'Sicko,' Health Care and SCHIP

Michael Moore's movie "Sicko" is deeply troubling. Critics have objected to its various stunts, its flip title and slight distortions, but its basic points are on target. The United States spends an enormous amount of money on health care, yet there are approximately 45 million people who are uninsured.

Included among them are illegal immigrants and some who could easily afford insurance. Perhaps more significantly, there are countless millions who have insurance but whose reasonable and justifiable claims are routinely denied.

No other developed country lacks universal coverage, and others that spend considerably less on health care, such as Britain, Canada and, particularly, France, achieve better results, including greater average longevity. Perhaps needless to say, the legitimate interest of insurance companies, HMOs and others in saving money is often at odds with providing needed care.

(Not unrelated to health care is vacation time, another area in which the United States differs from other developed countries. A report by the Center for Economic and Policy Research states that the United States "is the only advanced economy in the world that does not guarantee its workers paid vacation." Other industrialized countries offer their work forces a government guarantee of annual paid vacations. In Britain, it's 20 days of compensated leave, in Germany 24, and in France 30! The United States guarantees zero days, and even those Americans who do get paid vacations take an average of just 12 days.)

But how can health care in these other countries be "free" as "Sicko" and many experts claim? Well, it is and it isn't. People do pay more in taxes, but they don't pay for insurance premiums, associated and often inflated medical expenses, and the burdensome blizzard of insurance paperwork. Other approaches such as mandatory private insurance also play a role in some cases.

The bottom line is that universal coverage, done right with appropriate incentives, reasonable limitations, etc., can result in better and lower cost health care. Of course, this doesn't dictate that we emulate any existing system.

Uninsured Children and SCHIP

Of course, there's an army of ideologues and lobbyists who will depict the push for universal coverage as a nefarious effort to undermine the free enterprise system. Witness President Bush's recent rejection of pleas from even a majority of fellow Republicans to compromise with Democrats on renewing the State Children's Health Insurance Program (SCHIP) that gives health coverage to millions of children whose parents don't qualify for Medicaid, yet can't afford private insurance.

This popular decade-old program, which would cost between $7 billion and $10 billion more dollars per year to retain (financed by increases in tobacco taxes), will expire at the end of September if it's not renewed. True to the politics of nope, Bush has threatened to veto it if it passes Congress.

The incongruities are almost too painful to note. Spending $1 trillion ($1,000 billion) on the utter debacle that is Iraq has not made us safer from international terror. Spending a few billion dollars on a children's insurance program that has worked will make us safer from the domestic terror of facing life-threatening illnesses without medical care.

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