WASHINGTON -- There is no need to wait until a new president is elected next year for the great national health care debate. It is underway right now, disguised as a routine extension of an immensely popular, non-controversial 10-year-old program of providing coverage to poor children. In fact, this proposal is the thin edge of the wedge to achieve the longtime goal of government-supplied universal health insurance and the suffocation of the private system.
The Senate Finance Committee was scheduled to mark up this portentous legislation expanding the State Children's Health Insurance Program (SCHIP) today [Thursday], but disagreement over the size of the program and how to pay for it forced postponement. Democratic Sen. Jay Rockefeller's version would triple SCHIP's current five-year cost of $25 billion to a level of $75 billion. That would grant federal largesse to more than just poor "kids" (as politicians endearingly call children). An estimated 71 percent of all American children in families of four making as much as $82,000 a year would become eligible, with states also continuing present coverage of adults under SCHIP.
But where to find money to cover the massive cost? Senators of both parties want to raise tobacco taxes, but that well is not bottomless, as existing taxes have reduced cigarette smoking. Instead, House Democrats want to take money from private elements of Medicare instituted by the Bush administration. The overall effect would make three out of four American children accustomed to relying on government care no matter what course their parents take. In sum, SCHIP turns out to be socialized medicine for "kids" (and many adults).
A principal sponsor of the $75 billion program is Sen. Hillary Rodham Clinton, whose hand is detected in health care struggles the past 15 years. After the Clinton administration's sweeping "Hillarycare" failed in 1994 and contributed to that year's Republican takeover of Congress, the first lady miniaturized her goals by limiting coverage to poor children. Republicans, led by Sen. Orrin Hatch in one of his several collaborations with Sen. Edward M. Kennedy, had lost their revolutionary zeal after the government shutdown of 1995 and accepted SCHIP as a fallback position at a beginning outlay of $4 billion a year. It was the bargaining chip given President Bill Clinton in return for him signing the Deficit Reduction Act of 1997.
SCHIP over the past decade has been a beloved "kids" program whose faults were overlooked, much like the Head Start school program. The federal government has consistently granted waivers to permit 14 states to cover adults under SCHIP, which now cost $5 billion a year. Minnesota led the way, with 92 percent of money spent under the program going to adults.
The massive expansion was proposed by Sen. Clinton this year, furthering her promise of "step by step" advancement toward universal health care. Her proposal extends SCHIP to families at 400 percent of poverty (or $82,000 annually). Hatch after 10 years is back again supporting a Democratic program along with Sen. Chuck Grassley, the Finance Committee's ranking Republican. But they want a mere $55 billion (a $30 billion increase), compared with Rockefeller's $75 billion, causing the postponement of today's markup.
The Democratic congressional majority now faces the consequence of its "paygo" mandate to account for higher spending. The Senate's preference for tobacco taxes runs into present overall cigarette taxes of more than one dollar a pack, lower legal cigarette purchases and reduced smoking typified by a 19 percent decline in New York City. More creative funding comes with Rep. Pete Stark's scheme in the House Ways and Means Committee for slashing the popular private Medicare program. That not only would fund an expanded SCHIP but move toward government monopoly over all health insurance.
An indirect but pervasive impact of Sen. Clinton's grand design would be the impact in the same family of children who are insured by the government while their parents are covered privately. Would the children become accustomed to Washington taking care of them? Would the adults drop private insurance? The future is now for universal health care coverage, and President George W. Bush may soon face the decision of whether or not to veto it going into the election year.