The president’s ardent (and purely ideological) opposition to expanding S-CHIP to include more middle-class children has been getting more and more attention, slowly but surely. As Brian Beutler noted, Paul Krugman tackles the issue today, and in the process, distills conservatism into two paragraphs.
[W]hy should Mr. Bush fear that insuring uninsured children would lead to a further “federalization” of health care, even though nothing like that is actually in either the Senate plan or the House plan? It’s not because he thinks the plans wouldn’t work. It’s because he’s afraid that they would. That is, he fears that voters, having seen how the government can help children, would ask why it can’t do the same for adults.
And there you have the core of Mr. Bush’s philosophy. He wants the public to believe that government is always the problem, never the solution. But it’s hard to convince people that government is always bad when they see it doing good things. So his philosophy says that the government must be prevented from solving problems, even if it can. In fact, the more good a proposed government program would do, the more fiercely it must be opposed.
He shoots, he scores. The proposed S-CHIP expansion is specifically targeted at children in middle-class families. Bush resisted the healthcare program in Texas even when it was geared towards low-income kids, but the current fight represents an even greater challenge to his philosophy.
Why? Because as Brian explained, “The fear for conservatives is that it’ll work so well that people will begin to realize that it might be worth paying for broader reforms with broader taxes, and so would blossom a vastly improved health care system in this country at the expense of a few very powerful interests.”
And we really can’t have that.
Matt Yglesias, meanwhile, adds an important angle.
Unfortunately, the public opinion data does tend to suggest that Bush’s staggering achievements in the field of maladministration have, in fact, boosted public skepticism of government capacity to do anything at all to some extent.
One way of thinking about what the country’s experienced since the fall of 2001 is just large-scale consequences of perverse incentives. We have a president whose ideological goals on the domestic front are, on some level, advanced every time he screws up, with his own failures, his own corruption, providing evidence for the correctness of his ideology.
I think that’s partly true. Thanks to the Bush administration’s spectacular incompetence, Americans probably have a lot less confidence in their government than before 2001. It feeds into Mitt Romney’s argument from last week: “I don’t want the guys who ran the Katrina cleanup running my health care system.”
But I’d add that public skepticism is hampered by an enormous desire for a larger government role in the healthcare system. In March 2006 (seven months after the Katrina disaster), a poll conducted by the Princeton Survey Research Associates for the Pew Research Center for the People and the Press found that 70% of Americans think the government spends too little on health care. Asked if they thought the average American spends too much, too little or the right amount on health care, respondents came to largely the same conclusion — 65% said people spend too much.
In other words, despite Bush’s efforts to undermine public confidence in government, Americans still want the state to spend more (and for families to spend less) on healthcare. People aren’t worried about philosophy; they’re worried about access to quality care.
And getting back to Krugman’s original point, that’s especially true when it comes to children.
According to a recent Georgetown University poll, 9 in 10 Americans — including 83 percent of self-identified Republicans — support an expansion of the children’s health insurance program.
There is, it seems, more basic decency in the hearts of Americans than is dreamt of in Mr. Bush’s philosophy.
Congress is scheduled to vote on S-CHIP this week. Stay tuned.