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Monday, July 23, 2007
Is SCHIP the Opening Salvo in the Great Health Care Debate?
President Bush, as you probably know, says he's gonna veto any SCHIP expansion, the principle rationale being that government doesn't belong in health care.
My hunch is that this won't carry the day. SCHIP's focus on kids is its trump card. But Bush is right that SCHIP is only the beginning of the policy fight over health care, and when the focus isn't on kids or some other sympathetic demographic group, the arguments being made today could win out by tapping into public distrust of government, which the Bush administration has deepened.
The good news is that recent events have demonstrated the superiority of government-sponsored health insurance and government-provided health care, properly administered. Once neglected, hospitals in the care of the Veteran's Administration have been transformed into some of the best examples of how to efficiently deliver health care. Medicare has experimented with privatization in insurance and prescription drugs- both of which have turned out to be more expensive than if government just did it itself.
And the positive conservative agenda -give everyone tax breaks, privatize government and let the market do its thing- really has no prospect of success. More market forces aren't what's needed. Market forces create perverse incentives and do not encourage the information distribution needed for effective market competition and long-term care. The market prices goods arbitrarily. It encourages actors to provide health insurance to the healthy but not the sick. In other words, the market isn't the solution- it's the problem.
I don't expect SCHIP supporters to risk political capital and make this argument just yet, especially with an expansion being so likely. But at some point they'll probably have to show some leadership and challenge the dominant narrative about government and the market if they want to get anything done.
Posted by Matt Lewis
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