Monday, October 22, 2007

It Only Looks Like Suicide: The Politics of S-Chip

Update: A similar version Rescued at Daily Kos and frontpaged at E Pluribus Media.

Why would the very unpopular lame duck President lead Republican members of Congress to defeat a bill to expand SCHIP, a successful program favored by 81% of Americans (according to CBS) to save the lives and health of children?

It's counterintuitive, even for Republicans. Next to advocating arsenic for babies, this was the most daringly callous, profane and seemingly brain-dead political stand possible. It seems like political suicide. So, why do it?

I believe the answer is this: the Republicans are gearing up to fight Hillary Clinton, the presumptive nominee (in Bush's eyes), and they are going to do so on the issue of government-run health care, the issue they defeated her on before.

Here's briefly what the debate is about, as summarized by Keith Olbermann:
SCHIP currently covers six million children too poor for insurance but not poor enough for Medicaid. But a growing number of Americans, two out of five, are not covered by employer insurance; 47 million don‘t have any health insurance. That number is also up. The uninsured children increasing by 600,000 last year alone. So Democrats want to expand S-CHIP to cover four million more kids. The cost, seven billion dollars a year.

Last week the White House and Republican congressional leadership fought hard to deny Congress enough votes to override the Bush veto. Moreover, they did it by distorting what the law would actually do, including who it was intended to cover. And by the viciousness cited here in the previous post.

The answer to "why" is partly in the White House statement, and partly in exactly how they distorted the bill. And the most direct part of that answer is this: the Republicans are gearing up to fight Hillary Clinton, the presumptive nominee (in Bush's eyes), and they are going to do so on the issue of government-run health care, the issue that they won against her before.

Bush said his opposition to SCHIP was partly on principle, because the bill goes down the road of "socialized medicine." That's been a regular Republican refrain for at least a half century; they used it to oppose what became Medicare in the Kennedy administration. Now it's being linking directly to Hillary Clinton's health care reform proposal, not only by Republicans in Congress, but by the leading Republican presidential candidates, as reported by Brian Tummulty for Gannett and published in USA Today:

At a forum for Republican presidential candidates Wednesday in Detroit, former Massachusetts Gov. Mitt Romney and former New York City Mayor Rudy Giuliani sparred on some issues, but they were united on Clinton's health care plan.

"If we do HillaryCare or socialized medicine, Canadians will have no place to go to get their health care," Giuliani quipped, referring to the Canada's single-payer national health system.

"HillaryCare is government gets in and tells people what to do from the federal government's standpoint," Romney said.

Ironically, the "socialized medicine" charge was not made so often or so boldly against President Clinton's universal health care plan, which was organized in a very public way by Hillary Clinton. Universal health care was immensely popular, and one of the issues that elected Clinton. (Its potency was first discovered a couple of years before when one ad on the subject virtually propelled Harris Wofford into the U.S. Senate in a Pennsylvania special election.)

Clinton's proposal was defeated, not by Republican political bombast, but by a very well financed campaign against it by the pharmaceutical and health insurance industries. When a series of TV ads began changing the poll numbers, Republicans eagerly pounced on the issue again.

But though the term "socialized medicine" wasn't so prominent, the arguments behind it were. They were prominent in the ads especially: individuals and families would lose their right to choose their doctor, and their doctors would not decide on their treatment--government bureaucrats would. Further, a huge, faceless, powerful but unresponsive federal bureaucracy would waste billions of taxpayer dollars, driving up health care costs.

So the Clinton proposal for universal health insurance was defeated, and the private corporate HMO and health insurance industry grew so fast and so big that few seem to remember when it didn't totally dominate medicine in this country. The reality that everyone knows is that everything the opponents of the Clinton plan said did come true--but it is the huge, faceless, powerful corporate medical insurance system that routinely decides what doctors patients can see (or if they can see any), and what treatments and services doctors and hospitals can provide. They spent a high percentage on "administration," and they have driven health care costs higher and higher, until now they are bankrupting middle class families and small businesses, and threatening the financial viability of large and otherwise successful corporations.

Yet the Republicans are using exactly the same arguments. And they may be successful. And they know it.

Why is that possible--when health care is emerging as the domestic issue that voters care the most about? Because Hillary's health care plan--as well as those of most of the other Democratic candidates--include private insurance companies. They mostly funnel taxpayer dollars to those companies. So it is very hard for them to point out the obvious: corporate run health insurance has been a cruel travesty.

One of the reasons that it never made sense was the demonstrably false argument that corporations could run health care for their own profit, and do it cheaper than the government, which does not seek to make a profit. But for-profit healthcare has amassed not only huge profits, but huge amounts of money these companies use to destroy and buy up their competitors, and--very much to the point--to lavishly lobby government officials and finance their increasingly expensive campaigns. All paid for by that chump, the consumer, otherwise known as the taxpayer.

The amounts of money are huge because of another fallacy in the Republican argument, trotted out for every attempt to "privatize" a formerly public responsibility, but used especially to argue against government financed health insurance. Corporate care is more efficient because corporations compete, and have to be efficient to make a profit. But corporations compete, not by efficiency, but by destroying or absorbing their competitors--then they expand, and keep expanding until there is no competition, unless limited by regulation.
This has happened to private health insurance, which means that the amounts of consumer-dollars they have to spread around to politicians are huge. No presidential candidate can apparently afford to offend them.

So that's the second part of the answer to "why." Republicans are representing the interests of medical insurance and related corporations, such as Big Pharma. It's also likely that Republicans will actually do much the same on health care should their candidates be elected (this same USA Today article points out that Mitt Romney's plan is not very different from Hillary's.) After all, the most successful innovation of the Bush administration was turning the federal government into a funnel, transferring taxpayer dollars to selected corporations, as Naomi Klein has shown so well. Eventually they will pass laws that will further enrich the criminal enterprise known as health insurance corporations. They are already passing such laws in the states, making it against the law not to do business with them.

So while the Republican "death to children" march seems like suicide, and indeed it may turn out to be politically fatal, it had a purpose--to breathe life into their Get Hillary campaign. And it's not going to be pretty.

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