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News of the Day ... In Perspective

8/21/2007

Socialized medicine for children—and accompaniments

SCHIP, the State Children’s Health Insurance Program, or HillaryCare for children, needs to be reauthorized by September 30, or expire. Predictably, it will not be allowed to die, nor will it simply be extended as is. Rather, Congress is attempting to expand government dependency further into the middle class, and also accomplish a number of objectives unrelated to caring for children.

The House and Senate have passed substantially different versions: the House Children’s Health and Medicare Protection Act (CHAMP) and the Senate Children’s Health Insurance Program Reauthorization Act. A presidential veto is threatened if the final bill expands government “too much.”

“The tradition of using children for political gain dates back to when the first politician kissed a baby,” writes Tony Perkins of the Family Research Council. The estimated minimum cost of the legislation is $300 billion over 10 years. FRC objects to the bill as a “direct attack on private insurance.” Additionally, the House bill terminates coverage for unborn children, in what FRC calls a payoff to one of liberal congressmen’s biggest supporters, Planned Parenthood.

“This is a calculated move to open the door to federal taxpayer-funded abortions,” Perkins said. It would also massively fund state funding for abortions in the 17 states that currently permit it. http://www.freerepublic.com/focus/f-news/1875651/posts

Other provisions of the House bill remove funding for abstinence education and fund abortofacient drugs.

The Clinton-Dingell CHAMP bill would expand eligibility to 400% of the federal poverty level, and would cover 71% of all children in families of four making as much as $82,000 per year. The Congressional Budget Office reports that 77% of children about 200% of families have private insurance, which would largely be replaced by SCHIP. A “child” is defined as someone up to age 25 (Galen Institute, Health Policy Matters 7/13/07).

This proposal would make three of four children dependent on the federal government for health insurance—and incidentally many adults. In Minnesota, 92% of SCHIP expenditures are for adults (Robert Novack. Chicago Sun-Times 6/28/07).

Changes to Medicare include tinkering with the federal price-control scheme. If the provision survives, physicians would get a 0.5% pay increase in 2008 and 2009, instead of projected cuts of 9.9% and 5.0%. Separate conversion factors would be introduced for different types of physician services such as preventive care and imaging. The $1.35 billion physician payment and quality improvement fund would be eliminated to help cover fee increases (David Glendinning, AM News 8/20/07).

The tiny physician payment increases would be offset by 11% cuts in 2010 and 2011. Specialty societies report that the various cost-control schemes will pit physicians against each other—for example, it sets up an advisory panel to re-do Relative Value Units (RVUs) for “over-valued” services.

The bill outlaws referring patients to hospitals in which physicians have an ownership interest. This would probably be a death blow to specialty hospitals (Medicare Compliance Alert 8/6/07).

Earmarks would funnel hundreds of millions of dollars to selected, cryptically described hospitals (Robert Pear, NY Times 8/12/07).

Other changes include abolishing “Health Opportunity Acounts,” the provision that allows HSA-programs in Medicaid; repealing a provision of the Medicare Modernization Act that restricts the use of general revenues to fund Medicare; and raises fees of certified nurse midwives to equal those of obstetricians. There is a plethora of new requirements that enrich some interest groups and kill off others (Greg Scandlen, Consumer Power Report 90, 8/9/07).

Democrats plan to pay for the bill by boosting federal tobacco taxes and hiking taxes on insurance companies by $2 per person.

On the whole, the bill contains “the most sweeping changes in decades” to American medicine—changes that will affect every American, stated Rep. John Shadegg (R-AZ). It marks a sharp turn away from a re-invigorated private market and toward government-run medicine.

The bill implements Hillary Clinton’s promise of “step by step” advancement toward universal care after the more ambitious Clinton Plan failed. The beginning outlay of $4 billion per year was the bargaining chip given President Clinton in return for signing the Deficit Reduction Act of 1997 (Novack, op. cit.).

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