Cokie and Steven Roberts
SALINAS, Calif. — Dr. Pablo Romero's clinic is filled with the happy sounds of healthy kids and pregnant moms — punctuated by the occasional wail from a youngster facing the business end of a syringe. Most of his patients work in the rich lettuce fields and packing sheds that surround this market town, and many can only afford health care for their children under a subsidized insurance program called Healthy Families.
Jointly financed by federal and state money, Healthy Families expires on Sept. 30. It's designed for the working poor, who don't qualify for Medicaid but can't afford private policies, and Dr. Romero argues that strengthening the program is essential. "We could save a few bucks now," he says, "but we'll pay dearly 10 or 20 years down the line."
Healthy Families is California's version of the State Children's Health Insurance Program (or SCHIP), and back in Washington, Congress is debating its future. The White House has vowed to veto any measure that significantly expands the program, but a brief visit to Dr. Romero's clinic shows how Bush's position is misguided.
Caring for kids is the moral thing to do, but it also makes financial sense. Rep. Sam Farr, D-Calif., recently wrote in the Monterey Herald that $1 spent on immunization now saves $13 down he road. Insurance costs less than $100 a month, while a single emergency room visit costs $435.
Dr. Romero, who first came to the valley as a teenage farm worker with a sixth-grade education, stresses the importance of early vaccinations: "What does it cost if a kid goes deaf from rubella?"
His latent concern is an "enormous outbreak" of diabetes. Parents work 12-hour days in back-breaking jobs and can't supervise kids who watch too much TV, eat too much junk food and don't get enough exercise. "Look at the number of McDonald's outlets that have opened, and the rise in diabetes cases, and the rates are exactly the same," he says.
The answer is prevention — regular visits to primary caregivers who teach families good health habits and monitor their progress. And those visits more than pay for themselves. Diabetes, and kidney dialysis, is far more expensive.
This message has gotten through to sensible Republicans like Sen. Orrin Hatch of Utah, who says Bush is being pennywise and pound foolish not to help kids. But the president has a remarkable ability to ignore facts, whether on the streets of Baghdad or in the clinics of Salinas. He wants to augment the program by only $5 billion over five years, not nearly enough to keep up with rising costs. If he prevails, fewer kids — not more — will be covered by insurance.
Fortunately, Congressional Democrats are calling his bluff. The Senate would increase funding by $35 billion, enough to add about 3.3 million children to the 6.6 million currently on the rolls. The House measure is even more ambitious, adding $50 billion and covering 2 million kids above the Senate numbers.
Both bills would finance the cost by raising the tobacco tax — a brilliant idea, since smoking cigarettes, like eating Big Macs, pushes up long-term health care bills. (The House would find additional cash by cutting payments to managed care companies under Medicare.)
The White House keeps frantically searching for a plausible reason to justify a veto. One argument is ideological: The bills raise taxes and taxes are bad. But that ignores the point made by Hatch and Romero — that in the long run, preventive care is an investment that saves money. It also ignores the point that Bush himself has made higher taxes necessary by squandering $200 billion a year in Iraq.
Since they cannot directly attack a program that helps children, opponents are pulling out a whole closet full of scary monsters. The Democratic bills are another version of "Hillary care," a step toward "socialized medicine," an attempt to "squeeze tax dollars out of Americans" to subsidize illegal aliens.
Some Democrats certainly would like to build on the success of SCHIP and move toward a system of universal health care. But that's not the issue this year. And in any case, this is an insurance program, financed by the public but managed by private companies. There's nothing "socialist" about it.
Lawmakers should produce a reasonable bill that focuses on poor families, and the president should sign it. If Bush stays stubborn and exercises his veto, they should, for the first time, override him. The kids in Pablo Romero's clinic are counting on Congress.
Steve Roberts' latest book is "My Fathers' Houses: Memoir of a Family" (William Morrow, 2005). Steve and Cokie Roberts can be contacted by e-mail at firstname.lastname@example.org.
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