When Dollars Trump Compassion

By BOB HERBERT
Op-Ed Columnist
The New York Times
June 19, 2007

You won’t see these stories on television, but Marian Wright Edelman and Dr. Irwin Redlener could talk to you all day and all night about children whose lives have been lost or ruined because they didn’t have health insurance.

This is not a situation one associates with a so-called advanced country. That you can have sick children wasting away in the United States, the wealthiest nation on the planet, because medical treatment that could relieve their suffering is withheld by men and women with dollar signs instead of compassion in their eyes is beyond unconscionable.

Ms. Edelman is the president of the Children’s Defense Fund, and Dr. Redlener is president of the Children’s Health Fund.

Both are appalled at the embarrassing fact that nine million American children have no health coverage at all. Among them are children with diabetes, chronic asthma, heart conditions, life-threatening allergies and so on. In many instances they are left untreated until it is too late.

Leaving children uninsured is a form of Russian roulette, Dr. Redlener said.

“All children should be covered,” said Ms. Edelman.

Congress and the president could do something about this right now. Of the nine million children without coverage, six million are already eligible for either Medicaid or the popular State Children’s Health Insurance Program, or S-chip, which covers children whose parents earn too much to qualify for Medicaid but too little to afford private health insurance. The bulk of the funding for S-chip comes from the federal government.

S-chip, which had strong bipartisan support when it was established 10 years ago, is currently up for reauthorization in Congress. The program should be expanded as part of a broader effort to cover as many of the six million eligible-but-uninsured kids as possible.

Eligible children remain outside of S-chip and Medicaid for a variety of reasons, including the following: because there is insufficient funding to cover them; because families do not realize their children qualify for coverage; because red tape and complicated regulations discourage families from signing up.

A number of S-chip re-authorization proposals are being developed. The best-case scenario would be legislation — costing as much as $50 billion in additional funding over the next five years — that would cover millions of additional youngsters from poor and working-poor families. This would put the U.S. on the road toward universal coverage for children.

Ten billion dollars a year is considered a pittance when it comes to funding wars and tax cuts for the very wealthy. But it’s suddenly a lot of money when the subject is the health of American children.

One of the worst scenarios has been offered by President Bush in his White House budget proposal. That calls for just $4.8 billion in new funding for S-chip over the next five years. The result, according to the Congressional Budget Office, would be a net loss of coverage for 1.4 million children.

The old expression was “taking candy from a baby.” The White House is ready to take away vitally needed medicine.

Negotiations over the reauthorization of S-chip are under way. It will be interesting to see whether the Democrats who crowed so much about their newfound power when they took control of Congress will stand tall for the kids of the poor and working poor, and whether there are enough caring Republicans to resurrect the spirit of bipartisanship from a decade ago.

As the heat gets turned up on this issue, the White House appears to be falling into its old habit of creating its own reality.

The Congressional Budget Office and most researchers have agreed on the six million figure for the number of youngsters who are eligible for government-sponsored health coverage but remain unenrolled — roughly four million for Medicaid and two million for S-chip. This has not been controversial.

Yesterday, the Department of Health and Human Services began circulating a study that tries to make the case that the total number of eligible but uninsured youngsters is a mere 794,000, an absurdly low figure.

If you can wave a magic wand and make five million poor kids disappear, you no longer have to think about caring for them.

Advocates like Dr. Redlener and Ms. Edelman don’t have that luxury.

“Kids who grow up with poor access to health care carry a high risk of having underdiagnosed and undertreated chronic illness, both physical and emotional,” said Dr. Redlener. “We know what to do. We should fully fund this effort at the $50 billion level and make coverage mandatory for all children.”