A Modest Proposal
posted by Frank Pasquale
From: Carthago Delenda
To: Mephistopheles, Cato Institute Health Policy Staff
Date: Oct. 10, 2007
Re: SCHIP Strategy Session
Momentum is building for our fight to change the health care system. But the recent veto of SCHIP has generated some public resistance. How are we going to reshape the debate? There’s one obvious answer: stop federal meddling and permit uninsured children to work for their health care.
Once upon a time, this country respected the age-old right of children to work. Our Supreme Court struck down federal child labor laws in Hammer v. Dagenhart in 1918, only to see that wisdom exiled in 1941 in U.S. v. Darby. Now is the time to fight Darby and to provide all children the opportunity to work for their health care.
In an increasingly competitive global marketplace, this proposal is a win-win for all concerned. Children get to choose between school and work, and can immediately contribute to national productivity. Also, they can buy the kind of health care they want–some will be able to economize with cheaper plans, while others will work harder to assure state-of-the-art care. The most productive will likely buy the best insurance, and that will help assure a cost-effective distribution of medical resources.
Some people will whine about the inevitable disparities that will arise, but we need to keep the focus on liberty, not socialistic fantasies like health security. We’ve done our best to reduce dependency and create an ownership society in America. An “ownership society means that you’re on your own” . . . right from the start.
Photo Credit: Lewis Hine, “Trapper Boy”.
October 5, 2007 at 1:18 pm
Posted in: Health Law
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Responses (17)
KipEsquire - October 5, 2007 at 4:30 pm
Great straw man argument: opposing another potential middle class entitlement = kids in mines.
And you’re not exactly Jonathan Swift.
Frank - October 5, 2007 at 4:51 pm
Kip: First, I’d love to hear your response to my earlier posts on SCHIP today and yesterday.
Second, I’d enjoy hearing your account of how to provide insurance in the private market to families like the ones mentioned here:
http://covertheuninsured.org/stories/
If you have a good plan for them, I’d love to hear it.
My bottom line is: why are we willing to let some lottery of luck determine who gets health care and who does not? How is a child responsible for, say, a parent not being able to land a job with insurance? Have you tried to get insurance for anyone on the individual market who has a preexisting condition?
Finally, and most impportantly: Should any child lack insurance just because their family can’t pay for it?
To me, this is not just one more DC story of wrangling interest groups. This is about real people with real problems getting denied care. To reject any effort to help them as a “middle class entitlement” is to betray a startling insensitivity to the plight of millions of uninsured people.
Disappointed - October 5, 2007 at 4:52 pm
Hammer nowhere references a “right of children to work.” Not that Frank actually intended his post to seriously contribute actual information to an important debate on a serious issue.
Can we not debate serious issues without this sort of straw man? Shall I look forward to a post on abotion that defends “an unborn child’s right to die”?
Disappointed - October 5, 2007 at 4:57 pm
“That there should be limitations upon the right to employ children in mines and factories in t e interest of their own and the public welfare, all will admit.”
Yeah, the Hammer case certainly was a rousing defense of child labor. Maybe you should borrow PrawfsBlawg’s slogan, and let intellectual honesty trump partisanship on this one.
Frank - October 5, 2007 at 4:58 pm
Disappointed: well, if you want my serious takes, take a look at any of the posts on SCHIP i’ve written in the health law archive category to the left.
and in terms of a right to work: remember, the post is not my effort to characterize Hammer, but to project how a policy strategist might categorize it.
Still Disappointed - October 5, 2007 at 5:52 pm
So it was a parody? Or are you expressing your belief that policy strategists supporting the expansion of the program would turn to such demagogy instead of arguing the case on the honest merits?
Drexelstudent - October 5, 2007 at 9:45 pm
Well, Frank, I appreciate your satire. Its nice that people will ignore your serious defenses of the new SCHIP and choose to attack a satirical work as a “straw man.”
AYY - October 6, 2007 at 1:08 am
Frank, here’s the problem. These mean, nasty, evil Republicans want to increase the program by only $5 billion instead of $35 billion (that’s supposed to be paid by smokers!!) So for you to write “satire” like this isn’t fair or accurate.
The program is just the beginning of Hillarycare. For a sample of what it will be like see
http://www.bostonherald.com/news/opinion/op_ed/view.bg?articleid=1035832
Frank - October 6, 2007 at 10:21 am
AYY: Ahh, the Herald, a fine, unbiased news source.
Many estimates say that the President’s small increase will “not only be insufficient to expand SCHIP, but amounts to a funding cut that will force states to trim the rolls of low-income children from the program.”
But AYY, I do understand that you probably think it very important that the $30B at stake here be put aside to keep us in Iraq for another 4 months or so:
http://lawprofessors.typepad.com/healthlawprof_blog/2007/09/schip-in-graphi.html
I’d just be careful to read, say, Jon Chait’s book, The Big Con, before alleging this is all part of a policy of fiscal conservatism.
quotefromeugenerobinson - October 6, 2007 at 10:43 am
this is from a eugene robinson editorial in the wash post
“An estimated 9 million children in this country are not covered by health insurance — a circumstance that should shock the consciences of every American. Democrats and Republicans worked together to craft an expansion of an existing state-run program that would have provided coverage for about 4 million children who currently don’t have it.
The program Congress voted to expand provides health insurance for children who fall into a perilous gap: Their families make too much money to qualify for Medicaid but don’t make enough to afford health insurance.
The president said Congress was trying to “federalize health care,” even though the program in question is run by the states. The president said that “I don’t want the federal government making decisions for doctors and customers,” even though the vetoed bill authorizes no such decisions — the program enrolls children in private, I repeat, private, health insurance plans.
And here’s my favorite: “This program expands coverage, federal coverage, up to families earning $83,000 a year. That doesn’t sound poor to me.” But the bill he vetoed prohibits states from using the program to aid families who make more than three times the federal poverty limit, or about $60,000 a year for a family of four. Most of the aid would go to families earning substantially less.
Bush’s spurious $83,000 figure comes from a request by New York state to use the program for some families earning four times the poverty limit. That request was denied by the Bush administration last month — and that upper limit is not in the bill Bush vetoed. End of story. If New York or any other state were to ask again to be able to raise the income limits, the administration could simply say no.”
Disappointed - October 6, 2007 at 4:16 pm
Wow, so your new tactic is to call the Boston Herald “biased” and then to criticize a critic’s supposed support of the Iraq War?
Where’s the part where you get serious about this? Pretty weak showing on this post.
Disappointed - October 6, 2007 at 4:22 pm
“How is a child responsible for, say, a parent not being able to land a job with insurance?”
OK, now you’re just begging the question, suggesting that every parent making thrice the poverty line is “not … able to land a job with insurance.” Do you have any evidence to suggest that those making between twice and thrice the poverty line are unable to get insurance?
And by your logic, why limit it to thrice the poverty line? Why aren’t you supporting free health care for all children, everywhere, regardless of parent salary?
And why stop at health care? What about free college educations? After all, we shouldn’t punish young adults for having parents who can’t or won’t support their educations, right?
Simply put, your analysis is pretty thin. You want to expand a government program, without showing that a true need for expanding that program currently exists. And you don’t really care about how it gets funded — what about the children whose parents pay a disproportionate amount of money in taxes? How do we make them whole?
Frank - October 6, 2007 at 4:27 pm
Disappointed, had I any confidence that you read any of my other SCHIP posts that I’ve pointed to, or the Health Affairs blog posts I linked to in the other SCHIP post I did yesterday, I might continue arguing.
But at some point the old blogger’s bromide has to kick in: “You can lead commenters to reason, but you can’t make them think.”
47 million people lack insurance. Millions of them are children. Face reality.
humblelawstudent - October 6, 2007 at 7:25 pm
Why should I be forced to pay because other people can’t properly provide for their children?
Here’s a better proposal. Everyone who thinks all children should be insured should contribute to a charitable organization that pays the medical costs for the children. Or perhaps, “sponsor” a child.
Frank, since it is so important to you, I expect you are already contributing to such a cause.
Oh wait, that’s right, instead you demand the coercive arm of the governmen to enforce your preferences. Silly me.
Frank - October 6, 2007 at 8:23 pm
Well, HLS, shifting all those social welfare functions to charity would be a brilliant way to weaken the political and cultural influence of those who donate to the charity. Donors who donate to provide health care for the poor will have that much less to donate to candidates of their choice during the election season. That’s the hard truth of a money-driven political system.
But you’ll probably be pleased to know that I do donate regularly to GlobalGiving.org.
As for your view that the millions of people who can’t afford health insurance are “people can’t properly provide for their children”–do you know uninsured people? Look at these people’s stories:
http://covertheuninsured.org/stories/
And here’s how denying a kid decent access to a dentist can cost the health system overall a quarter-million dollars:
http://www.washingtonpost.com/wp-dyn/content/article/2007/02/27/AR2007022702116.html
AYY - October 7, 2007 at 3:47 pm
Frank, you ought to know by now I wouldn’t send you to a biased news source. It was the Boston Herald for heaven’s sake. You’re confusing it with the Boston Globe.
Anyway, I don’t blame you for not reading the article. It’s about what happened when the writer’s daughter went to her pediatrician in Massachusetts. It’s scarier than a Stephen King novel. And the libs aren’t denying that it’s true.
Now as far as the 30 billion for Iraq, a lot of that is going for health care and to rebuild the infrastructure so that people can have things like schools, sanitary water, and hospitals. Most of the rest is going to eliminate the guys who are trying to kill innocent people. What’s not to like?
AF - October 9, 2007 at 2:48 pm
Frank, I actually think you’re underselling the aptness of your own satire. It is inconsistent to support bans on child labor, but oppose public health insurance for children (yes, of all income levels). If we trust families to provide health insurance for their children, why don’t we trust them to prevent children from working? Either the government is responsible for protecting children from the free market, or it isn’t.
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