Or so say I, in today’s Dallas Morning News.

Here I am asking a few in the Orange County Register.

Democracy NOW! quotes New York Times columnist Paul Krugman on the State Children’s Health Insurance Program:

the reason that Bush and much of the Republican leadership is so hostile to S‑CHIP is not because they think it’s a bad program, but because they think it’s a good program, and that terrifies them. What bothers them so much is the fact that it works.

Why does Krugman think that SCHIP “works”? There is no evidence that the program is a cost-effective way of improving child health. It makes health care more expensive for those outside the program. It does not address the systemic problems that lead to low-quality pediatric care. It reduces the benefits of education and work effort, trapping families in low-wage jobs. It covers four uninsured children for the price of ten …

Krugman is an economist. Has he thought about these issues? Has he read any of this literature? What about this program “works”?

It’s easy to dismiss right-wing hacks. These issues … not so easy to dismiss.

I like to open with this: “If your goal is to improve the health of low-income children, the State Children’s Health Insurance Program is a bad tool for achieving that goal.”

Then I make as many of the following points as possible.

1. SCHIP does a bad job of targeting assistance. About 60 percent of children currently eligible for SCHIP already have private health insurance, while 77 percent of those targeted by this expansion (i.e., children between 200–300 percent of the federal poverty level) already have private health insurance.
2. SCHIP covers four uninsured children for the price of ten. Economists Jonathan Gruber and Kosali Simon estimate that, in effect, 60 percent of children covered by SCHIP expansions already had private coverage.
3. There is no evidence that SCHIP is the best way to improve the health of targeted children. Economists have found no evidence that SCHIP is a cost-effective way of improving health. Discrete health programs or policies that improve incomes or education could deliver as much or more health for the money.
4. SCHIP discourages families from climbing the economic ladder. If a single mother of two earning minimum wage in New Mexico increases her annual earnings by $30,000, she pays an additional $4,000 in taxes and loses $26,000 in SCHIP and other government benefits. In other words, her net income would not change, therefore she has no financial incentive to climb the economic ladder. Expanding SCHIP would put downward pressure on even more families’ incomes, which could harm child health.
5. Like Medicaid, SCHIP makes private coverage less affordable for people outside the program. Under Medicaid (and therefore SCHIP) rules, the government agrees to pay a percentage of what drug makers charge private payers. Economists have found that manufacturers respond by raising prices for private purchasers an estimated 15 percent.
6. SCHIP would do nothing to address systemic quality problems. According to a recent study in the New England Journal of Medicine, “Expansion of access to care through insurance coverage, which is the focus of national health care policy related to children, will not, by itself, eliminate the deficits in the quality of care.”
7. SCHIP’s self-interested advocates. Why do you suppose the physician, pharmaceutical, and health insurance lobbies are agitating for health care subsidies that lack any evidence of cost-effectiveness?
8. This SCHIP expansion taxes the poor to benefit the middle class. Isn’t that just cruel?
9. Eliminating SCHIP and letting people purchase coverage from out-of-state is a better alternative. The latter would enable families to avoid unnecessary regulatory costs, which the Congressional Budget Office puts at about 15 percent of health premiums. That would benefit SCHIP-targeted families most of all. And it would do so without raising anyone’s taxes, showering subsidies on non-needy families, pulling families into a low-wage trap, or increasing the cost of private insurance. As for eliminating SCHIP, when Congress cut non-citizen immigrants from the Medicaid rolls, contrary to all predictions the number of uninsured non-citizen immigrants actually fell. Why wouldn’t SCHIP families, who are more affluent, fare even better?

Then I like to close with this: “If you’re not interested in the best way to promote child health, not interested in targeting government assistance to the needy, and not concerned about trapping families in low-wage jobs…exactly what is it you are hoping to accomplish?”

Here [audio file] is what happened after I made just a few of these points to left-wing talk show hostess (and frequent Alan Colmes stand-in) Leslie Marshall.

National Review Online’s Health Care Week is in full swing. The site features a week’s worth of essays on how conservatives should approach health care.

My contribution offers friendly advice about how conservatives can avoid abetting the Left as well as the special interests who profit from the creeping socialization of American health care:

Health care is a tough issue for conservatives only because they have strayed from their free-market principles. When conservatives return to those principles, health care will again become a tough issue for the Left.

It was the most fun I’ve had with an oped in a while. Read the whole thing here.

The Rev. Robert A. Sirico is a Catholic priest, as well as president and co-founder of the Acton Institute for the Study of Religion and Liberty. In today’s Detroit News, he weighs in on the debate over the State Children’s Health Insurance Program:

The Catholic Health Association has blasted President Bush for vetoing a program called SCHIP, the State Children’s Health Insurance Program. How can anyone be against the health of children?

Well, public policy is more complicated than that. When the state gets involved in public health, there are unintended consequences. In fact, there is enough wrong with this program to make it possible to oppose SCHIP in good conscience…

There is not a living soul who would not wish that every person, especially every child, would have access to perfect medical care. But the essential condition for universal coverage is universal prosperity, and the only means available to create that is a flourishing and free economy — a condition that programs like SCHIP help to undermine…

It is folly to seek short-term gains at the expense of long-term economic development. Eliminating taxes and regulations that hinder private industry will make greater strides toward universal coverage than any state program can or will…

What I fear most is that politicians use legitimate issues to gather more power unto themselves and their friends in government. The population becomes more dependent on the public sector and less reliant on the sectors over which they exercise real control.

Amen to that. Now how do we get the Catholic hospitals to stop taking Caesar’s coin?

The New York Times reports:

Death rates from cancer have been dropping by an average of 2.1 percent a year recently in the United States, a near doubling of decreases that began in 1993, researchers are reporting.

“Every 1 percent is 5,000 people who aren’t dying,” said Dr. Richard L. Schilsky, a professor of medicine at the University of Chicago and president-elect of the American Society of Clinical Oncology. “That’s a huge sense of progress at this point.”

I’ve complained in the past that good news like this gets buried or ignored, while even minor bits of bad news make the front pages. In this case the good news was bannered on the front page of USA Today and was the lead story on the CBS Radio News. (It was on page A18 of the Times, but teased on page 1.)

The Times did manage to find the cloud in the silver lining: As is universally the case in all human affairs, the decline is not uniform across all demographic groups. In particular, groups who still have high rates of smoking are not seeing cancer declines as large as other groups. But the news still fits the message of Indur Goklany’s book, The Improving State of the World: Why We’re Living Longer, Healthier, More Comfortable Lives on a Cleaner Planet