54 deaths/1,000 live births
32. New Zealand 5.67 deaths/1,000 live births
33. Isle of Man 5.72 deaths/1,000 live births
34. Italy 5.72 deaths/1,000 live births
35. Cuba 6.04 deaths/1,000 live births
36. Korea, South 6.05 deaths/1,000 live births
37. United States 6.37 deaths/1,000 live births

Mild Mannered Reporter said...

I agree. Christians should support efforts to expand access to health care. It is a matter of basic fairness and life and death in many cases.

Anonymous said...

Statistics are kept differently in some countries. For example , in the U.S. if a baby shows any life, even for a few seconds, it is counted as a live birth. In some countries, a baby that dies soon after birth is counted as a stillbirth and not counted in their infant mortality statistics.

Anonymous said...

Anonymous 8:04, very weak point. These statistics are universally accepted, even by U. S. health authorities. The problem here is not statistical quirk, but failure of public health approaches in the U. S.

Anonymous said...

One time, early in my teaching career I was eating in the teacher's lunch room and of a "free Lunch" discussion started. Many of us, including myself I am now ashamed to say, started throwing around phrases like..."I doubt if all of these kids really qualify for free lunch..ya,da,ya,da..and so on". One very wise black substitute teacher said something that slowly changed the way I thought about everything....He said
ALL children who go to school should get a free lunch...and breakfast too. Our government wastes so much money why not "waste" it by feeding all children rich or poor...I feel the same way about health care...If we just pooled the "wasted" money, we would
have plenty to go around...and that means "children" still trying to make it in the world...21 year olds in college...or in very low paying entry level jobs...We might have to quit paying for other "Important" care and eating should be basic rights...Terry

Anonymous said...

Soon parents will not even be necessary, just turn your children over to the government.

Anonymous said...

Anon 8:49 - Especially since a lot of parents are too concerned about getting rich than about spending time with their children. Might as well let the government do what they're failing to do.

Justin said...

Statistics can be used in many different ways to represent many different things. I have a hard time trusting them, not because they aren't necessarily correct, but because statistics often don't tell the whole story. Just like poverty statistics from the Cato Institute saying that most poor people have cars, tvs, own their own homes, etc.

I often wonder if the infant mortality rate difference in our nation has anything at all to do with having government health care or not. It could have something to do with the make up of our country. Has anyone done studies on infant mortality rates amongst different segments of the population... like whether for genetic reasons one group may have a higher likelihood of healthy birth than another?

Every country on that list above the United States has a significantly smaller population than we do. Could that have any effect? Japan, for example, doesn't allow immigration. With no immigration, you don't get people from third world countries moving in who have little or no understanding of what needs to be done to keep a baby healthy. I imagine, that many infant deaths have to do with people who don't know some basic things about how to care for baby and mother. No matter if there are government programs in place to help them, it still may not change the infant mortality rate.

I just think we need to be very cautious in asking the government to take care of everything for us. Luckily, for the last 240 years or so, we've had decent enough people running our government, and we've had the ability to get rid of those who aren't decent. I fear when we give up liberty in the name of security (whether it be the patriot act or universal health care) we may one day regret it. I mean, if one day government care is no longer "the best" and you are sick yourself, but the government won't allow anyone to practice medicine privately... I feel like that's even worse than not having good medicine because you can't afford it. At least its legal.

Maybe those that are so gung ho about government health care should pledge, when it is passed, that they will only use government care themselves, out of solidarity with the poor. I think it'd be interesting to see how that pans out.

osipov said...

I'll be expecting to get a reply from Justin on this one . . . my husband is from Russia. I'm a big fan of universal health care.