Indigenous Peoples Day
Entitled to an Opinion

"Compassionate Conservatism" and the "Undeserving Poor"

On Wednesday October 3, President George W. Bush vetoed a bill that allocated $35 billion over the next five years to expand the number of children eligible for the successful and popular State Children’s Health Insurance Program (SCHIP) which presently provides the only access to medical care for 6.6 million of the nation’s poorest children. Both houses of Congress approved a bill late this September that would have added at least another 3.4 million children to the program, significantly reducing the number of children who presently have no medical coverage. The President’s veto threatens the survival of the program, as the legislation that originally created SCHIP has come due for reauthorization. If the veto is sustained, children currently covered under the program will once again be without insurance, and the number of children in the U.S. without access to a physician’s care and to vital medicines will continue to grow.

Conservative Republicans echo the President’s reasons for rejecting the bill—that it is a step toward federalizing the U.S. health care system, and that it offers coverage to children of working families who can afford to pay for their health care. Some Congressional Republicans have even condemned the bill for allegedly providing aid to the children of “illegal” immigrants. But moderate Republicans, especially those facing close races in 2008, are openly questioning the wisdom of the veto. Nineteen Republican Senators  voted for the bill, opening up the possibility that, in the Senate at least, there may be a chance of overriding the President. It will be a tougher fight in the House: though the bill passed with a 106 vote margin, that is still short of the 2/3 majority needed to push past the President’s veto. Still, the veto is vulnerable. At a time when a majority of voters list rising health care costs as one of their key concerns in the coming election—and rightly so since more than half of those filing for bankruptcy in the past few years have listed medical expenses as the cause—some Republican lawmakers worry that voting against health insurance for children damages the credibility of their Party. They fear, as Democrats hope, that this veto will strip the last shreds of popular support from the increasingly threadbare rhetoric of “compassionate conservatism.” Such fears moved key Republican power brokers, including Utah Senator Orrin Hatch, to break with the president on this bill. “It’s unfortunate,” Hatch told CNN on the day of the veto, “that the president has chosen to be on what, to me, is clearly the wrong side of this issue.”

40 years ago, President Lyndon Johnson made expanding health care coverage in the U.S. a priority—pushing Medicare for the elderly, Medicaid for poor families, early medical screening and treatment for poor children, and community health center legislation through Congress. Using these federal program dollars, a group of hotel maids, welfare mothers, and waitresses in Las Vegas opened their neighborhood’s first health facility. Among the children they screened and treated, fewer than half had ever seen a dentist or an eye doctor. In this neighborhood and many other poor communities across the country, federally funded health care programs dramatically improved the health and quality of life, even the life expectancy of millions of poor Americans. Republican as well as Democratic legislators were forced to admit that federally administered health care programs might not be such a bad idea after all.

The U.S. ranks 37th in the world in infant mortality rates. One in five U.S. jobs does not provide health insurance, a pension, or wages high enough to support a family. For a family of four, one year of health insurance costs an average of $11,000. These facts beg the question of whether low-income working families can, in fact, afford private health care plans, as the president insists, and whether we as a nation can afford not to use the power of the federal government to expand health coverage for all Americans. With the president asking Congress for $190 billion next year to pay for the war in Iraq, it’s difficult not to see a $7 billion annual price tag for children’s health care as the best bargain in Washington.

Annelise Orleck is professor of history and women's and gender studies at Dartmouth College. She is the author of Storming Caesars Palace: How Black Mothers Fought Their Own War on Poverty, Common Sense and a Little Fire, and The Soviet Jewish Americans and coeditor of The Politics of Motherhood.