TCS Daily

A Moral Case Against SCHIP Expansion

By Max Borders - October 31, 2007 12:00 AM

When it comes to SCHIP, even some on the right have lost their moral compass - having fallen victim, perhaps, to the notion that if it involves "the children" then they should abandon both principle and common sense. But with the left's attempt to expand medical entitlement benefits to the middle class, this is no time for compromise. For even compromise will work toward their ultimate goal of incrementally socializing healthcare.

Most opponents of SCHIP expansion have been mired in the pragmatics of politics, the minutiae of markets, or the defensive posturing that comes when engaging a majority power that uses moralistic soundbites like daisycutters. What we have failed to realize, however, is that we have the moral case. Allow me to explain.

Intentions and Actions

Mens Rea is the term folks in criminal law use when talking about the intention behind a criminal act. In other words, the act alone does not make a person guilty; he must also have a "guilty mind." So, for example, if Vice President Cheney had accidentally killed his friend in a hunting accident (rather than merely wounding him), we certainly wouldn't say he is a murderer. We would have to show that Cheney had some motive, or possess some evidence that he was acting with malice.

Can't something similar be said about a good act? That is, an act of kindness, benevolence, or charity? Is someone doing a moral good if there is no intention to do good behind the act—i.e. a "good mind"? Most reasonable people would say no. If a five-dollar bill falls out of my pocket into the hands of a beggar as I dig for my transit card, I haven't done anything good. If someone points a gun at me, takes the five, and gives it to the beggar, I still haven't satisfied any moral obligation I may have to the poor (much less the middle class). And that's precisely why we should be suspicious of any claim that "we" or "society" has a moral obligation to provide healthcare for the middle class.

Not only is the government not society, but society is merely an agglomeration of individuals. Societies cannot have moral obligations any more than they can tell the truth Only individuals can. (As Arnold Kling says, " Lose the we.") Indeed, if a majority in Congress were to expand SCHIP (Children's Medicaid) to families making from $60,000 to $80,000 per year, the state would simply be stripping certain people in society of resources and redistributing said resources to others—others who don't need them by definition (read: they aren't poor). And the IRS becomes our moral proxy?

Compulsory Compassion

It's not merely that the government would be stripping people of resources, but of the very moral impetus from which 'being good' arises. By expanding any entitlement, the government is not somehow helping people carry out their moral duties. One's internal sense of goodness is the sense upon which the very notion of moral responsibility rests. By expanding Medicaid, the government would be removing part of that moral sense. Perhaps worse, the government would be absolving people who have means of their responsibility to provide for their own children, while foisting that duty upon those who never asked for it. And there is nothing moral whatsoever in that.

The left is attempting not only to co-opt the language of morality, but to do so with the up-is-down postmodern rhetoric that makes middle class people the "working poor" and calls coercive redistribution to them a "moral duty". But one can't simply vote away the onus of responsibility for the less fortunate to Washington.

Max Borders is a contributing editor to TCSDaily, an adjunct scholar for the NCPA. He blogs here.



Let's take this reasoning all the way
Emergency room care at county hospitals is given without reference to ability to pay. Does not this short-circuit opportunities for charity in the name of misplaces "humanitarianism?" Child protective services intervene on the behalf of children at risk. Why are we not depending on goodness and charity to accomplish this? Children with learning disabilities and handicaps receive special aid in schoool. Shouldn't we end this travesty and stop letting legalism stand in the way of ordinary people seeing the right thing to do and doing it?

in eric's world, if a little govt is good, then having govt take over everything must be better
As usual eric doesn't even bother to check whether any of the items he uses as examples are appropriate, or even justifiable.

Mark's even more confused than usual
I was using the author's argument to talk about getting government out of areas where it now is in. If you agree with the reasoning, just say so, and we can all get started expanind charity opportuniites in, for example, emergency rooms and special-ed classrooms.

SCHIP Expansion
Lemuel...huh?? The examples you have outlined are situations where individuals or charities are not equipped to address needs which you have stated. They are also not applicable to the SCHIP question.
Why should taxpayers be forced to foot the bill for healthcare for children of middle class people, when there is no "need" to do so? A much more efficient method of easing healthcare costs to those who must provide their own insurance is a tax deduction, as Republican candidate Giuliani has suggested.
As an aside, I am really tired of my tax dollars going to people who insist on having children they cannot afford to take care of, then expect the government (i.e., the taxpayers) to provide the means to feed, clothe, and provide healthcare to those children.

we the people
Basing a challenge to the morality of SCHIPS expansion on the claim that "societies cannot have moral obligations any more than they can tell the truth" crashes your whole piece.

Taking seriously collective action and shared responsibility is not the same as being a collectivist. And even though individuals make decisions, collections of individuals do in fact have legal and moral status and more importantly responsibility.

I can understand any number of moral claims that can be made against SCHIPS, but I am afraid what you have here is not moral reasoning but simply ideological homiletics.

SCHIP Expansion Addendum
And while we're discussing this, before we expand SCHIP, why don't we cut out the fraud committed by some states who use SCHIP funds for other than their intended use, like providing healthcare for adults, etc.?

let's see if I have this straight
expansion of free health care to middle class kids, is the moral equivalent of protecting children from abusive parents?

OK, I had it backwards
In eric's world, arguing to get the govt out of one area, is the equivalent of arguing to get it out of everything.

As usual, eric can't imagine that there would be any charity in the world, if the govt didn't force it.

your argument would have more weight, if you provided more than homilies in it's defense
specify how collective's can have moral obligations above and beyond what the individuals in them have.

The error lies on
both side of this argument. Health care, and the degree to which it should or should not be provided by public resources are not moral issues. They are practical matters of the interests of public health balanced against the rights of individuals to be responsible for their own health care. As soon as any side enters the debate with claims about the moral high ground, any chance for rational debate has been lost. "What is effective" becomes submerged by those shouting the loudest for "what should be".

Hey, it's just a few dead kids. Stop this sentimental blubbering
We have these emergency rooms costing the honest, hardworking taxpayers a fortune. Let people pay up or bury their sick kids. Doing this would create a whole world of opportunity for charity. Why aren't you coming out for it. I mean, where's the "need" for free emergency care??

The Moral Case
Borders may not be able to find any morality inherent in SCHIPP because he sees no redeeming feature about being forced to give.

But I can certainly make the moral case for seizing some of his ill-gotten and hoarded wealth and using it to provide health care to a sick child. So can a bunch of my friends - that's where the "we" comes from. We understand that Mr. Borders plays no part in our moral gesture.

Indeed, the fact that he would have to be forced to give money to help a beggar or to help a sick child shows the paucity of his own morality.

Of course you don't have it right
You don't think not getting preventive care is abusive?? You don't want to stop this?

Exactly right.
And the argument for SCHIP on that basis is totally solid.

As to the argument itself
I have no opinion, lacking any useful information on the topic. This is a matter of practical policy; either it's worth doing or it's not. But I think we agree that moral arguments are no good basis on which to conduct public policy.

Your arguments are totally emotional.
There is no substance in your arguments. Just whining about kids (25 year olds) dying because we didn't give people who make up to 80K free health care.

Why stop there?

Government is Charity
Didn't you know that?

Only in your feeble mind
There is no argument for expanding it to 25 year olds and families who can afford health care.

When did morality ever influence government?
If moral arguments were actually used we might be a lot better off.

Example: Thou shall not covet my neighbors property. Yet we have tax policy based entirely upon this premise. In fact, the democrat candidates are clamoring for huge tax increases all to soak the rich playing exactly on this premise.

It is endless.

Try not to be
myopic about this. The fact that current government in the United States is not influenced in any particularly way by moral principles, as you might see them or indeed as I might see them, in no way implies that this has always been the case, either in the United States or for other nations.

For evidence refuting your contention, one of a host of examples will do, the Wilberforce Acts.

I don't see you offering to pay for it. All I see you do is demand that others be forced to pay.
And no, not getting preventative care is not abusive. Not in that sense.

OK, I'll bite
Why is the government regulating health care in the first place?

Where I live there are 2 non-profit corporations that run hospital. Each time one wants to expand they have to get a permit from the government and the other always objects.

If they over build the price will drop for patients. :)

The rich middle class?

The moral dilemma is this: the rich can afford to pay for health care. The poor receive health care because it is "morally right to help the poor". Some middle class people have no insurance, and cannot afford it, nor can they afford to pay cash for health care.

So, the wealthy get health care by paying for it, the poor get health care through taxpayer subsidy, while many working class low-middle income people have no insurance, have no money, and have no subsidized health care.

By the way, for Christians, the Bible tells us to help both the poor and the needy. One can be needy without being chronically poor. A sudden acute illness, loss of job, debilitating chronic illness, or other setback can make a middle class person needy without their being considered to live in poverty.

If you are wealthy, healthy, or covered by employer or taxpayer insurance, more power to you. If you are middle class, without insurance, and sick, forget it!

I speak from personal experience.

SCHIP as middle-class entitlement?
By expanding SCHIP as a middle-class entitlement, we are putting the taxpayers on the hook for the health care of everyone elses kids. As a taxpayer, if I am required to pay for the health care of other peoples' kids, should I not have some input into deciding who can have kids and what kind of kids they can have?

No, government is not charity
Charity is voluntary. But you knew that.

You're the one who's getting emotional
All I've done is pointed out other possible cost savings with regards to sick or endangered kids.

So, let's not give preventive care but pay for them with taxpayer $ when they show up in the ER
Costs more money, and worse for the kids, but who cares about factors like that?

Drooling Eric is so effing stupid
that he can't deduce the fact that charities are largely hamstrung by the inefficient, stumbumbling "help" of Big Brother.

Were Big Brother to step out, charity would step in (where it was truly needed), just like in days of old.

Big Brother hates charity.

Grow up, Eric, you pockfaced SOB.

I have now figured out Eric's j-o-b.
He's in sales.

He has to be.

All he ever does is irrationally sell, sell, sell the Regressive Left. He uses ridiculously emotive hot-button talk like "it's just a few dead kids" and "the Iraq war is all about lies" and every other piece of polarizing tripe.

All you ever sound like is a slimy salesidgit, Eric. And, like every salesman, you can't accept it when doors are slammed in your face.

Reading disability still severe, I see
In my post I took up the essay's lead and I suggested government step out all over the place to give charity more room to work. I'll take Droolbuckets latest post as a yes for this suggestion.

I think you need a job but all you seem qualified for is drooling and that doesn't pay much
I mean, is it really impossible for you to post anything on topic? And if it is, why are you posting at all?

Just to be fair,
that $83,000 annual income thing was only offered in New York.

SCHIP is still SH*T, mind you. The Socialists (uh, that is Democrats) still want to do their worst to get more entitlements to the middle class under the clever guise of "helping the poor". But I just didn't want to give any leeway for that slimy salesman Le Mule de Drool to call you out.

Agreed Colin, but does anyone here understand what SCHIP is??
The State Children's Health Insurance Program (SCHIP) is a stop-gap measure designed to help the working poor who don't qualify for medicaid but can't afford family health insurance and don't have it available through their job. It was specifically designed to help those who are trying to help themselves out of the poverty cycle; and it was designed to work well in conjunction with the welfare reforms of the 90s.

It is purely a Democratic Party vote buying scheme to increase this program to the level that is being pushed presently. Any family making $80,000 should be able to afford some level of health insurance and preventative care visits to the doctor.

Also, putting the cost off on a tobacco tax is goofy as the money generated through such taxes is already declining (as the number of smokers and tobacco users is declining). The point will be reached where it will not be able to pay for the program. (and probably pretty quickly)

It has been made pretty clear to me that this is just the first step in a democratic universal healthcare plan, and an underhanded way to go about it. (A pretty large majority of the population do not want to see this program die in a veto and democrats are pushing their agenda to force the issue. If Bush vetos it, Republicans are against kids; if Bush passes it, Republicans supported a tax increase.)

In other words, it is pure politics and vote buying.

Er, no.
The principle starts here: healthcare is not a universal right. It is a commodity.

It requires human ingenuity and effort to create it. If you want to go out into the woods and gather herbs (I'm not putting that practice down, btw; there's a lot of preventive and curative medicine to be got that way, and I'm a user of herbal teas), then you can have some "universal" health care.

The government has absolute zero place in the health care business.

The only exception would be as we have discussed elsewhere about preventing natural catastrophes, in the context of which mandatory vaccinations could be considered legitimate (as long as private doctors were paid in full by the feds to carry out those vaccinations).

However, if government strictly stuck to doing that, along with its two other strictly limited duties, there would naturally arise very, very few types of things like vaccinations for government to take care of.

Even 150 years ago, the cutting edge thinkers in America were saying that there is no such thing as 100% security, and any nation that tries to have it will only end up squeezing to death its own populace.

Health care and medicine are not rights. Food is not a right. These things are commodities. Whosoever understands this principle does indeed the moral high ground, no matter what anyone says to the contrary.

Again, if you want to grow your own food, then you don't have to pay for it (although you still have to be paying for something, since you have to either be renting or the owner of property). If you want to gather herbs, if you want to practice ayuverdic medicine, then so be it: that will, if you are successful, greatly reduce your health care costs.

Otherwise, you're going to have to pay. The people who will provide your health care don't have to work for free; furthermore, they don't have to be accountable to bureaucrats or government price-fixing.

"What is effective" happens to be privatization. Even the fu*king Canadians are now realizing that they are being hurt by lack of competitive incentives among even knock-off pharmaceutical makers and distributors. Their own Bureau of Competition is demanding more, not less, privatization and competition.

Excellent, and perfectly true, explanation, Pauled.
But SCHIP is just one piece of the socialized medicine machine the building of which was begun way back in 1965 with the creation of Medicare.

THAT, actually, is the connundrum.

Just because some people in government might, and do, want good things
does not make government moral.

The big problem is that even when governments try to be moral, they inevitably fail and make things worse or, at the very least, they make things less optimal than they would otherwise have been. What's the highway to Hell paved with?

Incidentally, I don't have any problem whatsoever with government trying to distantly educate or inspire people. It does not bother me that the Surgeon General puts warning labels on boxes of cigarettes.

But government is ill-equipped to act; and the bigger it gets, the more ill-equipped it becomes. Warnings are fine, but increased taxes are not.

"Reading disability still severe, I see."
Eric continues to mumble aloud to himself...and continues to parrot my own words in order to enact this auditory dissonance.

"Ill-gotten and hoarded wealth"
is what the, I mean, Democrats...get with.

Oh, yes, so do the Republicans. But while they're fatally flawed, the Democrats are just vile.

Your argument, Downe Syndrome, is not only stupid, but repugnant.

So, I guess that means
you need to elevate yourself out of the middle class.

What that means for you is: figure out how to make more money.

I speak from personal experience.

Eric, did you sell that bridge in New York yet?
Or are you still trying to get Bill Gates to buy $480 billion worth of life insurance?

forced virtue is no virtue at all. In order for an act to be virtuous it must be a free choice done only because the law (of obligation) demands it. It is not an act that simply conforms to the law but instead is an act that is done because it is the law. But this is all well-known.

Studies have shown that when the tax system is less onerous there is more voluntary giving. Here's were Dems make a contradictory choice. First, they use a tax system that is immoral (legalized theft) and severely onerous. Then they complain that there is not enough "charity." So to rectify this problem (which is created by the first), they propose more spending and more taxes. First they create a problem with too much government, then they propose to solve the problem with even more government.

It's time to end these government programs for good. There is no reason that the FEDERAL government should be doing these things. The are within the province of the states.

Please document your charge...
that Borders' wealth "ill-gotten and hoarded".

Also, if you can make the moral case for seizing "some", why not for seizing "all", "ill-gotten and hoarded wealth"?

There are moral issues here....
You write "Health care, and the degree to which it should or should not be provided by public resources are not moral issues. They are practical matters of the interests of public health balanced against the rights of individuals to be responsible for their own health care."

If a health care system becomes nationalized, then moral issues do arise. One issue is that it is easy for those with poor health habits to get a free ride on the system, in effect receiving subsidies from those who have good health habits. Unless a person has some individual responsibility, the person can always dump an obligation on to someone else who has no say in his or her being obligated. This indeed is a moral question.

No Subject
You write "And even though individuals make decisions, collections of individuals do in fact have legal and moral status and more importantly responsibility."

Collections of individuals provide the best way of avoiding individual responsibility. The extreme case is that of Marx's socialized person, a person whose essential characteristic derives from the society, a person without any personal responsibility. This is anathema in a society that believes in personal freedom and responsibility.

Such wild assumptions....
You write "But I can certainly make the moral case for seizing some of his ill-gotten and hoarded wealth and using it to provide health care to a sick child."

How do you know that any wealth he might have is ill-gotten and hoarded? Is any wealth only obtained that way? Middle class parents usually do have the means to provide health care to their children. They should be able to purchase health care insurance for major medical events just like car insurance. If such a market existed (and it could if there were some IRS Code changes), then those middle class parents would have private means for caring for their children.

Better get your Bible quotes correct....
You write "By the way, for Christians, the Bible tells us to help both the poor and the needy."

"Us" here does NOT mean the government. It means you and I personally.

I'm sure you think you have a point.
Sorry you're not able to make it clear.

some reason you can't post anything but stale insults, big guy?
I mean, why are you wasting everyone's time with this lame BS?

these are risk-sharing issues, but let's talk moral issues too.
this happens in any health insurance system:

>One issue is that it is easy for those with poor health habits to get a free ride on the system, in effect receiving subsidies from those who have good health habits. Unless a person has some individual responsibility, the person can always dump an obligation on to someone else who has no say in his or her being obligated. This indeed is a moral question.

But speaking of moral issues: One thing that does happen is that insurance companies often refused to insure people with pre-existing conditions -- even though personal habits may have nothing whatsoever with these conditions. A child with cancer, for example, is a part of a family no pinsurance company wants to cover. Does this raise any moral issues in your mind?

source, please
>studies have shown that when the tax system is less onerous there is more voluntary giving.

can you say what studies there were, and what was the control?

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