SCHIP: A Personal Tale


Returning to SCHIP, the federally funded program aimed at providing health care to those children whose families are neither poor enough to receive Medicaid nor wealthy enough to afford private health insurance, the Bush administration has now ordered states such as New York, which have decided to extend their SCHIP programs to those earning 250% of the poverty line, to lower their income line or lose funding. Mr. Bush claims he wants to protect citizens’ ability to purchase private health insurance. Mr. Bush says that those families can actually afford health insurance.

Some facts:

  1. Employers who provide health insurance paid an average of $11,000 in 2005 for a family of four, and the family contributed an average of $3,000. And, by the way, the percentage of those receiving health insurance through their employer is decreasing. Moreover, the self-employed and those working for small businesses who cannot provide health insurance have to pay an even greater amount because they are unable to negotiate for group rates as are the large businesses.
  2. The cost of health insurance rises at an average of around 6% to 10% per year in the past 7 years, twice or more the rate of inflation, and many more times the rate of growth of minimum wage.
  3. There are 8 million completely uninsured children in the US who receive neither Medicaid nor private health insurance. They are obvious victims of a gap in the market, where it is not worth it to private insurers economically to provide care.

What does this mean? It means that there is a large group of people who we might call “middle class” that cannot afford health insurance, and for whom the private insurers do not wish to provide insurance. They work for small businesses or are self-employed, and paying 1/2 to 1/5 of their income for health insurance is absolutely not feasible. They are forced to play the odds, day by day, hoping that nothing goes catastrophically wrong with the health of the parents, thus destroying income to pay for the children’s health care, or to the children themselves, which would likely bankrupt the parents.

Insurance normally makes such horrors as a seriously injured parent or terminally ill child survivable, but for the uninsured every day is a gamble. Will this chest cold become the flu? Do I test this discoloration on my arm for cancer or save up the money for either groceries, house payments, or some more potentially immediate medical emergency that might just occur in the future? Living without insurance is absolute hell.

I know this because I’ve lived it. My family’s income varies dramatically because we are self-employed — we never qualify for Medicaid and never can afford health insurance. If my father or mother were to get hurt in such a way as to be unable to work, then the world stops. And, before I went to college and received my health insurance as part of a financial aid package, I saw the debate every time one of us got sick: do we go to the doctor now, or do we wait and hope that it blows over? If my parents were ill, the debate became: do I take myself to the doctor, or do I save up in case either I get worse or my son becomes sick himself?

Can all of the comfortably insured and moderately wealthy people take a moment to imagine living like that? Stop…and think about it. Imagine having the flu…or is it pneumonia?…but there is no way to know, because that doctor visit might mean that when it is known to be pneumonia it’ll be twice as hard to pay for the treatment. Hospital stays? Forget it: absolutely unaffordable. And, if it is chosen to finally go to the hospital or the doctor, what happens when the time comes to pay for a child’s doctor’s visits and medicine. Think about this horror. The fall from the bliss of middle class, but uninsured, is a harsh one that is far too frequent.

SCHIP does not fix all the health care problems in our country. It does not insure the parents (though some programs in the past have provided basic insurance to at least one parent of a young child). Sadly, nationalized health care is a completely different fight — one which will require a change of president and far more stomach than most candidates of either party have. But, in the case of the children, SCHIP still eases the minds of parents. A parent who knows their children are cared for, no matter what, will fear far less taking themselves to the doctor as needed. They will not have to save for the day their child becomes ill. Should they have to leave their self-employment behind or their job because of illness, they will know their child is taken care of.

Mr. Bush tells us to fear nationalized health care. He acts as if that in and of itself is immoral, as if the word nationalized is a sin. But SCHIP is not nationalized health care. It is not the end of private health insurance. It is insurance for those whom are economically inviable to the private carriers. It is proxy protection for the parents in families, who can devote what money they have available to their own care. For a president and party who claim to protect “family values” the decision to provide insurance of security to lower-middle class families should be a no-brainer.

Fundamentally, unless the conservative right wishes to claim that the innocent children, who had no choice to whom they were born, do not deserve an equal opportunity to succeed, regardless of their parents’ status economically, there is no reason to withhold funds from SCHIP.