Getting to the Bottom of the SCHIP Debate

The State Children's Health Insurance Program battle -- soon to heat up once Bush vetoes a bipartisan compromise and attention turns to the politically tenuous House Republicans -- is about two things.

One, of course, is the children themselves: 6 million currently covered under SCHIP (less if conservatives get their way) and 9 million still uninsured.

Without more health insurance, more kids will get sick and die. Period.

Conservatives, being compassionate and all, will swear up and down they don't want more sick kids. They just don't want "big government" to deal with them.

Now, I could give you some defensive arguments to insist SCHIP really isn't "big government." States take the lead in implementing the program. Private insurers generally deliver the coverage.

Which would be true. But that would leave out a critical part of the program's success: our federal government.

We all chip in and fund children's health insurance through our federal government. And we make sure the coverage is decent by regulating the private companies involved.

In return, we all save money and strengthen our economy as kids get more preventative care, instead of waiting for grievous illness to take them to the ER.

This is not theory. While more and more adults have had to go without health insurance, SCHIP has increased the percentage of kids with health insurance.

It is simply a proven success.

And local media has begun introducing their readers to kids who are alive and well thanks to that success.

None of this was happening, or would happen, without government -- without us citizens calling on our federal government to invest our taxes and set ground rules to solve this problem.

Having said that, this is not really a debate of government versus no government.

This is a debate between good government and bad government.

As I wrote in an earlier post:

Bush and fellow conservatives are just fine with government subsidies to prop up Medicare Advantage private plans, even though they cost taxpayers more than the traditional Medicare public plan.

They are just fine keeping the children's insurance program, so long as we underfund it and millions remain uninsured.

As Robert Borosage commented earlier: "faced with a choice of providing children with health care or protecting the profits of private insurance companies, the president chooses the latter."

Conservatives fear losing the SCHIP debate because they fear losing the entire health care debate. This fear is unchanged from 1993, when they decided they had to kill universal health care, because "[i]ts passage will give the Democrats a lock on the crucial middle-class vote and revive the reputation of the party."

Politics over policy. Party over people. Bad government over good government.

SCHIP is not health insurance for all. It's just a rare bright spot in our overall inefficient, convoluted, patchwork, private-sector dominated health care system.

Expanding SCHIP does not automatically get us to quality, affordable health insurance for all.

Nor does defeating SCHIP -- and further upsetting the public by worsening our health care system -- ensure conservatives (despite their delusions) that they can stop the momentum for universal health insurance. Perhaps the opposite.

And that bigger debate is rapidly coming, as Sen. Hillary Clinton's new health care proposal joins plans from Sen. Barack Obama and former Sen. John Edwards.

To address the myriad of domestic problems that Americans want solved, including our shoddy health care system, we need effective government.

To win these debates with the public, we need to be able to propose solutions that involve our government.

That means when we have a program where our government has shined, we must praise it for that very reason.

The fundamental question that is always before the public is: whose people and which philosophy knows the difference between good government and bad government?