George W. Bush doesn't want you to think of a sick child. Not Graeme Frost. Not Gemma Frost. Not Bethany Wilkerson. Not any of the real children affected.
He wants you straining your eyes on the fine print of policies, puzzling over the nuances of coverage -- whether you can afford premiums for basic, catastrophic, comprehensive or limited health insurance. Last week on "Real Time With Bill Maher," even Tucker Carlson kind of got it right, saying, "No one child is a metaphor -- he's a kid!" That's the point. They're all kids, each one, one by one. The question is, do you care?
The actuaries don't. And can't. Health insurance companies make their money by denying care. They maximize profit by authorizing as little care as they can get away with. That's what all those administrative costs -- as high as 30 percent -- and all that paperwork are mostly about. It takes a lot of people to justify denying care.
It's the opposite of the way the market is supposed to work: Make more money by delivering more product. The health insurance industry makes more money by delivering less product. It maximizes profits by minimizing care.
Profit-run medicine is not, and cannot be, full care. What is needed is patient- and doctor-run medicine. The State Children's Health Insurance Program (SCHIP) is just that. Our children need care. Our doctors provide it. The government handles the transactions, period. And we pay a lot less and get a lot more, because there are virtually no administrative costs and no profits being taken by outsiders.
Profit-maximizing insurance, as opposed to doctor-provided care, forces the nation to choose among its children: who will get care and who won't, who will suffer and who won't, who will live and who will die.
Bush and his conservative allies don't want us to see sick children, just as they don't want us to see those bodies in bags coming back from Iraq. They're in the habit of sweeping our human casualties under the rug.
But Americans are a compassionate people. We do care about sick children. We do care about our dead and wounded vets and their families. We do care about victims of Hurricane Katrina. Empathy and compassion are what this country is about. America is about caring for one another, about being in the same boat, about being a national family. It is not about profiting from someone else's suffering, especially if that someone else is a child.
Government in America has a sacred moral mission to protect us, its citizens. Protection means more than the military and the police. It means worker protection, consumer protection, environmental protection and Social Security. And it means health security.
President Bush warns us against "government-run" healthcare, which is anything but government run. In SCHIP, the government doesn't deliver care, it enables it. It directs payments. Bush wants to leave the nation's children -- and the rest of us -- to the mercy of profit-run healthcare. The reason we need SCHIP is that profit-run healthcare has failed.
When children in your family fall sick, you don't look away. You make sure they are cared for and get better. That's the way the American family should also work.
George Lakoff and Glenn W. Smith are senior fellows at the Rockridge Institute in Berkeley, Calif.
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