Little media attention has
been paid to the fact that the same Clinton health plan that
Americans resoundingly rejected in 1994 is being implemented for
children. Efforts to establish government health care programs are
stronger than ever; they are just not as obvious and are occuring
with little or no public debate. Reporters should start paying
attention to this important trend.
The Clinton Health Care
Task Force documents — made public through court order — reveal that
a "Kids First" approach would be used as the first step to phase in
the full Clinton-style health care plan if the original plan failed.
Today, the "Kids First" strategy is working:
government Medicaid program, which provides medical assistance to
low-income families, is rapidly evolving into a middle-class
entitlement program that could soon replace private insurance for
our nation’s children. Forty states have already expanded Medicaid
beyond the federally established mandate. In fact, some states have
offered Medicaid to families with incomes three to four times the
poverty level and some do not require an asset test to determine
Medicaid eligibility. Today, one-quarter of America’s children
already participate in Medicaid.
Care. School clinics have long delivered first-aid and emergency
care, but lately they have expanded their missions, adding a broad
array of services such as psychological and reproductive counseling.
In 1985, there were only
about 40 school-based health centers operating in the United States.
By 1993, 40 states used federal block grant funds or state general
funds to support school-based health clinics, according to a Robert
Wood Johnson Foundation survey. Today, there are over 900 hundred
school-based health centers operating in all but seven states. In
fact, over half of all states have established mechanisms that
permit them to deliver health care services in public schools
financed by Medicaid.
SCHIP. Under the new
State Children’s Health Insurance Program (SCHIP), states have
several options for spending the new federal health care dollars.
Thirty-nine states will likely include Medicaid expansions to cover
uninsured children. Some states are using tax dollars to lure
families into government-sponsored health care in an effort to
promote an agenda of universal health care for children, with little
or no public debate.
It is not difficult to
envision how a children’s health care system, delivered through the
public school system and/or through Medicaid, could serve as a
precursor to nationalized health care.
While efforts to expand
health care access and affordability for children may be well
intentioned, this current trend could have serious unintended
consequences. Such expanded government health care programs could
encourage families to drop their private health insurance, reduce
health care choices, infringe upon parental rights, and threaten
medical privacy. School-based health centers give public schools
broad responsibility and latitude regarding medical treatment and
psychological and reproductive counseling of children — trumping
this parental responsibility.
Another concern with
school-based health care is the lack of health privacy. In many
cases, children are subjected to intrusive physical exams and
psychological testing without parental consent. Psychological
testing information and records can then be shared between state
government agencies, again without parental consent.
While Americans agree that
children should have access to quality health care, few believe the
federal government should be most responsible for providing that
care. In fact, more than half believe the responsibility for health
care rests with the children's parents. Yet the first major steps
toward Clinton-style universal health care for children have already
been taken and they could rapidly evolve into a government-mandated
program for all children in the U.S.
The framework for
socialized medicine for children is becoming entrenched across the
nation. Although efforts to pass a large-scale version of socialized
medicine failed in 1994, the "Kids First" back-up plan is
successfully being implemented at the federal and state levels.
Medicaid expansions, school-based health care, and SCHIP have
enormous potential to force all American children into government
health care. Reporters should make sure Americans know about and can
debate government’s role in providing health care to children before
all are forced under a single, government health care roof.
Naomi Lopez is director
of health and welfare studies at the Pacific Research Institute in
San Francisco, California and author of the Institute for Health
Freedom's recent study, Are American Children Being Lured Into