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Monday, July 30, 2007

Paul Krugman: An Immoral Philosophy

Paul Krugman wonders what sort of philosophy allows health care to be denied to children:

An Immoral Philosophy, by Paul Krugman, Commentary, NY Times [Update: full column]: ...Congressional Democrats, with support from many Republicans, are trying to expand [the State Children’s Health Insurance Program (Schip)], which already provides essential medical care to millions of children, to cover millions of additional children who ... lack health insurance.

But President Bush says that access to care is no problem — “After all, you just go to an emergency room” — and, with the support of the Republican Congressional leadership, he’s declared that he’ll veto any Schip expansion on “philosophical” grounds.

It must be about philosophy, because it surely isn’t about cost. One of the plans ... would cost less over the next five years than we’ll spend in Iraq in the next four months. And it would be fully paid for by an increase in tobacco taxes.

The House plan, which would cover more children ... offsets Schip costs by reducing subsidies to Medicare Advantage — a privatization scheme that ... costs taxpayers 12 percent more per beneficiary than traditional Medicare.

Strange to say, however, the administration, although determined to prevent any expansion of children’s health care, is also dead set against any cut in Medicare Advantage payments.

So what kind of philosophy says that it’s O.K. to subsidize insurance companies, but not to provide health care to children?

Well, here’s what Mr. Bush said...: “They’re going to increase the number of folks eligible through Schip; some want to lower the age for Medicare. And then all of a sudden, you begin to see a ... a strategy ... to get more people to be a part of a federalization of health care.”

Now, why should Mr. Bush fear that insuring uninsured children would lead to a further “federalization” of health care...? It’s not because he thinks the plans wouldn’t work. It’s because he’s afraid that they would ...[and] that voters, having seen how the government can help children, would ask why it can’t do the same for adults.

And there you have the core of Mr. Bush’s philosophy. He wants the public to believe that government is always the problem... But it’s hard to convince people ... when they see it doing good things. So his philosophy says that the government must be prevented from solving problems, even if it can. In fact, the more good a proposed government program would do, the more fiercely it must be opposed.

This sounds like a caricature, but it isn’t. ...[T]his good-is-bad philosophy has always been at the core of Republican opposition... Thus back in 1994, William Kristol warned against passage of the Clinton health care plan “in any form,” because “its success would signal the rebirth of centralized welfare-state policy at the very moment that such policy is being perceived as a failure in other areas.”

But it has taken the fight over children’s health insurance to bring the perversity of this philosophy fully into view. ...[D]enying basic health care to children whose parents lack the means to pay for it, simply because you’re afraid that success in insuring children might put big government in a good light, is just morally wrong.

And the public understands that. According to a recent ... poll, 9 in 10 Americans — including 83 percent of self-identified Republicans — support an expansion of the children’s health insurance program.

There is, it seems, more basic decency in the hearts of Americans than is dreamt of in Mr. Bush’s philosophy.

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Previous (7/27) column: Paul Krugman: The Sum of Some Fears
Next (8/3) column: Paul Krugman: A Test for Democrats

    Posted by on Monday, July 30, 2007 at 12:33 AM in Economics, Health Care, Policy, Politics | Permalink  TrackBack (0)  Comments (51)

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