There are two approaches.

The private approach says we should move away from employer-provided health care to a system where individuals control their health care choices, carry their coverage with them if they change jobs or work at home, and that gives them the flexibility to choose the best provider for their needs.

This would reduce the cost of health care, so that more people of low income could afford coverage. Then, fewer people need SCHIP, and SCHIP could do more yet cost less.

The big-government approach would abolish private insurance. This approach would have citizens pay more taxes to the government, which then becomes the sole source of income for health care providers. The government would then have all the leverage needed to tell those working in health care what to do and how to do it.

Government-run systems waste countless of billions of dollars and take decisions away from patients and doctors, putting them in the hands of government bureaucrats. Medical careers then pay less and attract less-talented people. Lack of incentives hurt research and development of new medicines and techniques. And, lack of accountability means lower quality of care and fewer choices for patients. The whole system suffers.

The bill President Bush vetoed was a step in that direction. With SCHIP expansion into the middle class, government’s role increases. A critical mass of middle-class voters, dependent upon SCHIP for care, would demand broader coverage for more people. Within a generation, enough voters would be on it that popular support would be there for government-run health care. That’s the political game plan.

This could happen because the free health care comes right away. It takes more time to exhaust private resources, drive talented people from the health care field, and build an established bureaucratic mindset. Aside from immediate delays, the quality of care might be acceptable at first. But, after the system is federalized and becomes run down, it may be too late to reverse. Think Canada and Great Britain.

In the meantime, the ones who suffer the most are children of low-income families.

The thought of those children lacking good care is unacceptable. The original SCHIP was designed to help them. It should not be transformed into a middle-class entitlement that would eventually degrade our entire health care system. It must remain focused on helping children of low-income working families.

The last bill Congress passed failed to keep that focus. Congress must now pass a bill that does. The children are waiting … while the Mad Hatters of big government just keep moving.