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The art of the possible



It appears that narrow partisanship has trumped the national interest yet again. Reauthorization of the State Children's Health Insurance Program has been held up by a Democratic Congress too eager to emulate Canadian health care and a president who wields a veto pen without having any credibility on spending restraint. Oklahoma's congressional delegation voted along party lines in the veto override vote.


So now we are faced with the possible expiration of SCHIP, which provides much needed help for those who earn more than the traditional Medicaid limit but yet cannot afford private health insurance. The Oklahoma delegation should work together to propose a compromise where the program is reauthorized, with increased funding and greatly increased flexibility for states to determine how to implement their individual programs.

Our state officials must begin preparation now to use whatever flexibility is available. Let us find commonsense, common-ground principles upon which we can improve upon the past 10 years of SCHIP " in Oklahoma a part of SoonerCare.


The promise of Oklahoma, the home of the land run, is opportunity. We must remember, though, that opportunity only exists with a certain level of security. A child is unable to fully develop his or her potential when access to quality health care is precarious at best. We all benefit and are more united as a people when Oklahoma's children, if no one else, are secure enough in their person that they can focus on their education and development as citizens.


Secondly, to avoid dissipation, any program must have focus. Before increasing the cap for eligibility to above 185 percent of the poverty line, we must do whatever we can to ensure that every currently eligible child is covered. This can be advanced by more ambitious public education campaigns, including through the schools. In the meantime, let us consider extending refundable tax credits for households above 185 percent of the poverty line (and yet under, say, 300 percent) to ease the transition to purchasing private insurance.


This policy would help prevent the unintended consequence of a householder receiving a raise at work only to lose his children's health insurance as a result. Further, it would keep choice and competition in the system so that we avoid the stagnating effects of a health care system solely funded and administrated by the state.


Finally, we need to remember that funding and administration are not cosmically linked. SoonerCare provides the perfect opportunity to exemplify this principle. Create more public-private partnerships and redirect money to be more like vouchers that can be used for any qualifying insurance program. Changes in the tax code would have to complement this program.


This whole discussion of SCHIP comes back to the dangers of polarization. When two parties face off as if across barbed-wire trenches, then solving problems takes a back seat to rhetorical posturing. Let's face it: You cannot rev up an audience by shouting the virtues of moderation and compromise, but politics is, after all, the art of the possible. The duty of a statesman is to fight for the interests of his or her constituents, in line with their ideals and within the realm of the possible.


Reese is an attorney who lives with his wife and son in Oklahoma City.

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