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Bush's Health Care Scare Tactics

By Tom Daschle

On Halloween, President Bush called the State Children's Health Insurance Program (SCHIP) reauthorization bill currently pending in the Congress a "trick." It is ironic that a man who receives the world's best health care from government trained doctors on government purchased machines at the Bethesda Naval Medical Center chose to spook Americans by suggesting we should worry that the SCHIP bill is a trick to increase government control of our health system.

Short of answers to America's health care crisis, the President and his allies are falling back on old myths to undercut SCHIP and to prepare for the looming national debate on health care reform.

The first myth is that the United States has the best health care system in the world, and changing it will lower quality, reduce access, and impose added costs on our businesses. There is no doubt that some Americans have access to the best care anywhere, but not all care is excellent. The system is better described as islands of excellence in a sea of mediocrity.

Sadly, far too many Americans are pushed off the islands of excellence into the sea of mediocrity. We learned in a report released today that Americans are more likely than citizens in other developed countries to experience medical errors. And they are more likely to go without needed care because of costs.

The second myth is that fixing our ailing health care system would be worse than the disease. Critics claim it will lead to harsh rationing and "socialized" medicine. Those opposed to health care reform often argue that reform will prevent patients from choosing their doctor or be forced to wait months for a doctor's appointment.

Yet, only a third of sick Americans have same-day access to their primary-care physician, less than people in the United Kingdom. Americans find it two times harder to get care at night and on weekends without going to emergency rooms compared to those in the Netherlands.

The final and most misleading myth is that the U.S. cannot afford to reform our health system. Fact is that we can't afford to continue this current system.

In the business community, heath care costs have always been a problem, but they are getting worse. Businesses provide insurance to 158 million non-elderly Americans. In 2004, employers paid 43% of total health care benefits in the country, up from 38% in 2000 and 36% in 1990. American business can't remain competitive if they must forgo reinvestment in innovation in order to pay for health care costs.

We spend more money per capita than any other nation on health care - 50% more, in fact - and our investment has resulted in a ranking of 37th in the world in health system performance. We're not even getting what we pay for.

These myths are easy to exploit, as we have seen in this debate over SCHIP. SCHIP is a perfect example of how a health care program, with strong bipartisan support, can succeed. The program helped reduce the number of uninsured, low-income children by one-third. Its major flaw has been inadequate funding: roughly 6 million children who qualify for SCHIP or Medicaid remain uninsured as a result.

Congress passed bipartisan legislation to expand SCHIP and help children get the coverage they need. The bill would have covered almost 4 million additional children. The federal cost of the program would have been an additional $35 billion over 5 years. I believe this is a smart investment.

We all know what happened next. President Bush exercised the 4th veto of his Administration, claiming, among other things, that the program was too costly and setting the stage for a battle over the future of the U.S. health care system.

But the President is wrong on substance and strategy. There is a wide substantive gulf between the public-private, targeted program for low-income children and socialized medicine. Indeed, there is no reality to this claim for virtually all the mainstream health reform proposals.

Strategically, this unpopular position is not just overreaction. The idea that no progress should be made on the top domestic policy concern, irrespective of its conservative components, suggests fear. The Administration appears to have reacted to the clear signs that the nation is on the verge of a national health debate by trying derail the debate. This will backfire.

The President's position does make reauthorizing SCHIP more difficult. It will take redoubled efforts from policy makers, payers, providers, patients and the public. Hard analysis is needed to tear down the myths that are the shields of opponents. And what is at stake - coverage for several million uninsured children - must be made clear.

But at the end of the day, there is no costume that can cover up the emptiness of the President's position. And without some more preparation on the Republican side, the coming debate over health care reform will be scary indeed for them.

Tom Daschle is a former U.S. Senator and Senate Majority Leader from South Dakota.

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