Health care should cover kids
America desperately needs a universal health insurance plan, but political realities suggest Congress will move toward it incrementally. The demand for universal coverage, quality improvements and cost containment is mounting across the political spectrum, and every 2008 presidential candidate will have to have a plan.
The demand is fueled by the steadily increasing ranks of the uninsured, now numbering close to 47 million, continuously rising insurance costs that burden U.S. businesses in global competition and a quality crisis that kills tens of thousands of Americans yearly.
But ideological splits between Democrats favoring government-dominated health care and Republicans emphasizing consumer-driven cost-containment almost certainly will block enactment of any plan in the next two years.
Instead, Congress and the White House need to reauthorize and expand the State Children’s Health Insurance Program, and Democrats should give a fair hearing to President Bush’s proposal for a standard tax deduction for the purchase of health insurance.
Bush budget officials would not tell me what their number will be, but health experts say it will cost about $14 billion over five years to keep 5 million children covered under the program. That still leaves 9 million to 10 million children uninsured — 6 million to 7 million of whom are eligible for SCHIP but are not enrolled mainly because states don’t reach out to them.
To cover them would cost an additional $50 billion over five years. And to cover all children in families with incomes under $66,000 for a family of three — twice the federal poverty line — would cost $20 billion on top of that.
It’s worth noting that Bush not only agreed to — but sponsored — a Medicare prescription drug bill for seniors that will cost an estimated $400 billion over five years.
Administration officials argue that providing drugs to seniors is a major way of preventing disease and holding down costs. The same argument can be made for preventive care for children, for whom coverage is cheaper than for adults.
A number of initiatives to cover all children have been proposed, including one by Sen. Hillary Rodham Clinton, D-N.Y., Rep. John Dingell, D-Mich., and a coalition of 16 disparate groups including the liberal Families USA, the conservative U.S. Chamber of Commerce and America’s Health Insurance Plans.
Meanwhile, Bush’s proposal to grant a standard tax deduction of $7,500 per individual or $15,000 per family for the purchase of insurance was declared DOA by Dingell and Rep. Pete Stark, D-Calif., chairman of the House Ways and Means subcommittee on health.
It deserves resuscitation and revision — possibly to provide for a refundable tax credit to enable more low-income workers to afford health coverage. The main Democratic objection to Bush’s plan — an alleged “tax increase on the middle class” — could be ameliorated by phasing it in.
Advocates of universal coverage, such as Henry Simmons, president of the National Coalition on Health Care, argue that America can’t wait until after the 2008 elections to repair a broken system.
America needs to have everyone covered to bring down the average cost of insurance and keep everyone healthier. But how to deliver that service — through the government or the private insurance market, with price controls or consumer choice — is a subject for a presidential debate. For now, let’s cover the kids.
Morton Kondracke is executive editor of Roll Call, the newspaper of Capitol Hill.