Anecdotes Won’t Keep America’s Kids Healthy

Opinion

By Noam Neusner

Published October 03, 2007, issue of October 05, 2007.
  • Print
  • Share Share

In the ongoing debate over expansion of the federal children’s health insurance program — a debate over whether an extra $5 billion or $35 billion is enough to meet the health needs of America’s poor or near-poor kids — the Democrats have a decided advantage: They own the anecdote.

In their press conferences, they can trot out young children of struggling families who, by virtue of a rule set by politicians before they were born, do not qualify for publicly paid health insurance.

On stage, it’s a simple formula: If the Democrats get their bill, this kid gets insurance. If they don’t, the kid, usually with some chronic sickness, doesn’t get health care. And when the kid is standing right there, it’s a pretty devastating message.

You’re probably wondering: On the basis of this one kid, should we spend an extra $30 billion? But in American politics, the answer is almost always yes — even if the results are less than impressive. I know, because I’ve seen it up close.

In late 2003, I was a speechwriter for President Bush and was tasked with coming up with some kind of way to sell his proposal for a drug benefit add-on to Medicare. I would’ve liked to have had the president talk about the importance of overall reform in Medicare, using the introduction of the drug benefit to bring real money-saving changes to a system well on its way to bankruptcy.

But it wouldn’t have worked — nobody likes to hear such a downer.

So instead, we decided to tout the sugar, and virtually ignore the spinach. In town after town, we would find a handful of seniors who lacked drug coverage and who stood to benefit from the president’s proposal, and inserted them into the president’s speeches and public events.

So while the Democrats sputtered about the inadequacy of the coverage, we kept rolling out seniors who were paying punishing monthly bills for drugs. We owned the anecdote; the Democrats owned the “yes, but.” We didn’t get the money-saving reforms we hoped for, but we got a major legislative victory — or at last it seemed so at the time.

And so it will be with the debate over the State Children’s Health Insurance Program, the children’s health care plan known as S-CHIP. The Democrats have owned the issue because, quite simply, they promise to cover kids who would otherwise not get coverage at all.

The president would increase the program by 20%; the Democrats would raise it by $35 billion, or 140%, from current levels (and quite likely more, once you strip away budgetary gimmicks). The president’s proposal would cover all children living in households with incomes twice the poverty level, which stands at about $20,000; the Democrats would cover all children living in households with incomes three times the poverty level (and even higher in New York and New Jersey, where a family earning $83,000 a year could be eligible).

Do these differences matter, beyond creating a whole group of anecdotal children who are poster kids for a Democratic victory? Absolutely.

The extra money would have huge impacts on private health insurance markets, incentives for businesses to accelerate the trend of dropping private health coverage, future budget deficits, and so on. Those are all serious issues, and it would be good to heed them.

But for now, the only thing that matters is the anecdote. So the Democrats will very likely win this round.

But the Democrats should be forewarned: Their victory may be short-lived. When you win policy battles by anecdote, you can lose them by anecdote, too. Once the Medicare drug benefit went into effect, the anecdote of the cash-strapped senior desperate for help with drug costs turned into the anecdote of the confused senior upset with the premiums for that drug coverage.

Ultimately, policy does matter, and eventually, the voters do notice. In the case of children’s health insurance, if 3 million families choose federal-paid coverage over business-paid, voters will notice. If the deficit is even bigger and taxes even higher, they’ll notice.

If childless adults get coverage under this “children’s health” program, people will notice. And if the rate of uninsurance among children, especially the poorest kids, remains stubbornly high, people will wonder what all that money was spent on.

And in will roll the anecdotes — of the free-loaders, the bureaucratic snafus, the children still denied coverage, and the childless adults getting free coverage.

The anecdotes will be there, and there will be a Republican ready to exploit them. It may not happen next year, but it will happen — because when you live by the anecdote, you die by it as well.

Noam Neusner was President Bush’s principal economic and domestic policy speechwriter from 2002 to 2004.


The Jewish Daily Forward welcomes reader comments in order to promote thoughtful discussion on issues of importance to the Jewish community. In the interest of maintaining a civil forum, The Jewish Daily Forwardrequires that all commenters be appropriately respectful toward our writers, other commenters and the subjects of the articles. Vigorous debate and reasoned critique are welcome; name-calling and personal invective are not. While we generally do not seek to edit or actively moderate comments, our spam filter prevents most links and certain key words from being posted and The Jewish Daily Forward reserves the right to remove comments for any reason.





Find us on Facebook!
  • "I’ve never bought illegal drugs, but I imagine a small-time drug deal to feel a bit like buying hummus underground in Brooklyn."
  • We try to show things that get less exposed to the public here. We don’t look to document things that are nice or that people would like. We don’t try to show this place as a beautiful place.”
  • A new Gallup poll shows that only 25% of Americans under 35 support the war in #Gaza. Does this statistic worry you?
  • “You will stomp us into the dirt,” is how her mother responded to Anya Ulinich’s new tragicomic graphic novel. Paul Berger has a more open view of ‘Lena Finkle’s Magic Barrel." What do you think?
  • PHOTOS: Hundreds of protesters marched through lower Manhattan yesterday demanding an end to American support for Israel’s operation in #Gaza.
  • Does #Hamas have to lose for there to be peace? Read the latest analysis by J.J. Goldberg.
  • This is what the rockets over Israel and Gaza look like from space:
  • "Israel should not let captives languish or corpses rot. It should do everything in its power to recover people and bodies. Jewish law places a premium on pidyon shvuyim, “the redemption of captives,” and proper burial. But not when the price will lead to more death and more kidnappings." Do you agree?
  • Slate.com's Allison Benedikt wrote that Taglit-Birthright Israel is partly to blame for the death of American IDF volunteer Max Steinberg. This is why she's wrong:
  • Israeli soldiers want you to buy them socks. And snacks. And backpacks. And underwear. And pizza. So claim dozens of fundraising campaigns launched by American Jewish and Israeli charities since the start of the current wave of crisis and conflict in Israel and Gaza.
  • The sign reads: “Dogs are allowed in this establishment but Zionists are not under any circumstances.”
  • Is Twitter Israel's new worst enemy?
  • More than 50 former Israeli soldiers have refused to serve in the current ground operation in #Gaza.
  • "My wife and I are both half-Jewish. Both of us very much felt and feel American first and Jewish second. We are currently debating whether we should send our daughter to a Jewish pre-K and kindergarten program or to a public one. Pros? Give her a Jewish community and identity that she could build on throughout her life. Cons? Costs a lot of money; She will enter school with the idea that being Jewish makes her different somehow instead of something that you do after or in addition to regular school. Maybe a Shabbat sing-along would be enough?"
  • Undeterred by the conflict, 24 Jews participated in the first ever Jewish National Fund— JDate singles trip to Israel. Translation: Jews age 30 to 45 travelled to Israel to get it on in the sun, with a side of hummus.
  • from-cache

Would you like to receive updates about new stories?




















We will not share your e-mail address or other personal information.

Already subscribed? Manage your subscription.