June 30, 2007
A Call for Pragmatism
The setting is the upcoming debate over the State Children's Health Insurance Program, or Schip, a brawl that could well determine the future direction of U.S. health care. Democrats see expanding Schip as the first step toward socialized medicine. If Republicans fail to meet that challenge with their own more compelling plan for market-based, consumer-driven reform, it may prove the beginning of the end of today's private model.Kimberly Strassel, my new favorite WSJ Ed Page writer, details the Democrats' plan to incrementally enact Socialized medicine -- and GOP plans to stop it. It's an outstanding bit of inside baseball that has the potential to decide the World Series.
Rather than risk a 1993 full frontal, HillaryCare assault, they will provide health care "for the children." Then they will increase Medicare with a bailout of UAW workers and lowering the enrollment age to 55. Pretty soon, a huge majority of Americans will be getting health care from Uncle Sam, and the final takeover will be easy.
Schip is the first step. The program, with its $25 billion budget, was originally designed to provide insurance to only the poorest children. Democrats want to throw an additional $60 billion at it, expanding Schip's rolls by three million. They would expand eligibility so much that as many as half joining would drop private insurance to do so. Even adults could sign up.Next: Even as Democrats work to expand Schip to cover older Americans, they'd expand Medicare to cover younger Americans. House Energy and Commerce Committee Chairman John Dingell is said to have recently floated the idea of allowing the struggling Big Three auto makers to enroll workers in Medicare at the age of 55, or 10 years early. Consider this a pilot program for dropping Medicare's age limit overall and instantly subjecting tens of millions more Baby Boomers to the government's tender care.
Democrats will meanwhile argue the only way to pay for Schip and other expanded programs is to gut Medicare Advantage and similar free-market reforms. See how clever? Swallow up ever more Americans into federal programs, banish any last vestiges of popular market plans, and voilą! It is Hillarycare! Only nobody ever had to use the dreaded word!
They are going to fight at the margins: a little more socialism here, a little more there. A good friend tells me he's ready to let the GOP lose a few more elections to get "real conservatives" in power. Another 16 years from Goldwater to Reagan. At the same time, the ever restless libertarian wing is crying for more purity.
I know it is unpopular to be so impure but I am calling folks to get their head and heart and wallets into the game. We are going to lose in Iraq, and we're going to lose the most innovative health care system in the world. Or we can write a position paper on abolishing Medicare.