My Two Cents on SCHIP

My family has never qualified for SCHIP, because our income is higher than 200% of the local poverty level. We might qualify if we lived elsewhere, because our city has such an astonishing amount of the population living in extreme poverty, but we've always managed okay without it.

I don't think people realize the absolute life and death importance of SCHIP to kids much like my own. When Susan's health was most unstable, our out of pocket medical care costs approached $1000 a month. That's after private insurance - very decent private insurance compared to most - had already paid out for what was covered. We managed with help from family, and by taking out some stunningly large mortgages on our house. I ordered formula and supplies from eBay to save some money. Whenever Susan saw a doctor, I would load up a bag with free samples. There were certainly times that I mentally justified the cost of the co-pay to see the doctor with the value of the free formula I could get.

Now, we're middle class people. We're better of than most. Even after I had to quit my job to care for Susan, I was able to continue working on a freelance basis for my former employer. That income made a huge difference. Because we were educated and had internet access, I could spend hours online researching less expensive resources. I could fight with the insurance company to maximize coverage. But what do you suppose happens to kids whose parents don't have the resources we have? I'll tell you:

Sometimes their parent will quit his or her job so that the family qualifies for Medicaid.

Sometimes their parents divorce so that a single parent can qualify for Medicaid.

Sometimes the child will be placed into a residential facility, a nursing home, because then he or she could qualify independently for Medicaid.

And sometimes, the child just dies.

Isn't it strange that impoverished families often get better health care than working class families? It takes very little income to disqualify a family from Medicaid coverage. Medicaid covers consumable supplies, hypoallergenic formulas, sometimes even in-home nursing for severely ill people. Private insurance rarely covers any of those things, and let's face it, fewer and fewer working class people have any insurance at all.

Susan received monthly injections to prevent RSV, a severe respiratory virus, each winter until she turned three. Those injections cost our insurance company $2200 a month. That's one shot, once a month, for five months a year - $11,000 a year. I do not doubt that those injections kept her out of the hospital those winters. She had some severe colds, but no major viral infections. For healthy kids, RSV isn't that big of a deal, but for those with weak immune systems it can trigger a fatal series of infections.

Medicaid usually covers that shot for preemies their first two winters, if the family meets the income guidelines. But a working class family, ineligible for Medicaid but without very good private insurance, would be on their own. Those families are put into the position of making a cost-benefit analysis on potentially life-saving health care. I've known some who could not afford it who essentially quarantined their child through the entire cold and flu season. These children, and their primary caregivers, are basically imprisoned for months every year, because they can't afford a single shot per month.

Is this really the best we can do as a nation? Is THIS the best medical care the world has to offer?

SCHIP fills the gap between Medicaid and private insurance for thousands of working-class families. These are folks doing what they're supposed to do: contributing to the economy, paying their taxes, and trying their best to take care of their kids. Cancelling SCHIP won't save the government any money: it will just force more families into poverty, when they'll qualify for Medicaid and other social services as well. It certainly won't improve medical care: it will just force parents to postpone seeking medical care until a child is so ill they will require hospitalization or institutionalization, at which point Medicaid will pick up the tab.

The sole function of eliminating this program is to make a political point: that certain politicians don't think the government should be involved with health care. So why make kids the political football? Why not cancel the new Medicare Drug program? Well, people on Medicare can vote. Kids can't, and the parents of sick kids are too overwhelmed and broke to put up that much of a fight.

The entire argument against "socialized medicine" - a Republican's bogeyman - is premised on the outdated idea that most people have a family doctor on whom they can rely for primary care. That might have been true forty or fifty years ago, but with more people living in urban areas, and with the increasing specialization of medicine, the family doctor is an anachronism. If my kid needs to see a developmental endocrinologist, or nutritional gastroenterologist, do you really think I have a choice of who to see, or even if I did that I would have any way of making that decision. I go to who the insurance company tells me to go to.

Our current system gives to private insurance companies every single power that opponents of "socialized medicine" decry. The only difference is that instead of a government bureaucracy making health care decisions, you have a private bureaucracy making health care decisions - and the private bureaucracy exists to maximize profits, not health. Long waits to see a specialist? It takes us months to see a G.I., even if Susan is seriously ill. I've yet to meet a Canadian or Brit who would trade our health care systems for a single day.

While we've not had to take dramatic measures to pay for Susan's health care (if you don't consider debt too dramatic), it's certainly an ever-present issue in our lives. Susan's dad would probably have changed jobs if we weren't too scared to disrupt our health insurance. No insurance company would cover Susan if they weren't required by a group coverage agreement, and there's no telling that a future employer would offer a decent group plan.

I hadn't meant to ramble so long about this, but I am very worried about what kind of nation we have become if we can turn our collective backs on sick kids just to make a political point and pander to an ideological minority. This is America, dammit. We're better than this.