Health care is a basic human right, not a privilege. For some reason, we’ve allowed ourselves as Americans to be fooled into accepting that one must be blessed with “means” to actuate appropriate health care. As a nation we have failed to realize that our health care system is a barometer of our society’s value for human life.


Tuesday, October 16, 2007

A Response to Michele Bachmann's Form Letter Regarding SCHIPS Bill

“Thank you for contacting me about the State Children's Health Insurance Program (SCHIP). I appreciate hearing from you on this important issue. Unfortunately, the program has become politicized, and Congress recently passed legislation to expand SCHIP coverage beyond children, beyond U.S. citizens, and beyond those who are truly in need, and that is where the problem lies.”

First of all, I would imagine that a program that must be politically approved is open to some measures of politicization. Assuming that politicization is bad, you are just as guilty as anyone else of politicizing this program.

SCHIP coverage moves beyond US citizens in the form of Emergency Medicaid. If you are not familiar with this program, I will help to enlighten you. Emergency Medicaid is created not to assist illegal immigrants (or rather those who are not US citizens) but rather to act as a safety net to hospitals that provide care to illegal immigrants in emergency situations. Hospitals cannot send an emergency patient away because they are not citizens. This is unethical, inhumane, and even were it ethical and humane it is not easily practiced (How exactly do you verify a patient is a citizen while said patient is having a heart attack?) It is near impossible to track these patients, or set any consequences for not paying the bill for this service. Emergency Medicaid was set up to give reimbursement to hospitals for what they would never be paid for as a result of following law as well as ethical standards. People who are not US citizens qualify only for Emergency Medicaid in “emergency” situations (i.e. traumas).

Adults who are covered under the SCHIP program are covered because said state has received a waiver from the federal government allowing them to do so. How does a state receive a waiver to cover adults, you ask? They receive a waiver to cover adults when they prove they are covering a large percentage of children who are eligible for the SCHIP program, and in doing so have money leftover with which the federal government allows that state to cover adults. In fact, you should know this Ms. Bachman as one state that receives this type of waiver is Minnesota! States that are under-serving their eligible children would NEVER qualify for this type of waiver to cover adults.

Another aspect of this bill is the removal of requirement to provide proof-of-citizenship to receive SCHIP benefits. In Wisconsin alone, there were 21,000 children whose SCHIP coverage was cancelled due to inability to provide proof-of citizenship (ie. birth certificate). Many of these children were known to be US citizens but did not provide proof. Eligible children are ending up not having the health insurance they qualify for because of a technicality. This provision attempts to accommodate for that sad fact.

“According to the U.S. Census Bureau, several million SCHIP-eligible children are still uninsured. Surely, children in need should have the health insurance promised to them before expanding SCHIP further up the income ladder or using more of the program's limited resources for adults.”

Each state should be held accountable for programs designed to help inform the public about the SCHIP program. Not all states have informed the public about SCHIP as well as Minnesota (again your state!) Perhaps they could take some cues from Minnesota to work harder to cover their children. Although, I do wonder how states not getting the word out to eligible children means that this SCHIP bill should not be approved. As stated previously (and you should know and understand this!) states that are not adequately insuring their eligible children would not be eligible for federal waivers to insure adults!

“Here's my idea. Let's cover the kids first. Let's focus on children in need without access to health insurance, and fund SCHIP as it was meant to be. I've publicly supported legislation that would accomplish these goals and keep SCHIP moving forward to help those it was intended to help. “

That is the goal of the current SCHIP bill!

“But some want to move SCHIP in the wrong direction. Under the bill passed by Congress and vetoed by the President, SCHIP dollars could be used to cover childless adults and more affluent families - in some cases, households earning up to $83,000 per year. It also changes current law to make it easier for illegal immigrants to get SCHIP funds.”

I’ve heard that $83,000 word flung far and wide like it actually affects more than one state. Ya, that’s right. That $83,000 cap is obtained by a waiver in New York State. Which makes sense in NYC. $83,000 in New York City is nothing like $83,000 in Minneapolis. In the state of Minnesota, the actual income limit would be just under $63,000 for a family of four. As far as the illegal immigrants and SCHIP funds comment goes, please see above. I would like to point out, though, that your misleading references in regards to how money in SCHIP is used are tiring.

“Rather than focusing on low-income, uninsured children, a Congressional Budget Office (CBO) study shows that more than 77 percent of children affected by this expansion already have personal, private health insurance. In other words, the bill creates an incentive that pushes kids out of private insurance into a government-run program.”

Have you ever heard of Medicaid fraud? I’ll help you out on this one. In the state of Minnesota, if you have affordable private health insurance (determined by employer paying at least 50% of premiums) it is ILLEGAL and FRAUDULENT and punishable by FINES and JAIL TIME should you drop your private affordable health insurance in lieu of the public SCHIP. There is more to this though. Did you know that the state of MN actually contracts with private health insurance companies to provide SCHIP coverage? That’s right. That means that the children and adults in the state of MN covered by SCHIP as a primary health insurance are covered by a private health insurance that is contracted by the state of MN.

So…………..Government run? Not exactly….Government paid for to promote our garish capitalist state? Absolutely.

“Worse, this legislation makes SCHIP financially unstable. In order to appear fiscally sound, it gives children health insurance for 5 years, and then it cuts SCHIP funding by nearly 80 percent - a classic bait and switch that will cause millions of American children to lose their health coverage.”

Well, this may be the one drawback I MAY agree with.

“According to the CBO, the bill will lead to only 800,000 currently eligible-but-unenrolled children being enrolled in SCHIP by 2012. The sad fact is that it would be cheaper to give each of these kids $72,000 than it would be to enact this bill, and it would probably show healthier results.”

I doubt that is the fact, but since you aren’t going to vote yes on this bill anyhow, where’s my 72 grand?

“Rather than playing politics with children's healthcare or scoring political points with radio and TV ads, I believe Congress should show the American people that we are here to solve problems, and I will continue encouraging House leaders to do the right thing by bringing up an SCHIP bill we can all support.”

Oh, do you mean that SCHIP bill that would end up cutting the number of eligible children, remove all eligibility for adult waivers (even if the kids in your state are covered to an overwhelming degree?), shut off Medicaid reimbursement for transportation services to disabled children, and would offer a “tax credit” to people who purchase affordable private health insurance? Oh, and just to cue you in, SCHIP is available to people who don’t have affordable health insurance available so they wouldn’t get that tax credit. Another clue concerning that? Most families on SCHIPS don’t make enough money to even PAY federal income tax, so what good is a tax credit on tax you don’t pay? No good, that’s how.

”Once again, thank you for contacting me. Please keep in touch.
Michele Bachmann
Member of Congress”

Thanks for your support. I appreciate all the “politicization” you had to offer.

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