There is nothing funny about resource allocation
by Jim Nichols
Sep. 3, 2007
I wasn’t expecting parents struggling to pay health care costs across my district to be disrespected in a discussion of SCHIP. But in his piece entitled
“Open up your wallet and say ‘Ah’ my Congressman Lynn Westmoreland made an analogy that did just that. In it he challenged the wisdom of spending when one is “in debt up to your ears and your credit cards are maxed out,” asserting that “a new credit card is not the answer.” First the “problems” he was citing were shortfalls in long-term budget projections. The combined budget shortfalls of Medicare and Social Security have more to do with health care cost inflation–which the rest of the industrialized world has learned to manage–rather than entitlement programs run amuck as Westmoreland infers. But more importantly it’s a question of tact; as my fiance stated to me after reading it, “if our child needed medical care we’d take out as many credit cards as we could to make sure they got treated.” Reading Westmoreland’s piece I felt the struggles of constituents being ignored.
SCHIP is a federal program designed to work in a targeted manner to capture low income children who do not fall within Medicaid qualifications, its one goal is to improve health care coverage of children–not end the health care crisis. Since 1997 the programs have reduced the number of children without insurance by about one-third. The best synopsis I can give of his position is that Westmoreland questions the wisdom of how the bill is paid for and sees it as a burden on taxpayers. I won’t waste space on the question of crowd-out rates or the claimed superiority of private health insurance, and would direct people to the nonpartisan Congressional Budget Offices analysis for context on those issues
Beyond the rhetoric I question framing the $157 billion cut to Medicare Advantage as a cut to Medicare. A change that saves taxpayer money and increases efficiency–providing people the same quality of care–is a cut? This cut has been a recommendation of groups such as the National Committee to Preserve Social Security and Medicare, and the American Medical Association; not to mention MedPac– the advisory body for the congress in charge of Medicare payment policy. According to MedPac the largest overpayments “average 19% more than it would cost to treat comparable beneficiaries under regular medicare, with half of these overpayments going to profits, marketing, and administrative cost.” This doesn’t devastate Medicare it creates a situation where more people get health coverage.
The context of the numbers, with claims of “staggering” and “upsetting” spending increases that create “Government-run health care” seem questionable as well. $130 billion over 10 years is $48.82 per-capita according to the budget calculator at Center for Economic and Policy Research website. To assert a better funded SCHIP would lead to government-run health care is a leap in logic. SCHIP and Medicaid are programs using private doctors and private health care plans where states negotiate the limits, rates, and package details. These are decisions made by people at the state level.
By cutting payments which typically go into marketing, administration, and profits; and increasing the cigarette taxes (which in-its-self is projected by the American Cancer Association to ‘prevent more than 900,000 Americans from dying prematurely because of smoking’) the SCHIP bill increases the number of children covered in this country. If one more parent is kept from needing to open an extra credit card to get the quality care their child needs, my $48.82 will be well worth it.
Mr. Westmoreland, please publicly clarify your position on SCHIP in a more precise manner. I will acknowledge that your criticisms on a point by point basis might be sound if the bill was intentioned as a long term fix to the health care crisis but the question at hand falls short of that framework. Claims that families of four with incomes above poverty are less deserving of reprieve and assistance than a family in poverty seems divisive–the nuances of government spending are not black and white questions of who works harder or which struggle is more burdensome. By using analogies about bad credit you frame it in that way. The problems with your piece–the representation, analogies, and logic—make the case that it will be the inability of those opposed to Universal plans to come up with workable solutions over the past 20 years that will give us universal health care... not Hillary Clinton.
