Some thoughts on the Graeme Frost issue

I'm on deadline, so I haven't been following the ephemera of S-Chip as closely as I might. Apparently the Democrats paraded some kid name Graeme Frost in front of a camera in support of S-Chip. Now conservatives are claiming that the kid is actually affluent, and therefore shouldn't be getting gummint money for health insurance. My thoughts:

1) I told y'all this was going to happen. Maybe next time you'll listen, hmmm?

2) Anecdotes, no matter how photogenic, are terrible ways to make policy. It doesn't matter how crappy your public policy is; I guarantee I can find one very telegenic person who is better of under your godawful boondoggle of a system than under almost any other potential system. But argument by anecdote is what we seem to be stuck with, particularly in the realm of social policy affecting children. Isn't democracy marvelous?

3) If Think Progress's account of the case is basically accurate--the family owns its own business, has a lowerish-middle class income, but lives in a basically nice neighbourhood--this actually raises important issues about benefits that no one is asking. To wit: should we expect families to sell assets in order to qualify for benefits? On the one hand, Medicaid's ludicrous rules keep disabled people in crippling poverty. On the other hand many people, including me, don't want to pay for the health care of someone so that they can stay in their Park Avenue mansion. At some point, it is reasonable to expect people to liquidate assets in order to pay for expenses, rather than expecting society to pick up the tab. But I'm not sure what point is reasonable.

I don't think this is particularly interesting as it applies to S-Chip; frankly, I doubt there are enough low-income families with children and sizeable assets to make it even worth debating the issue. But it is a very important question regarding Medicaid, because of all the elderly people who shelter significant assets in order to get Medicaid to pay for their nursing home care.

In the case of a spouse, this seems (usually) legitimate, again with the Park Avenue mansion exception: I don't care how long you've lived there, if you're squatting on five or ten million worth of real estate, you should sell it and pay for your spouse's nursing home, rather than asking the payroll clerks and bank tellers of the world to lend a helping hand. But normally, I don't think it's reasonable to demand that anyone make themselves homeless in order to qualify their spouse for a nursing home.

But that isn't the only reason people shelter assets; often they're doing it so that they can leave something to their children. This doesn't strike me as at all reasonable. You have a right to have society pay for your nursing home care if you are destitute and will otherwise suffer and die. You do not have a right to have society pay for your nursing home care so that you can leave the house and some financial assets to the kids. Aside from its rather repulsive moral logic, it's regressive; the people who benefit are upper-middle-class kids who have already benefitted quite a lot from their fortuitous choice of parents.

We need a better, more granular system than we have for deciding who qualifies for public assistance: one that doesn't force families of modest means out of their homes, but also doesn't allow wealthy families to gain the system as they currently do.

4) That said, even if Graeme Frost is basically middle-class-ish, that wouldn't be a stunning indictment of S-Chip. No system is without error; all will let through some people who don't deserve benefits, and miss some people who do. That there has been one error, in either direction, is not necessarily an indictment of the system, but merely an indication that we live in an imperfect world. Moreover, in the case of children, I'm perfectly content to bias the system towards including too many undeserving children, rather than take the chance of missing too many deserving ones. I find S-Chip's practice of covering adults problematic, but frankly, the prospect that Graeme Frost might have gotten some undeserved healthcare ranks, on my list of things to worry about, somewhere between pandemic toe fungus, and finalizing the guest list for my Chicago Cubs World Series Victory Party.

5) Reading the comments on this, I have to ask conservatives and libertarians: is this really the hill you think we should die on? I do understand your objections to the program, but an informal survey of swing voters, in their current incarnation as my mother, indicates that this is killing you with the moderates. Save it for national health care next year, is what I'm saying. This debate is framing the issue in a way that is going to make things harder, not easier, when Hilarycare is on the table again.