President Bush and his Republican allies decry the proposed expansion through Medicaid of government-provided children's health insurance, the so-called SCHIP.
They wage a losing political battle from over there on the wrong side of sick children.
So far the best they've been able to do is sound a supposed alarm that middle-class kids might get helped, even those in households with incomes in the range of $80,000 annually. That apparently would be bad.
This is all about Democrats trying to sneak their way into government-run universal health insurance, Republicans cry. That also apparently would be bad.
Democrats, positively giddy about the political prospects for them in this debate, pooh-pooh any notion of help for children in $80,000-a-year-households. They point out that their proposed five-year incremental expansion of eligibility -- to households including higher multiples of the federal poverty level -- would be based on state-designed structures that would be submitted for federal approval. These could impose premiums and co-payments on a graduated scale. Thus the Republican rhetoric is overheated and oversimplified, they say.
I would point out that $80,000 is not what it used to be. I would point out that being middle class is no longer a ticket to economic security, particularly with health costs as they are and the credit crunch as it is.
I also would point out that, if indeed the program is all about children, then a child in a large family with a household income of $80,000 might be no better off in terms of health care than a single child in a family with an income of, say, $20,000.
Here in Arkansas, for example, we have a certain family semi-famous for its vast number. At last check, it contained 17 children.
Fortunately, the dad has valuable property holdings. But if something should go horribly wrong on that, and if his income should slip to, say, $80,000 a year, then I'd fail to see any harm in letting this prolific dad plug into Part B or a new Part C of his state's ARKids First program, the local SCHIP version. You could design the program with certain premiums and co-payments, if his escaping responsibility altogether bothered you.
After all, it's supposedly for the kids. And it's not a child's doing that he has 16 brothers and sisters.
As for Republican assertions that this is all simply a step toward government-provided universal health insurance -- toward what their consultants want them to call HillaryCare -- I'm thinking that's not altogether wrong.
Do not fear: We will continue in this country to have employer-based and other private insurance. But one of these days we're going to look up and see all the baby boomers on Medicare, assuming it's still solvent, and all or nearly all of our children covered one way or another. At that point, Hillary's idea to require that everyone in between buy coverage will start to look more achievable.
That leaves the Republicans with one argument. It's that the Democrats presume to tax cigarettes, and that this is bad policy. It relies, you see, on a dwindling resource and thus defers the invoice for a future entitlement to the taxpayers.
That's quite right. The political problem is that resisting health care for kids is bad enough, but standing up for the tobacco industry is perhaps even worse. Most folks will be happy to ride cigarette taxes as long as they can.
The only way Democrats can blow this issue is to overplay their hand. Predictably, perhaps inevitably, they flirted with that the other day.
They brought in sick children as props. If there is any sin that compares with insensitivity to sick children, it's exploitation of them.
John Brummett, an award-winning columnist for the Arkansas News Bureau in Little Rock, is and author of "High Wire," a book about Bill Clinton's first year as president. His e-mail address is jbrummett@ arkansasnews.com.