POLICY: Of unbiased Republicans, Thorpe, Kerry and uninsured kids, with UPDATE

Ken Thorpe writes in the NEJM on the uninsured. He’s been in the Clinton Administration, and he’s the author of the study that says the Kerry plan’s cost will be in the $650 billion range rather than the AEI’s $1.5 trillion estimate. So you can take his view the way you want to. But what he basically says is that both Bush and Kerry’s plans are incremental and neither of them will cure the problem of the uninsured. Then again I just had dinner with an (only) Fox-News watching, Bush supporter from Texas who told me –in all seriousness–that not only was my analysis of the health care system biased because the richest people in the world come here for their medical care (the Sultan of Brunei?) and so we have the best system in the world–whatever the Economist (which prefers the Swiss system) and WHO say (they rank the French first). He also told me that Iraq is in good shape, the Abu Grahib scandal wasn’t a big deal, all the networks are biased in Kerry’s favor and that uninsurance for 45 million wasn’t a problem. So given that’s the attitude of many on the Republican side (and I’m sure it is), it’s unlikely that this post is going to change many minds. However, Thorpe correctly says that:

Adults and children without insurance are given diagnoses at later stages of illness, receive fewer preventive and curative medical services, and have worse health care outcomes than those with insurance…..First, Kerry would extend coverage by Medicaid and the State Children’s Health Insurance Program (SCHIP) to people who are currently ineligible for such coverage — single adults and childless couples living below the poverty line and parents with incomes of less than 200 percent of the poverty line. He has also proposed extending the same coverage to more children by raising the cutoff level to 300 percent of the poverty line. Instead of continuing today’s federal–state matching arrangements in these programs, Kerry would have the federal government finance 100 percent of the costs of the expansion. Full federal funding is likely to result in higher rates of program enrollment.

This past week a progressive pressure group, Vote Kids, introduced several leading pediatricians in a Washington DC press conference to make a joint statement about children’s health care in America. The pediatricians included six past presidents of the American Academy of Pediatrics all supporting Kerry’s effort to extend coverage to all children. HHS Secretary Thompson responded to this week’s activity by calling the pediatricians “demagogues and said: “It is absurd and despicable that doctors are playing politics with children’s lives“. That sounds a little over the top to me, even though Sydney at Medpundit points out that some doctors (including her) don’t agree with the AAP on this. (Syd also has this great post on the relative risk of Vioxx, which I agree with BTW, showing my libertarian side…). Mitch Arnowitz from Vote Kids wrote to me saying:

8 million children and youth don’t have health insurance. We think that the present administration does not have a plan to provide health coverage to America’s children, and that their current tax and budget priorities are eroding hard won health care gains for children.

That statement is undeniably true so I’m going to respond to my Texan friend’s charge of bias by being biased in favor of the truth. I try not to use this blog as a soapbox, but try reading this story about a young woman born with a “pre-existing condition” who is disabled and has a terrible story, and you’ll understand why emotionally I feel that we need a single universal insurance pool for the most vulnerable. Kids are the cheapest and easiest to cover, and there is no way that even the crustiest Texan Republican can explain to me that its their fault if they are uninsured. So morally I think we should get them coverage.

You can give to Vote Kids, here. And in equal fairness you can give to Bush here. How unbiased is that?!!

UPDATE: Linkmeister Steve accuses me of going into “he said, she said” here without actually calling Thompson or Vote Kids on the truth. He cites a neat article from the Columbia Journalism Review, which tries to tell the truth on the candidate’s health care plan objectively rather than just allow each side’s spin to come out unhindered. The way it should be done is “he said, she said, we say”.

I honestly think I do the “we say” bit but let me reiterate. Vote Kids is right, in that there are more than 8 million uninsured kids and that uninsured kids (and adults) tend to be poorer and get fewer health services than insured ones. The KFF factsheet shows that. Tommy Thompson claims that Bush has done great stuff for kids–and to be fair the number of uninsured kids has gone down, due to SCHIP and Medicaid. But that’s not good enough, and the Bush “program” has no plans to further reduce that number. The Kerry plan, not that it’ll pass as is, does. And furthermore, insuring kids is relatively cheap and very good value in terms of future benefit to society–second only to getting them an education. We wouldn’t (I hope) as a society accept non-universal education for kids. At least Kerry wants to get us there for healthcare.

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