An article in yesterday’s New York Times chronicles the battle over expanding the State Children’s Health Insurance Program. Doctors, consumer groups, many state officials, and a broad bipartisan coalition in Congress want to see more children covered under SCHIP. Meanwhile the Bush administration stands staunchly opposed to the program’s expansion, deriding it as a step towards government-run healthcare, which some believe will be costly and add unnecessary bureaucracy.

But Yale senior Robert Nelb has a plan for SCHIP that will both reduce bureaucracy and significantly improve access to care for the nine million uninsured children in the U.S. Nelb will present his proposal, “Tax-based Automatic Enrollment in SCHIP,” at the Roosevelt Instution Policy Expo this Friday in D.C. By using tax return information to automatically enroll children in SCHIP, Nelb’s proposal will help more than six million uninsured children who are eligible but not enrolled in the program have access to health care.
 
In related news, my great state of Pennsylvania finds itself on the front of the Times today in a story about Gov. Ed Rendell’s efforts to cover the 900,000 Pennsylvanians who are without health insurance. The Times paints a great story of how Rendell (described as “an unapologetic big-city liberal”…that’s my mayor!) and other governors are crusading to make health care more affordable and extend coverage, but in doing so are running up against political barriers.
 
Nelb, a fellow Pennsylvanian, recently commented that since enacting system-wide change requires so many different interests to compromise, politicians “often resort to mere band-aids that don’t address the underlying problems.”

They [politicians] have created free-care pools for the uninsured, but haven’t done enough to prevent the uninsured from showing up at the emergency room in the first place. They’ve developed a Medicare Part D benefit to pay for some prescription drugs, but they’ve done little to reduce the high prices charged by pharmaceutical companies. They’ve offered health savings accounts to increase access, but they’ve simply shifted the burden of care onto the consumer. As a result, the problems of cost and access are only getting worse. At the current rates of increase, US health care expenditures will almost double to 4.1 trillion dollars in the next ten years. We can not afford to avoid this problem any longer.

Well put, Mr. Nelb. But judging from the current political atmosphere in Harrisburg –where the best Rendell can hope for is to “hold his nose” and sign a compromise bill – and in Washington – where Bush is set on blocking any efforts to expand coverage for children – there isn’t much hope in sight.