Here’s juicy reading for a Friday afternoon…
I was perusing my e-mail in-box in mid-October when this catchy subject line caught my eye: “CHIP Compromise, Fact vs. Fiction.”
The e-mail was sent from the Finance Committee staff of Sen. Charles Grassley, one of the panel’s ranking members, and it typifies the degeneration of the battle to provide healthcare for one segment of the domestic population.
By the time you read this, the end of the story will probably be known – we’ll all know whether Congress was able to mount a rare override of a presidential veto of the State Children’s Health Insurance Program. That political battle also might provide a disheartening preview of what lies ahead for healthcare reform in this country.
Congress sought to expand SCHIP in an effort to address one facet of the crisis of the uninsured in this country – health insurance coverage of the nation’s youngest citizens. State and federal governments cooperate on these programs, with states designing their programs within broad federal guidelines.
With SCHIP set to expire, and with Congress seeking to expand the concept, a five-year reauthorization has been making its way through Congress. Congress passed the SCHIP reauthorization by a wide margin, but the bill was vetoed by President Bush, who contents that expansion of SCHIP is a back-door way to initiate universal healthcare coverage and a potential expansion of the national budget.
The veto override effort, which focused on raising enough votes in the House of Representatives, was putting particular pressure on key Republican Congressmen who could provide crucial swing votes that could provide the two-thirds margin needed to override the president’s veto.
The pressure was expected to be huge on individual Congressmen. It’s large enough on President Bush, who found himself in the unpopular position of appearing to stand in the way of healthcare for children. At least that’s what the Democrats are painting the veto as. The president has since said that he would consider a small expansion of the program, but Democrats appeared to hold out for an override showdown.
From Grassley’s fact-or-fiction e-mail to the strident contentions of the Bush Administration, it’s really not a happy day for those who hope that we’ll someday engage in a rational, effective, non-political discussion on healthcare reform. If we can’t calmly find a middle ground to discuss a compromise on a program intended for uninsured children, it doesn’t bode well for a calm discussion of system reform, a tougher, more complex issue.
Make no mistake about it – healthcare reform will be a primary domestic issue in the United States because the healthcare system appears so ineffective and inefficient. Most presidential candidates have said they favor reform of the system, and several have issued reform proposals.
Still, merely issuing a plan doesn’t mean that it will be workable – or that it is being issued for purely political gain and posturing. For example, analysts said that while the healthcare reform plan of Democratic candidate Sen. Hillary Clinton addresses issues surrounding access to care, it doesn’t say much about the factors that drive up healthcare costs, such as defensive medicine, the lack of standardization in care, and incentives to encourage wellness and disease prevention.
Any reform discussion will need support from both sides of the aisle in Congress, and it will require massive quantities of consensus building, expertise-sharing and statesmanship. It also will require a united front to stand up to industry lobbying. Only by not caving in to pressure from interest groups – but rather by incorporating them into the reform discussion in the first place – will reform truly and effectively meet the nation’s needs.
If the debate over SCHIP is a dry run for how we’ll handle reform discussions, it looks like a long, rocky and contentious road to reform. A little less politicizing, please, and give me an extra helping of cooperation.