SCHIP Sliding Toward Socialism (Updated)
Matt Yglesias and Megan McArdle, who are on different sides on the merits of SCHIP are nonetheless agreed that President Bush’s veto makes no sense politically since it opens him up to charges that he doesn’t want kids to go to the doctor.
Kevin Drum figures the president’s own explanation is a reasonable starting point:
He says he doesn’t like it because it’s the camel’s nose under the slippery slope on the road to hell of national healthcare, and I think that really is the reason.
After all, Bush is right: we liberals really do think of things like SCHIP as building blocks on the road to universal healthcare, don’t we? It’s hardly a big secret. And one should never underestimate the horror with which conservatives view “socialized medicine.” They’ve fought it like crazed lemmings for decades, and they fight it even when it conflicts their own bottom-line interests.
That’s largely right, I think. Indeed, they’ve we’ve generally lost the fight — winning the occasional battle but ultimately sliding further toward a non-market system — while taking the political hits for insufficient empathy.
Alex Massie homes in on one of the keys: the issue of fairness. Noting Yglesias’ touting of a cigarette tax as a perfectly good means of paying for expanding SCHIP — since it either makes it harder for people to smoke or punishes them for doing so while netting money for the state — Massie cries Foul.
Well, ain’t that a pretty thing: let’s make the poor pay for health insurance for middle-income people. Now you may say that this is fine; poor people should be discouraged from smoking too. Fine. But most of them won’t be and will, consequently, be paying for SCHIP. It’s a very regressive way to do these things. (Indeed, the supposed concern for the poor smoker is bogus: you need them to keep smoking otherwise you can’t fund your program. So the task is to find the optimum level of tax that won’t drive folk to the black market. You need smokers, otherwise how can you exploit them? All of which would be fine if it weren’t accompanied by the sanctimonious tut-tutting so characteristic of the health crusaders).
The current health care payment mix is economically irrational but it’s the status quo and benefits from inertia. Any attempt to change the system will invariably disadvantage a lot of people.
There’s an overwhelming consensus that society should guarantee that those who can’t help themselves — especially children — some minimal standard of health care. But each incremental expansion brings into question where precisely to draw that line. And someone has to pay for it, after all.
Former Senator Phil Gramm (R, TX) used to rely on the Dickie Flatt test, purportedly named after a rather unfortunately named constituent of modest means. The question, Gramm claimed, that he considered when voting for any new government entitlement was, “Will the benefits to be derived by spending money on this program be worth taking the money away from Dickie Flatt to pay for it?” There comes a point, presumably, even when talking about doctors for children, that the answer is No.
In all honesty, I haven’t spent a lot of time fretting over that precise line of demarcation and thus have no strong position on this current squabble. But, surely, the mere fact that the money would be “For the children” is not disposative.
Update (Dave Schuler)
The rhetorical strategy that Democrats will be using to get votes for an override of President Bush’s veto is beginning to emerge:
“Today the president showed the nation his true priorities: $700 billion for a war in Iraq, but no health care for low-income kids,” added Rep. Rahm Emanuel, an Illinois Democrat. “Millions of American children and their families won’t forget that they are on the bottom of the president’s priority list.”
That’s likely to be effective as long as the war in Iraq remains as unpopular as recent polls have suggested.
Unfortunately, at this point it’s just a rhetorical strategy. All of the top tier Democratic candidates have been candid about their plans to leave a sizeable number of American troops in Iraq for the foreseeable future. Although all would like an end to the troop presence there none will commit to a complete withdrawal in the foreseeable future and I don’t know of any specific proposals for reductions.
In the absence of troop reductions in Iraq by any conceivable president for the foreseeable future the plaint about the expense of maintaining those troops is a non sequitur. Under the Democrats’ plan we’ll have the expanded SCHIP program and the war in Iraq. So much for fiscal responsibility.