Monday, July 11, 2005

"We want to get them enrolled"

That's easy to say when it's not his money being spent.
Child Insurance Program May Face Crunch

A government program that provides health insurance for poor children could run into money problems in several states over the next two years unless Congress acts.

Six to 14 states will use up their share of federal money for the State Children's Health Insurance Program during the 2006 budget year, according to a report by the nonpartisan Congressional Research Service. By the next year, that number will range from 12 to 20 states.

The range occurs because analysts looked at two scenarios. One projected low demand for the program; the second factored in high demand.

Once states spend their federal share, they either have to use more of their own money to provide insurance coverage or find ways to reduce expenses by cutting services. Neither is a particularly attractive option for state legislatures.

Sen. Ted Kennedy, D-Mass., said on Friday that he planned legislation that would seek to add $1 billion to the program, known as SCHIP. The money had been allocated, he said, but was not spent by a deadline, so it reverted to the treasury on Sept. 30.

"It is unconscionable that children will go without health care because funds meant for the SCHIP program were not kept in the program," Kennedy said.

The program, created in 1997, now serves about 6.1 million people who would not otherwise have health insurance. Enrollment has increased steadily, though the pace has begun to slow in the past year....

The children in the health insurance program typically come from families whose income is too much to qualify for Medicaid but who cannot afford private health insurance.

When lawmakers created the program, they set aside $40 billion over 10 years. Most states have been unable to spend their share, which was particularly true in the program's earliest years.

After three years, states must return any unspent federal dollars so the money can go to states that have used up their federal share.

So far, the redistribution has prevented any widespread shortfalls. Only Rhode Island has exhausted all of its federal money coming through the program.

Soon, however, the redistribution will not be enough to cover the shortfalls in some states. That is because the pool of unspent money is shrinking as the program takes hold and enrollment expands, according to the report....

Ron Pollack, the executive director of Families USA, said he hopes the program's bipartisan support in Congress would lead to an expansion.

"I don't know of any Republicans or Democrats who don't like the program," he said. "I think they all like it." ...

"Remember, there are 6 million children eligible for this program who are not getting it," he said. "We want to get them enrolled."
This illustrates so many things gone wrong with big government that it's hard to decide where to begin.

First, notice how Pollack's concern is expanding the program and increasing enrollment, but not the quality of assistance the program provides. That's because bureaucrats and social activists measure social programs' success by participation levels and dollars spent -- volume, not results. Many such programs, especially if they cost "only" a modest few billion per year, enjoy support from both major political parties. Nobody wants to run for re-election against charges of cutting funding for poor children's health care.

But that's another thing people don't understand: as Don Boudreaux so well put it, lack of health insurance is not the same thing as lack of access to health care. Now, insurance by definition is a huge moneymaker for the insurers, not the policyholders. Even if big government "charity" were constitutional, paying for insurance policies is truly wasteful. Government would do better to pay for direct expenses, instead of wasting money on insurance premiums.

The next problem is how some states greatly benefit from the rest. This Tax Foundation report shows how uncontrolled federalism has created huge imbalances in how much certain states' citizens pay in federal taxes versus how much they receive back in federal spending.

The final problem is that government is trying to be charitable at all. By indoctrinating most of us in its public schools, government makes us feel entitled to others' money when we're faced with financial hardships, because we supposedly all pay our taxes. "I pay my taxes too," however, is not a good enough excuse, particularly when you receive more from the government than you pay in. Sadly, as Dr. Richard Ebeling, president of FEE, once explained to me, it's practically impossible to live without government making you the recipient of others' money: "Government makes criminals of us all."

The utilitarian argument against government charity is that it often fails miserably by giving to the wrong people, including giving Viagra to convicted sex offenders, and even when it gives to the right people, it's far less efficient than private charity would have been. Like many others, this insurance program encourages as many families as possible to sign up, even if they may not need it. Because the social program seems to be "free" when it actually is not, those enrolled will tend to use it unnecessarily. A doctor visit will be mandatory for the tiniest bump or ache, because, after all, the enrollees don't have to foot the entire bill.

As I explained toward the end of this entry, I do not argue at all against charity. I simply state that government has no right to dispose of anyone's money even for the most charitable of purposes, pointing to several decades of government social programs that have produced failure after failure. Charity should be the individual's decision, and there is no reason why it can't work better than government. When a child is sick and the family cannot afford proper medical care, whatever happened to the American ideal of the community taking up a collection for them? This has the advantage of the community determining that the child actually needs such care, and that the family genuinely needs it. Government, though, only wishes to dispose of the money because it makes the program appear successful. I've said before that government charity does the dirty work for us, sanitizing the process of caring for each other, and blinding us to how bad life can be. Government makes it too easy for us to be charitable. Private charity, though, makes us directly share each other's pain, and strength too, that part of community tradition which was once a very strong element of the American character.

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