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From the June 1997 MediaNomics

Guest Editorial, by Sue A. Blevins

Tell the Truth: It's a New Entitlement

Ever wonder how supporters of socialized medicine got most seniors to give up their private health insurance and join Medicare in 1965? They did it by adopting an "incremental" strategy -- the same strategy that is being used to establish government health care for children. First, they argued that seniors were paying too much out-of-pocket for their health care.

Next, they promised that Medicare would save the country money by guaranteeing health care for all seniors at a cost of only one percent of workers' payroll. However, after Medicare was passed, the federal government garnered enough muscle power to force private insurers to drop seniors. The same thing could happen to children if KidCare passes. That is why the media should cover these four important issues related to KidCare:

Paving the road to socialized medicine. Documents from the Clinton health care task force show that "KiddieCare" was to be the backup plan in case the larger Clinton plan failed. "The [Clinton Health Care] Task Force envisioned that the national version [of health care] would be implemented by January 1, 1995, with phase-in by population, starting with children, and universal coverage achieved by January 1, 2000," reports the Association of American Physicians and Surgeons.

Ironically, the Clinton administration failed to implement its large-scale version of socialized medicine while the Democrats led Congress, but with the Republicans in charge, Congress is going to pass a scaled-down version of ClintonCare.

A brilliant political strategy. How is it that moderate Republicans would support KidCare legislation? They know that Americans don't want socialized medicine, or any new entitlement program for that matter. It seems they are merely caving into the Democrats' political strategy, which goes something like this: "Let's propose to fund children's health care with cigarette taxes. Then, if Republicans oppose KidCare, we'll charge that they don't care about children, and the only reason Republicans oppose KidCare is that the party gets money from the tobacco industry." This is brilliant political strategy. Yet, the consequences will affect all taxpayers. Reporters should go beyond the strategy and report the likely outcome.

Another entitlement program. Supporters of KidCare stress that funding children's health care with cigarette taxes does not constitute a new entitlement program. But that claim is misleading. Any promise to pay for children's health care with cigarette taxes is certain to become an entitlement program. Here is why: A recent study by the National Center for Policy Analysis (NCPA) reports that the number of smokers is sure to drop it has for the last 30 years.

In fact, the share of Americans age 18 and over who smoke has dropped from 42.3 percent in 1965 to 25 percent in 1993. Clearly, that's good news for Americans' health, but it also means that any proposal to pay for children's health care with cigarette taxes would be making a false promise to children. The government cannot guarantee an adequate supply of smokers over the years to pay for a children's health care program. In the end, all taxpayers, not just smokers, would foot the bill. Reporters shouldn't keep this from their readers and viewers.

Tobacco taxes are unfair. Tobacco-funded KidCare policies discriminate against low-income and minority populations. The NCPA study highlights these three facts about smokers:

  1. Today, smokers are more likely to be blue-collar workers, have less than a high-school education, and be black, American Indian, or Alaska Native.

  2. Families making less than $30,000 per year pay more than half of all taxes paid on cigarettes.

  3. Through combined federal and state taxes on cigarettes, smokers already pay enough taxes to cover the net costs they impose on society.

For those reasons, cigarette taxes are one of the most regressive taxes even more regressive than taxes on beer, wine, or gasoline. Thus, is it fair to make minority populations pay higher taxes, when they are already paying for their smoking- related costs to society?

Today's politicians understand the difficulty in rolling back entitlement programs once they've been created. Democrats and Republicans alike find it very difficult to reduce the rate of growth of Medicare. And neither party has developed a long-term strategy for financing the $200 billion-a-year Medicare program for seniors.

So why in the world, at this point in history, would politicians want to create an entitlement program for America's children? Politics, not sound economic policy, is the only answer. Journalists should include in their stories about KidCare those who object to this plan and fear it could take us down the road to socialized medicine.

Sue A. Blevins is president of the Washington-based Institute for Health Freedom.

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