accountabilitybloke (old blog)

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The indirect way to reform health care insurance….

I have been multitasking again, trying to fit in as many tasks as possible on any particular day at any time. Blog posting has obviously been pushed aside, although there are certainly enough things to blog about.

One subject worth blogging about is health care insurance and the various ways the issue has come into our lives. Obviously there is Sicko the movie and “Hillarycare” — two notable and noticed efforts to directly confront the problems. But as important are two other news items — the battle over S-CHIPS in Washington and the role that health care is playing in the world of corporate America.

The S-CHIPS battle is interesting as a case study in contemporary US politics — not that driven by the so-called Culture Wars of Red/Blue states, but rather the politics driven by our political culture’s urge to take care of widows, children and especially orphans. Theda Skocpol (see here) and others have established that urge (in the form of a social consensus) as a foundation for US social policy since the late 1800s, and it still seems to trump the wave of more divisive politics in the long run. This can be seen in the bipartisan nature of the S-CHIPS debate as well as the overall parameters of the choices. It is not a matter of whether children ought to have access to health care insurance — that is accept as a given, and the ten year history of S-CHIPS has proven a quiet success in that regard. Rather, the issue is one of funding levels and the discretion given states in their implementation of income eligibility criteria. Thus, it is not that we shouldn’t extend the program (which is clearly a form of national health insurance), but rather at what level and to whom….

Viewed not as a social policy to assist and protect children, but rather as a national health care insurance policy, S-CHIPS is far more significant than the casual observer might imagine.Just as earlier policies prepared the groundwork for Social Security, S-CHIPS can play the role for naitonal health care without all the contentious debate over Hillarycare and similar approaches.

If one can view S-CHIPS as the road to health care insurance reform from the bottom (and the Massachusetts and California (also here) efforts as reform form the side door), then the current problem of US competitiveness — presently manifest in the GM strike — is the path to reform from above. Nothing holds more promise in the policy arena as corporate welfare, and it is becoming obvious to all that corporations — from the auto makers to big-box retailers — need relief form the costs and pressures of funding health care for their present, past and future workers. There are many cost factors at play in the corporate world, but clearly health care insurance is the most critical right now. Looking at the overseas competition in countries where health care is taken care of by the state (and funded mainly through taxes), the advantages of spinning off those obligations to the government seem all too obvious. Health care reform, therefore, can be pursued not for its own sake, but rather as part of the effort to keep the US competitive in a global economy.

With these pressure from below, above and through the side door, it seems that we are on a path to the substantial reform that Clinton and others desire on the basis of liberal social welfare policy. One wonders, however, whether the advances being made through the bottom-above-side approaches will be put at risk if the health care issue becomes part of the Culture War politics associated with the presidential season. Maybe it is not such a good idea to put the quiet progress in this area at risk by dealing with it directly….

September 26th, 2007 Posted by | corporate welfare, health care, politics | no comments