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Health Insurance for Children

As expected, President Bush vetoed the $35 billion expansion of the State Children's Health Insurance Program (SCHIP) that the House and Senate approved last week.

"The current bill goes too far toward federalizing health care and turns a program meant to help low-income children into one that covers children in some households with incomes of up to $83,000 a year," the White House said after the House passed the bill in September.

Democrats say their goal is to cover more of the millions of uninsured children. The number of uninsured Americans has hit an all-time high of 47 million, according to annual Census figures. The number of uninsured children is now 8.7 million.

Do you know children who are insured through SCHIP? What do you think should happen to children's health care?

By Stacey Garfinkle |  October 3, 2007; 10:39 AM ET  | Category:  The Debate
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Comments


The health care system as a whole needs a revision. 47 million Americans without health insurance is unacceptable. It makes no sense to me why Bush would veto this bill. He probably doesn't care because this doesn't affect his family.

Posted by: Anonymous | October 3, 2007 11:17 AM | Report abuse

There are many many uninsured children not covered by SCHIP, and yes I do know a few.

However, the fight over SCHIP is much larger than just insurance for children. As has been documented in the media, this is a kind of proxy for the larger issue of how to handle health care in this country. It is a pity that uninsured children and their famiies have the misfortune of being chosen as the battleground for this issue, but I fear this is only going to be the first in a long series of similar battles.

Unlike the president, his allies, and others I do not believe in the power of the free market to solve problems of efficiency and frugality. In the case of SCHIP, it makes sense to insure (even with some waste) the universal health care of children as the long term savings from quality childhood care to the overall economy would be high. The details of specific plans (ranging from the required coverage by private companies as was organized by former Gov. Romney, to the one payee system favored by former Senator Edwards, to the truely socialized systems of Europe) aside, however, the need for some form of universal health coverage for all, not just children, is a growing necessity. Expanding SCHIP prevents an obvious benefit, but expanding coverage further is also important.

Posted by: David S | October 3, 2007 11:29 AM | Report abuse

Health insurance for children is the job OF THE PARENTS. Why should we be paying for anything for somebody else's kid(s)? If you are a parent, you are responsible for everything for that kid. My taxes pay for public schools. Period. Health insurance, daycare, soccer games, orthodontia, clothing, head lice shampoo, $150+ sneakers, iPods, Xbox games, are all the responsibiity of the parents. If you can't afford them, you shouldn't have them.

Posted by: Anonymous | October 3, 2007 11:44 AM | Report abuse

The Republicans should all be thrown out on their a**es. That would solve many, many problems in this country.

Posted by: rlalumiere | October 3, 2007 11:46 AM | Report abuse

Posted by Anonymous @ October 3, 2007 11:44 AM:

"Health insurance for children is the job OF THE PARENTS. Why should we be paying for anything for somebody else's kid(s)? If you are a parent, you are responsible for everything for that kid. My taxes pay for public schools. Period."

Why school, but not these other things?
What is it about school that is more worthy of your tax dollars than health care?
What about the implications of lack of health care on the investment in schools (e.g. health issues leading to a student being unable to attend school or doing poorly in school)?


Posted by: David S | October 3, 2007 11:50 AM | Report abuse

What about children that come from families that cannot afford health insurance going to school sick, that makes your child sick? Oh, you probably don't care because you are one of the lucky Americans that HAS health insurance.

Posted by: Anonymous | October 3, 2007 11:59 AM | Report abuse

The Republicans should all be thrown out on their a**es. That would solve many, many problems in this country.

Posted by: rlalumiere | October 3, 2007 11:46 AM

And what has the Democratic congress done for you lately?

Posted by: WDC 21113 | October 3, 2007 12:10 PM | Report abuse

I have lived without health insurance for periods of time and have had only catastrophic insurance for periods of time as well.
That said, if someone is truly in need of care, there are many public health clinics that provide free/reduced cost care on a sliding scale basis according to income. The clinic that I work at does not turn anyone away because they do not have insurance. There are options out there.
An increase like that bill for coverage of children (or universal coverage), while in theory a good thing, would cost a lot of money that would most likely have to come from higher taxes. I am lucky right now in that I get insurance through my employer, but I cannot spare money in additional taxes without being able to provide the basics of food, clothing, or shelter. Working in public health is not a lucrative career. Many other people would have a hard time making ends meet as well if their income was taxed at a much higher rate as well. The working poor might be even worse off because money that they had before is now going into the health care pool so they now have less money to spend on food/transportation/etc.

Posted by: ducky | October 3, 2007 12:12 PM | Report abuse

I am usually a reader, not a poster, but after picking myself up off the floor from the previous post...

I am a mom and pediatrician. I remember clearly the days before SCHIP when ER's were full of uninsured kids. We still deal with this daily-- trying to get needed medications and tests for kids who can't afford them, but SCHIP has helped many kids, and has the potential to help many more.

As to the question of why we should pay for someone else's kids:
1. We live in a society and morally and ethically it is the right thing to do.

2. Appropriate health care shouldn't be a "bonus" in life-- it's a necessity.

3. There are many families who work hard, but still don't make enough money to pay the huge cost of health insurance. And obviously not all employers offer this benefit. For example, I would guess that many of the daycare workers that lovingly care for the kids who do have health insurance, don't get paid enought to afford it for their own kids. It is everyone's obligation to help.

4. Children without proper health care don't just suffer alone-- everyone loses in this equation. Whether it is lack of vaccinations leading to outbreaks, increased cost to the health care system passed on to other consumers or future health care costs for preventable, long term effects of diabetes, obesity, high blood pressure, the list goes on and on..

5. Did I mention that it's the right thing to do?

Posted by: peds | October 3, 2007 12:26 PM | Report abuse

Many parents work but cannot provide health care for their children. Employers are providing less insurance and employees are paying more of the cost when they do. Many jobs only cover the employee, and the price of dependent coverage, if even available, is entirely paid by the employee, if the employee can afford it.
It can take the job loss/serious illness of just one parent in a family to go from a family with family health insurance to a family without. SCHIP fills the gap when you have too much ncome to qualify fro MEdicaid, but cannot afford/cant get private family insurance.

Posted by: jess | October 3, 2007 12:32 PM | Report abuse

"I am usually a reader, not a poster, but after picking myself up off the floor from the previous post..."

I could not have said it any better.

Posted by: per | October 3, 2007 12:34 PM | Report abuse

Well, WDC 21113, they actually passed the SCHIP bill. Bush vetoed it.

But, apparently like you, I guess President Bush doesn't care about kids.

Posted by: Anonymous | October 3, 2007 12:36 PM | Report abuse

Ducky,

The bill proposed raising taxes on tobacco products by 61 cents to cover the costs for this plan. This isn't talking about raising taxes by hundreds or thousands of dollars a day. Click on the blue text in Stacie's blog and read it for yourself.


To Peds,

Thank you for your insight into this matter as you daily work with these issues.

Posted by: Anonymous | October 3, 2007 12:37 PM | Report abuse

I think children whose parents can not afford private insurance need coverage.

I am not sure this is the way to do it. The bill is funded on tobacco taxes, which are projected to decline - setting the stage for future problems in funding.

It is not managed. Throwing more money into health care has not been shown to improve outcomes. I think I might prefer total Federalization with a VA type system to provide care - that could operate under evidence-based guidelines. Otherwise I feel like you are giving hospitals blank checks.

Last I heard the bill also had some other "Goodies" like moving hospitals to higher reimbursement areas thrown in.

Clearly this is an area where we need to do better, but I think I would prefer that they continue what is there, and leave the overhaul to the next regime, which will be elected to do that.

Posted by: RoseG | October 3, 2007 12:40 PM | Report abuse

The President has said numerous times that he supports SCHIP. What he does not support is this ridiculous expansion of SCHIP.

Ridiculous, you ask? Yes, I believe it is. If the SCHIP expansion would have become law, tens of thousands of families would be in the absurd situation of qualifying for welfare while at the same time paying the Alternative Minimum Tax, a tax on the wealthy.

Anyone who wants to understand the President's veto can think of it this way:
SCHIP = good.
SCHIP+AMT = bad.

Posted by: Bob | October 3, 2007 12:41 PM | Report abuse

Posted by ducky @ October 3, 2007 12:12 PM:

"An increase like that bill for coverage of children (or universal coverage), while in theory a good thing, would cost a lot of money that would most likely have to come from higher taxes. I am lucky right now in that I get insurance through my employer, but I cannot spare money in additional taxes without being able to provide the basics of food, clothing, or shelter. Working in public health is not a lucrative career. Many other people would have a hard time making ends meet as well if their income was taxed at a much higher rate as well. The working poor might be even worse off because money that they had before is now going into the health care pool so they now have less money to spend on food/transportation/etc."

For Clarity - If you are referring to SCHIP, the version of the bill the President just vetoed was to be funded by a substantual increase in the Federal Cigarette tax (50 cents I believe).

If you are referring to a broader, more universal plan, it would depend on which plan. Some plans (such as the one favored by former Gov. Romney) are relatively tax light as they are reliant on the increased number of people buying into the existant insurance market to drive the price down. Others, such as single payee or Eurpean style socalized health care, are more tax intensive. Of the plans offered in the US (that is to say, not European socialized medicine) none I have seen propose raising payroll taxes across the board, or on the working poor. Most propose higher taxes (or rolling back taxes) on those families earning $200,000 a year or more.

Regardless of which plan, it could be argued for methods that would reduce the cost over time. Per capita costs over a person's lifetime could be reduced by directing more coverage to preventive medicine (something not encouraged by, say, your catastrophic coverage) like mamograms, prostate exams, regular physicals, etc. There could be tax credits for being a non-smoker. Farm subsidies could be shifted away from grains and starches and towards fruits and vegitables.

In either case, I would hope that your concerns are not the reality - or there could be said to be something very disfunctional about the funding for such a plan.

Posted by: David S | October 3, 2007 12:44 PM | Report abuse

I agree with the Mom/pediatrician. Currently, even today, about 25% of ER visits are by children, many of them uninsured or underinsured. Often they are not true emergencies, but the parents have no other choice. Or a problem such as asthma becomes life-threatening because the child was not getting regular meds and treatment. This strains the ERs, and makes wait times longer for everyone.

SCHIP is the right thing to do. I wish people cared a little more about their neighbors these days. One day, you might want them to care about you. Maybe a new administration will help.

Posted by: SFMom | October 3, 2007 1:06 PM | Report abuse

it's comical to me that someone would say, if you can't afford kids, you shouldn't have them.

there are millions of parents in this country who can afford their kids... but they are just a step or two away from despair. a string of bad circumstances can leave anyone in poverty.

it's very convenient to suggest that others should do things the way you do them. the arrogance astounds me.

Posted by: cantwaitfor08 | October 3, 2007 1:06 PM | Report abuse

To the author, Stacey Garfinkle:

1. Why do you regurgitate President Bush's assertion when it is demonstrably incorrect without also stating that it has been discredited? See Froomkin's article from a few days ago "The SCHIP Hits The Fan".

2. Democrats AND REPUBLICANS "say their goal is to cover more of the millions of uninsured children." Congress is only 15 votes short in the House of Representatives from a veto-proof majority in both chambers. The bill clearly has support from both sides of the aisle.

This is a useful discussion you are trying to facilitate, but the way you frame the debate is misleading.

Posted by: sean | October 3, 2007 1:08 PM | Report abuse

My neighbor works for West Virginia's HHS that administers the SCHIP program here. He said that even now, about 30% of the people who apply for SCHIP already have heath insurance provided by their employeers, and they are instructed that they have to cancel their current policy then wait for three months before re-applying. Expanding the program will only increase the move from private insurance to a Taxpayer funded system.

Posted by: West Virginia Jim | October 3, 2007 1:15 PM | Report abuse

Bob said:

"If the SCHIP expansion would have become law, tens of thousands of families would be in the absurd situation of qualifying for welfare while at the same time paying the Alternative Minimum Tax, a tax on the wealthy."

The AMT is NOT a tax on the wealthy. That might've been it's purpose initially, but the level at which it applies has never been raised concordant with inflation or the cost of living. Money Magazine wrote about it here:
http://money.cnn.com/2005/11/09/pf/taxes/amt_101/index.htm
As the article explains: "The problem? What defined uber-rich in 1969, when the AMT was first enacted, has never been adjusted for inflation. That means what made you affluent back then doesn't now -- but you're still taxed like it does."

Regarding the "absurdity" of people on SCHIP paying the AMT: What that should say to anyone with knowledge of the AMT is that the AMT needs to be adjusted, not that children should be denied health care.

Posted by: Irrelevant | October 3, 2007 1:20 PM | Report abuse

David S.: Because I have no choice but to pay those taxes. 50% of my property taxes go to local public schools. I would prefer not to pay for schools -- or health insurance for somebody else's kids -- but nothing is certain but death and taxes. I am all for 'the less government the better.'

Posted by: Anon at 11:44 | October 3, 2007 1:20 PM | Report abuse

Posted by Bob @ October 3, 2007 12:41 PM:

"Anyone who wants to understand the President's veto can think of it this way:
SCHIP = good.
SCHIP+AMT = bad."

I am with you Bob, in your disapproval of the Alternative Minimum Tax. It has numerous problems; the most obvious of which is that that the point where the AMT starts to take effect was not indexed for inflation. Thus, when it took effect in 1970, it was only a matter of time until the high ceiling it originally presented was not so high.

I will say, however, that your statment concerning the relationship between the AMT and SCHIP is not logically consistent. The AMT is no longer a tax upon the wealthy, as you state, since it increasingly effects families who are quite definitavely middle class. Those few cases where children in an AMT family are SCHIP elligable are a reflection of the poor design of the AMT, not in the SCHIP legislation in question.

The logic that the president used, that the expansion of SCHIP passed by the congress is an unnessary infringement upon the free market, is more defensible than the one you have proposed.

Posted by: Anonymous | October 3, 2007 1:21 PM | Report abuse

It is not managed. Throwing more money into health care has not been shown to improve outcomes. I think I might prefer total Federalization with a VA type system to provide care - that could operate under evidence-based guidelines. Otherwise I feel like you are giving hospitals blank checks.

Posted by: RoseG | October 3, 2007 12:40 PM

What do you mean that it is not "evidence based"? There are accredidation standards and HEDIS guidelines; it is not as if they are proposing to give money to anyone who hangs out a shingle with "pediatrician" on it.

This is not a case of "throwing money" at health care, it is about allowing moore families with small children to have access to preventative care, which benefits society as a whole.

I can assure you, being a practioner within a federal health system, that lack of funding severely restricts the care we provide. "Federalization" of health care would require a commitment of resources far beyond what most people are willing to support. Expanded health insurance coverage should be a reasonable middle ground.

Bush and his apologists should be ashamed of themselves.

Posted by: Dr. P | October 3, 2007 1:25 PM | Report abuse

"If the SCHIP expansion would have become law, tens of thousands of families would be in the absurd situation of qualifying for welfare while at the same time paying the Alternative Minimum Tax, a tax on the wealthy."

The absurdity lies with the Alternative Minimum Tax which hasn't been adjusted with inflation. So a program that originally was targeted at people with high incomes is now hitting the middle class as well. Congress needs to deal with that separately.

SCHIP needs to be expanded for the same reason the AMT should be adjusted. The number of uninsured children has risen since SCHIP was introduced, and as a result the program no longer covers those who it is supposed to: uninsured children.

It is sound policy to adjust programs as the situation changes to ensure they fulfill their intended purpose. This is why both SCHIP and the AMT should be modified.

Posted by: sean | October 3, 2007 1:28 PM | Report abuse

Posted by Anon at 11:44 @ October 3, 2007 01:20 PM:

"David S.: Because I have no choice but to pay those taxes. 50% of my property taxes go to local public schools. I would prefer not to pay for schools -- or health insurance for somebody else's kids -- but nothing is certain but death and taxes. I am all for 'the less government the better'."

Allow me to ask another question, perhaps more applicable then to your 'less government the better' philosophy:

Since taxes are inevitable, would you prefer that those taxes go to fund health care for children or schooling for those children, cost being equal?

To understand the logic behind my question, I just want to clarify that I believe that the taxpayer should pay for both, but I wish to understand your oppinion on which program would better serve the public good.

Posted by: Anonymous | October 3, 2007 1:28 PM | Report abuse

The Anonymous poster at 1:28 PM was me.

Alas, I think I am developing a nasty habit of posting without my "name" in the correct field.

Posted by: David S | October 3, 2007 1:30 PM | Report abuse

Bush has done more to hurt SCHIP besides just veto this legislation. CMS recently has produced, under the Bush administration's direction, new rules that will, at least in my state, boot about 2,000 kids out of the program, probably many thousands more nationwide. The legislation just veoted would have undone those new and onerous rules -- so it's dishonest of Bush to say he's just trying to prevent the expansion. In reality, what's he's done is begin to pull apart a very successful program that pays dividends in healthier more productive youth.

Posted by: From NH | October 3, 2007 1:33 PM | Report abuse

"it's comical to me that someone would say, if you can't afford kids, you shouldn't have them."

I couldn't agree more. Those who don't want to support kids who need help now almost certainly won't turn away when it's their turn to look to the government for help in the form of social security, prescription drug benefits, and all the other programs that benefit seniors. Guess who will pay for that? The same children to whom the President is trying to deny health insurance now.

Posted by: sean | October 3, 2007 1:36 PM | Report abuse

I can understand that many parents can't afford health insurance, but I get frustrated with parents who could afford health insurance if they made it a priority. My neighbor often complains that they cannot afford health insurance as it is not provided through their employers (they are both EMTs with a local ambulance company). These same neighbors, who just recently bought the house, also purchased a new car, a new pool for the house, etc. So obviously they have money to spend, but health insurance is not a priority over these other items.

People TRULY in need should get some assistance, but I am frustrated that I continue to pay higher taxes to help out those in society who make really poor choices, only to expect society or government to bail them out. We are seeing this with the mortgage bail out, the flood insurance program for people who continue to build / live in flood prone areas, and now health insurance for the 'masses' who can't say no to the luxuries and therefore can't 'afford' health insurance on their own...

I am tired of it.

Posted by: Tired NY Dad | October 3, 2007 1:40 PM | Report abuse

In New York state, the SCHIP is called Child Health Plus. If your income is more than a certain amount, you have to pay some premium for your child's coverage in the Child Health Plus.

I was greatly relivied that I could get my child in the program when I lost my job.

Posted by: cs2007 | October 3, 2007 1:43 PM | Report abuse

Tired NY Dad,
Then go after the big ticket items in federal spending -- say Pentagon spending perhaps, corporate subsidies, or tax breaks for the wealthy for starters.
We save money by insuring kids because if they get sick and their parents can't pay, you pay anyway in your own insurance premiums. We can save the cost of many an emergency room bill if we help pay for some doctor's office visits instead. It makes financial sense.

Posted by: From NH | October 3, 2007 1:47 PM | Report abuse

To TiredNYDad:

While you think your neighbors could afford health care coverage based on their "misplaced" priorities, that is not the case with most people. My husband and I just tried to apply for health insurance for the two of us and it turns out that it will cost us $850 a month for health insurance. If we had a child, it would be even higher. We don't have $850 a month to pay for coverage, and our employers don't offer health insurance because they are small companies that also can't afford a company policy. We drive one car and live in an apartment, we don't have "luxuries" to cut out to try to afford health care. Just because your neighbor may live extravagantly according to your standards, the rest of us without health insurance do not.

Posted by: Anonymous | October 3, 2007 1:53 PM | Report abuse

I thought no child should be left behind?

What exactly do you call not providing basic healthcare to children whose parents cannot afford it?

Posted by: Shannon | October 3, 2007 2:09 PM | Report abuse

I hate how people who haven't even READ the bill are posting about it and forming uneducated/bogus opinions ...

"It doesn't make any sense why he would veto it???" Try READING it, then it might make some sense to you.

* It is a regressive tax on the poor (tax on smokers, who are disproportionately poor)
* It expands SCHIP into the middle class (earning $83k per year)
* Analysts have shown that the above two will mainly tax people in red states and give the money to people in blue ones (smokers are more likely poor people in red states/higher incomes are more likely in blue states)
* SCHIP runs out of funds in 2012, so it's a false promise of health care for a program that ends in a few years unless it is renewed
* It rewards states for signing up the most people possible without oversight - so states have no vested interest in helping people OFF the dole, otherwise their federal kickbacks go away

Try actually READING about it folks ...

Posted by: StudentMom | October 3, 2007 2:11 PM | Report abuse

Forgot another BIG thing:

* Also, there is nothing in this bill that would prevent illegal aliens and their children from qualifying ...

Posted by: StudentMom | October 3, 2007 2:16 PM | Report abuse

A couple of things:

1) You are already paying for the cost of the uninsured in the form of higher premiums.

2) Our tax dollars pay for the excellent health coverage for federal workers - including Congress and the President. As Senator Kennedy wrote today, "If you don't believe the federal government should support children's health care, how can you in good conscience accept it for your own families?"

3) God help those of you who may need the safety net of a government sponsored program but aren't willing to share in the burden of paying for it. This country is too focused on individual needs, rather than the collective needs of the country as a whole.

4) Oh, and by the way, the White House has proclaimed October 1st Child Health Day. Ironic, given that he vetoed the SCHIP bill two days later.

Posted by: BDK | October 3, 2007 2:21 PM | Report abuse

I have read it.

Im not shedding any tears over smokers being taxed, poor or not, and I dont care what color states they come from. They can choose to smoke, kids dont choose to get sick.
SCHIP isnt the dole, you pay a premium that rises with income. Below a certain level, you qualify for Medicaid.

Posted by: jess | October 3, 2007 2:23 PM | Report abuse

Also, the $83,000 has ben widely debunked as a scare tactic (much like weapons of mass destruction):

"And the White House echoed the false talking point today in its official veto message to Congress:

[T]he current bill goes too far toward federalizing health care and turns a program meant to help low-income children into one that covers children in some households with incomes of up to $83,000 a year. If H.R. 976 were presented to the President in its current form, he would veto the bill.

However, no such proposal exists. The $83,000 figure comes from a request from New York to cover children in some slightly higher-income households because of the state's high cost of living, but the final Congressional agreement put the poorest children "first in line" for benefits."

Posted by: jess | October 3, 2007 2:32 PM | Report abuse

To student mom: many of these "illegal aliens" pay taxes as well. Why should the children of immigrants be punished and not be given health care? All people are human.
If you're dissatisfied with this bill, what is your alternative? That sick kids attend school? That poor people take over emergency rooms when they could have been given preventative care?
I find your arguments petty based on the overall picture. Children are dying because they lack basic health care. Shouldn't that be a more serious problem than smokers having to pay a few extra dollars? Maybe it will give people more incentive to quit smoking.

Posted by: College Student | October 3, 2007 2:33 PM | Report abuse

For the idiots who keep thinking tax payer money is going to pay for this program, it is not, it would be paid for by higher cigarette taxes. Also, with so many companies dropping health insurance benefits, a lot of middle class families can not afford to buy private health insurance when it could cost as much as a mortgage payment for a family of 4 or more. Bush is living in some absurb world where he doesn't seem to understand that most families, even those making $83,000, live paycheck to paycheck. For the first time since the depression Americans have negative savings and this a-hole is telling people the economy is great, go and spend money, just put it on your credit card. I am fortunate because my company does offer health insurance, but each year more and more money comes out of my pocket, with premiums and co-pays going up.

Posted by: Impeach Bush | October 3, 2007 2:35 PM | Report abuse

Meningitis is on the rise
Pediatric Pneumonia is flooding emergency rooms. Childhood obesity is up- Asthma is now the norm.
Childhood diabetes is on a drastic climb
Is this the plight of parents/families, yes? Never in the history of this country has there been a sector of people arriving "illegally" utilizing all support services - under the radar, so as not to be discovered.
The parents are not current or probably have never had inoculations for MMR, DPT, etc therefore the kids are under the radar. Many virus, diseases that were eradicated are coming back into society because of illegal immigration - children attending school w/o proper documentation (yes even in blessed MCPS) and a healthcare system (why we as a people define our healthcare as a system is beyond me) that is failing all who participate and those who can not or will not. "We" as a society must look beyond "just the parents" and move forward or in 10- 20 years our country will have been brought down by serious illness and our own desire to look the other way. Will it be cheap, NO, will it be easy NO. "The easier it looks - the harder it hooks!"

Posted by: Eddie | October 3, 2007 2:47 PM | Report abuse

For the idiots who keep thinking tax payer money is going to pay for this program, it is not, it would be paid for by higher cigarette taxes.

Posted by: Impeach Bush | October 3, 2007 02:35 PM

This is actually not quite true.

This proposal being "funded" by the cigarette tax relies on some serious fiscal slight-of-hand.

In order to make it look like the cigarette tax funds the increase, the bill drastically cuts funding for SCHIP down the road to even below current funding levels. The thinking is, that will make the accountants sign off that the spending increase is "funded", but down the line when the funding was supposed to be cut, there will be so much pressure not to take away health care from all of the starving children who make $83,000 per year, that the SCHIP increase will be made permanent.

Then, the funding will come from all taxpayers, and this debate from 2007 will be a distant memory.

Posted by: Bob | October 3, 2007 2:48 PM | Report abuse

* "It is a regressive tax on the poor (tax on smokers, who are disproportionately poor)"

- So I take it you're progressive when it comes to taxes? In other words, it's ok to tax higher incomes at higher rates? If that's your position, I agree.

* "It expands SCHIP into the middle class (earning $83k per year)"

- $83k is only in NY state where $83k is hardly middle class. If it were, there wouldn't be children without insurance at that income level, which clearly isn't the case. And thresholds are lower in other states.

* "Analysts have shown that the above two will mainly tax people in red states and give the money to people in blue ones (smokers are more likely poor people in red states/higher incomes are more likely
in blue states)"

- The reason there are more smokers in the "red" states in the first place is because cigarettes are taxed at a lower rate in most of those states. And a lot of those "red" states are looking more bluish-purple with each stroke of King George's veto pen. It's good to see legislation that actually has a realistic plan on how to pay for itself. Haven't seen that for... oh, I don't know... six years!

* "SCHIP runs out of funds in 2012, so it's a false promise of health care for a program that ends in a few years unless it is renewed"

- So tax cuts, by the same token, are a false promise? Because they too expire. I'm sure that's not your position. If SCHIP only helps uninsured children until 2012, that is better than nothing and it is still worth passing.

* "It rewards states for signing up the most people possible without oversight - so states have no vested interest in helping people OFF the dole, otherwise their federal kickbacks go away"

- The program is income-based, so people will move out of the program when they are no longer in need.

THE BOTTOM LINE:
In a WashPost/ABC survey, 72% of Americans support the SCHIP legislation. So King George and his Rubber Stamp Repubs are seriously shooting themselves in the foot with this one.

And on a non-political level, how selfish do you have to be to make the argument that poor children shouldn't get to go to the doctor when they are sick? That's flat out un-American.

Posted by: sean | October 3, 2007 2:52 PM | Report abuse

So Big Tobacco will have an excuse to encourage more smoking to help pay for this? Yeah, sure, start collecting those cigarette packs to pay for iron lungs. Does anybody remember what iron lungs were?

Posted by: Anonymous | October 3, 2007 3:07 PM | Report abuse

"Health insurance for children is the job OF THE PARENTS. Why should we be paying for anything for somebody else's
kid(s)? ... If you can't afford them, you shouldn't have them."

I bet your against my right to use contraception, emergency contraception, or have an abortion, too.

Corporate welfare? No problem! I'm sure you support our president when he wants to give Schlumberger billions of dollars worth of no-bid contracts.

Posted by: rb | October 3, 2007 3:08 PM | Report abuse

Nobody's saying POOR children shouldn't go to the doctor: don't speak fallacies in order to promote your agenda. I don't have a problem with the government being a safety net for desperate times - but this bill goes way beyond that, and by including high-income kids is basically trying to be first-line care, NOT backup care. Using "the children" as a political pawn is the first step to a population-wide single-payer system, and we all know that, so let's stop pretending it will end here.

Why don't I want illegals to benefit? Because they are illegal. The only thing I want them to have is a one-way ticket back to their home country, preferably on the dime of that home country.

As far as the tax on smokers goes, it is simply INSANE to propose taxing the poor in order to pay for a middle class entitlement. Robin Hood would have a field day with this one. The only reason they are being targeted is that nobody wants to speak up for them.

My alternative to the pile of poo that is this bill? Let nurse practitioners open clinics or set up shop in pharmacies to provide low-cost first-line care for underinsured/uninsured people. The MD lobby is largely standing in the way of this because it hurts the bottom line of primary care doctors.

Posted by: StudentMom | October 3, 2007 3:16 PM | Report abuse

Milk is $5/gallon (at least in Missouri), but god forbid we raise the price of cigarettes because it could hurt poor people. Please someone explain the logic in this? Bush has decided to take 1 figure...$83,000...and make it the focal point without (as usual) explaining the background. For a single person earning that in Missouri it's a lot of money, but a family in New York, not so much.

Posted by: Anonymous | October 3, 2007 3:21 PM | Report abuse

No, rb, I am all in favor of your birth control and your right to choose an abortion. I'm pro-choice. I am against having to pay for somebody else's accidents and poor judgment.

Posted by: Anonymous | October 3, 2007 3:22 PM | Report abuse

We have, quite literally, wasted, or lost track of, more money in Iraq than SCHIP would cost. And I don't mean that all the money in Iraq is a waste (well, I do, but that's another issue), but that there are billions of dollars unaccounted for or wasted or stolen because we have no controls in place to prevent it. The administrations' answer about that is, "well, when you spend that much money in a war zone, you have to expect some waste." But that's ok. That's not fiscally irresponsible, like providing health care to children would be. After all, the money spent in Iraq is going to goals near and dear to this administration: supporting corrupt businesses and killing people. Who could argue with those priorities?

Posted by: Frustrated Taxpayer | October 3, 2007 3:24 PM | Report abuse

Posted by Tired NY Dad @ October 3, 2007 01:40 PM:

"People TRULY in need should get some assistance, but I am frustrated that I continue to pay higher taxes to help out those in society who make really poor choices, only to expect society or government to bail them out. We are seeing this with the mortgage bail out, the flood insurance program for people who continue to build / live in flood prone areas, and now health insurance for the 'masses' who can't say no to the luxuries and therefore can't 'afford' health insurance on their own..."

Your case regarding your neighbors is well founded I think, provided that they or their children do not have a pre-existing condition.

Your other statements, however, are a bit more complex:

Morgage Bail Out - I assume you are referring to the people who took out adjustable rate morgages in this case. It is important to remember that adjustable rate morgages are not new nor is the rate of default on them unusual because lenders generally require documentation to prove that you can afford the loan. The failure, in this case, comes from a third party who originally arranged for the loan to take place without documentation, and assumably with assurance to the lendee that they could afford it. These loans were then repackaged and sold off so that the third party did not hold any liability for the loan. These packages of loans were then certified as good by accredation agencies so they were bought by investment banks. The fault then is not with the holders of the morgages by those with greater knowledge who took advantage of them and those who certified the bad loan packages that allowed the buisness of making bad loans to florish in the first place.

Flood Insurance - I am assuming that you are referring to New Orleans when you say this. It is important to remember that the government is the one that told the people of New Orleans that it was okay to build in the areas that they did when they built the levy system that supposedly guards the city against catastrophic flooding. The need for New Orleans as a major commercial port is obvious, but the building plans could have been changed had the governement not mistakenly informed the citizens it was safe when it was not.

Posted by: David S | October 3, 2007 3:28 PM | Report abuse

"Milk is $5/gallon (at least in Missouri), but god forbid we raise the price of cigarettes because it could hurt poor people. Please someone explain the logic in this?"

To anon:

Fine. If you need milk for your kids and can't afford it, you are probably already on WIC. Although I'm not sure where you are getting $5 from - in the major metro area where I live, it's only $3. If it is $5 where you live, then stop buying it at Whole Foods.

If you are a smoker, then you an addict. Although it's not impossible to quit, it is very hard because your nervous system is adapted to receiving nicotine and is going to go crazy without it. You are probably already poor, you are probably already going to have future health problems. But you are also a favorite whipping boy for the Democrats, and so on top of all of this, you will be taxed ... in order to fund entitlements for your boss and his kids.

Now where is the logic in THAT?

Posted by: StudentMom | October 3, 2007 3:29 PM | Report abuse

Bush has decided to take 1 figure...$83,000...and make it the focal point without (as usual) explaining the background. For a single person earning that in Missouri it's a lot of money, but a family in New York, not so much.

Posted by: | October 3, 2007 03:21 PM

Well, the median household income in New York for a family of 4 is $75,513, so you're talking about putting over half the state on welfare.

Great plan.

Posted by: Bob | October 3, 2007 3:31 PM | Report abuse

it makes no sense to me why Bush would veto this bill. He probably doesn't care because this doesn't affect his family.


Now there's an idiotic statement. The democrats would love to make more people dependent on the government and increase the people dependent on the democratic party. Bush did the right thing.

Posted by: pATRICK | October 3, 2007 3:31 PM | Report abuse

Posted by Bob @ October 3, 2007 03:31 PM:

"Well, the median household income in New York for a family of 4 is $75,513, so you're talking about putting over half the state on welfare."

There is a reasonable explanation that a family earning 75.5k per year cannot afford private insurance. It is important to remember that SCHIP only covers children not covered under their parent's employer's health care plan.

I suspect that the few families in New York that fall in the 83k figure range are not covered by their employers for whatever reason (their employers are small buisneses or they are self employed would be good examples).

Posted by: David S | October 3, 2007 3:45 PM | Report abuse

"Nobody's saying POOR children shouldn't go to the doctor"

StudentMom,

Actually you are saying poor children shouldn't be able to go to the doctor when they are sick because, guess what, it costs $$$ to go to the doctor when you don't have health insurance. Who exactly do you think will pay for the visit?

It's funny to see you strenuously defend one group of adults who consciously make a poor choice, namely smokers, while at the same time advocating that children suffer because of their parents poor choices that put them in the poor house. Please be consistent.

And FYI, $83k is the threshold in NY alone where cost of living is high. In other states it is much lower. People below those levels generally can't afford private health insurance if it's not subsidized by their employer, which is why Congress came up with those levels.

We can argue all day whether $83k in NY is middle or lower class, but the fact is that millions of kids below the income thresholds outlined in SCHIP don't have access to health care, and that is a travesty.

Posted by: sean | October 3, 2007 4:00 PM | Report abuse

Sean, I never made any comment re. "children suffer because of their parents poor choices that put them in the poor house." YOU please be consistent with your citations ...

And I said that poor kids sure, should be able to use the federal government as a safety net during hard times. Just not as a PERMANENT entitlement. And I also said that nurses should be able to treat patients, which would lower the cost of primary care. (You clearly didn't read very much of what I wrote and decided to leap to conclusions). Do a search under "safety net" or "nurse prac" on this page and you can clearly find my posts .......

$83k is fairly high whereever you live. Perhaps you can't get a great apartment on that salary, but you can certainly live outside the city or in a middle-class neighborhood and commute. If that weren't the case, there would be no actors flocking to NYC because they wouldn't be able to afford it ...

Posted by: StudentMom | October 3, 2007 4:05 PM | Report abuse

"Just not as a PERMANENT entitlement"

SCHIP is by definition not a permanent entitlement. It is based on income. Once a family's income surpasses the threshold, the children no longer qualify for SCHIP. Also once the children turn 18 they would no longer qualify for SCHIP. So where do you get that it's permanent?

And as for the actor argument, exactly how many actors with children are flocking to NYC?

Posted by: sean | October 3, 2007 4:18 PM | Report abuse

First off, student mom, I don't shop at Whole Foods, can't afford it. I am glad in your area a gallon of milk is only $3, but in mine is nearing $5 (I just rounded up), but it definately closer to $5 than to $3. I do not smoke, because I am not stupid enough to waste money on such a unhealthful habit (by the way, you don't want to subsidize poor children? Guess how many poor smokers you're subsidizing? Talk about a drain on our healthcare)Obviously you do not understand that the cost of living is different depending on where you live. I could not afford to live in New York on the salary that I make in Missouri, let alone purchase a home and try to raise children.

Posted by: Anonymous | October 3, 2007 4:21 PM | Report abuse

My employer doesn't offer insurance. I bought a high deductible policy for me and my husband for $80 a month. It doesn't have to be that expensive, if you are reasonably healthy.

Sure we have to pay for the doctor out of pocket, but we don't go very often. We just take out vitamins and get lots of exercise.
And if we get cancer or get in a car wreck, we're covered.

Posted by: Southerner | October 3, 2007 4:28 PM | Report abuse

Posted by StudentMom @ October 3, 2007 04:05 PM:

"$83k is fairly high whereever you live. Perhaps you can't get a great apartment on that salary, but you can certainly live outside the city or in a middle-class neighborhood and commute. If that weren't the case, there would be no actors flocking to NYC because they wouldn't be able to afford it..."

Re: Actors in NYC - Most actors I know of who try to make it in NYC cannot afford it. They save up a nest egg, work two or three jobs (generally as waiters or bartenders/baristas) and commute and still have to quit and come home after a period of time because they don't "make it." Most of them, also, do not have health insurance.

Re: the $83k figure - As I mentioned to Bob, the number of families making this amount but also qualifying for SCHIP is limited. Only those who do not have insurance otherwise (such as through an employer) qualify. Also, remember the $83k figure is for a family of four, and while clearly in the middle class, may not be enough for to afford private insurance after other necessities are met. As Bob pointed out, the median income for a family of four in New York State is in the range $75.5k. Even if the cost of private insurance for a family of four was $1500 a month (a very modest estimation for coverage including vaccinations, yearly doctor's visits and perscription medications), that would still be $18k per year, just short of 1/4th of that family's income. Since I suspect that number is the base amount, imagine if it was more like $2000 per month (a likely number for New York state) that would be $24k per year, almost a third of that family's income. The problem is that private insurance is very expensive, so even people who would otherwise be middle class cannot afford it.

Posted by: Anonymous | October 3, 2007 4:29 PM | Report abuse

Posted by Southerner @ October 3, 2007 04:28 PM:

"My employer doesn't offer insurance. I bought a high deductible policy for me and my husband for $80 a month. It doesn't have to be that expensive, if you are reasonably healthy.

"Sure we have to pay for the doctor out of pocket, but we don't go very often. We just take out vitamins and get lots of exercise. And if we get cancer or get in a car wreck, we're covered."

Three things.

First, I would like to know the plan and the company in question so I can sign up. Most low premium/high deductable plans I have run across still are running in the range of 400 dollars for a couple.

Second, I suspect that your plan may not, in fact, cover you as much as you think. many catastrophic coverage plans cap the payments they make or still require that you pay very substantual amounts. I would check your policy.

Third, low premium/high deductable plans are undesirable for children because they are more likely to be sick or injured than adults (not counting seniors, of course). This is without figuring in the costs of vaccinations, regular physicals, and the like which are often not covered by such plans.

Posted by: David S | October 3, 2007 4:43 PM | Report abuse

Wow is all I can say. I can't believe some of you people. We are talking about children of hard working citizens in this country. And to even begin to say that it is wrong to tax smokers because they are poor is ridiculous. If nothing else, insuring kids is a good thing for us in the long run. Studies show and pediatrician mom can back me up that early intervention is the key to life long health. And for the selfish people who say they are simply not your kids, well I hope we start saying that to YOU when your elderly. Hey, you won't need prescription drugs or medical care because frankly your just too old and are going to die anyway. The fact remains that health insurance costs have sky rocketed and small businesses (which employes the majority of Americans) can not afford to provide health insurance for their workers. I can totally see how you can earn 83K/year (think two workers earning slightly more then 40K) with out health coverage. And if you want to talk about wasted money, try IRAQ my friends. I don't hear your outrage that the government is providing $24 cases of soda for contractors. The amount of $$ wasted in IRAQ is sick and we have a problem with investing in our children? And yes, they are OUR children. They are the future of this country. They are the future tax payers, workers who will take care of the elderly, pay our pensions, fight our wars, educate our grand children and great grandchildren, doctors and scientists who will find cures for diseases. It is really sad what a selfish country we have become. And if you check the law a bit, the kids have to be uninsured for a year if their employers provide health insurance. What rational parent would deny their child health insurance for a year, just to get on the dole. Whether you believe it or not, this country will have to a lot to take care of the poor choices of the middle and upper middle class in the future. Not just the poor. There are a lot of people at all economic levels that are making poor choices. Think lack of retirement savings. I believe we still have a negative savings rate in this country. Like it or not, we are one country and we have a responsibility to our future generation as well as our current and our past generations.

Posted by: foamgnome | October 4, 2007 7:29 AM | Report abuse

"Let nurse practitioners open clinics or set up shop in pharmacies to provide low-cost first-line care for underinsured/uninsured people."

Please, no. NPs aren't exactly a source of reliable care. A few months ago, the one badly botched a diagnosis on my daughter, and her error could have had a terrible effect if I hadn't suspected she was wrong and done further research on my own. I've heard of others who have to consult books to diagnose even the most common ailments. It seems as if they lack even basic skills.

I know there must be competent NPs out there, but I'll rely on doctors from now on, thanks.

Posted by: NewSAHM | October 4, 2007 8:31 AM | Report abuse

We get the policy from a company called Humana. It has a $5,000 deductible (per person), it pays for nothing until you hit the deductible and everything after. No co-insurance junk.

I must warn you though, I live in Georgia and you can't buy insurance policies across state lines. If you live in a state where they have more regulations on Insurance companies, this policy won't be available at that price.

Posted by: Southerner | October 4, 2007 9:18 AM | Report abuse

Posted by Southerner @ October 4, 2007 09:18 AM:

"We get the policy from a company called Humana. It has a $5,000 deductible (per person), it pays for nothing until you hit the deductible and everything after. No co-insurance junk.

"I must warn you though, I live in Georgia and you can't buy insurance policies across state lines. If you live in a state where they have more regulations on Insurance companies, this policy won't be available at that price."

That is very generous. And you are correct, there appears to be no similar policy for Virginia, alas.

If you have children do you think you would switch policies to a more comprehensive plan?

Posted by: Anonymous | October 4, 2007 11:06 AM | Report abuse

I'm not sure, I hope to have a more stable job before I have kids.
If I work for a company that can offer me health benefits, then of course I'll take them.

If I don't, then I'll probably do what my mom did and take us to the health department for vaccinations (free, my parents had insurance but my mom was the CHEAPEST PERSON EVER and didn't want to pay the co-pay). Then, I'll shell out the $150-$200 for check-ups at the family med center.

From looking at the prices of full coverage health insurance, I think I'll save a lot of money, unless something bad happens. And I'll put away the money I save into a "just in case" savings account.

Posted by: Southerner | October 4, 2007 11:15 AM | Report abuse

My grandchild to be is currently covered by S-CHIP as her mother's prenatal care is being covered. Prenatal care saves about 5 dollars in neonatal expenses for about every dollar spen so this is a great deal for all of us. she is working poor, her company offers medical at about 15% iof her income to cover both herself and her child. With 50% going to rent and another 20 going to Utilities and living in a city with next to no public transportation the rest pretty much goes to trying to maintain a vehilcle to get to work and groceries. Before you start saying she should move closer to her job, there is no affordable housing in those suburbs but the job pays better than any of the jobs on her side of town.

Baby 2 B will be covered by S Chip in the future although my DD won't be, which is kind of a shame, um how do you support healthy babies if their parents don't have health care?

As far as the tobacco tax increase. I'm hearing a lot of selfish people calling S Chip welfare and that people should pay for their own, and then saying low income people smoke more so we are penalizing them. Well? Doesn't that mean they may be paying for their own insurance? And if more people quit smoking over the increased tax, so much the better.

Curtailing smoking will reduce the complications in pregnancy, decrease the number of repiratory infections in babies, reduce the number of ER visits for respiratory distress, reduce the amount of money paid out for disability when those smokers have disabling strokes, heart attacks or develop emphysema, circualtion disorders and a host of other issues too numerous to mention. No matter how you slice it raising that tax will save money.

third, those children growing up now will be the children firing up the economy when I am old and (hopefully) retired. If they are too unhealthy to get the education or to work, how will that support my SS or care for my health as I grow old and unable to work or afford my own insurance?

In short, S-CHIP is a pro life, pro family bill which rewards peoople who work their way off TANF and medicaid buy not yet into the progressivly more rareified atmosphere of jobs whith real benefits. We have a president who talks the pro life and pro child line, but consitantly refuses to walk that same talk, and this is probably one of the best examples of how he really feels about kids and families. My congressman is one of the people most likely to sustain the veto while still calling for womb to cradle care of babies. His dislike of living children should not go unnoticed.

Posted by: marge | October 11, 2007 10:00 AM | Report abuse

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