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Tuesday, May 29, 2007
PeachCare: Take control of its growth
The Atlanta Journal-Constitution
For conservatives attempting to contain the growth of government, three major obstacles loom.
One is that social programs, once created, become sacred cows, as PeachCare has, surrounded and protected by beneficiaries, by interest groups, by the media and by politicians who use the public purse as the currency of their power and longevity. All provide a protective phalanx around the good and the bad, the workable and the wasteful, resisting anything that is not a benefit expansion.
The second is that the more-government advocates, mindful of Ronald Reagan’s use of “welfare queen” imagery to push reform, learned quickly that the key to new and expanded social programs is to shift the focus of public attention from unsympathetic characters — irresponsible adults and “welfare queens” — to “children.” When the dispute is penny-pinchers vs. “children,” government grows.
The third major obstacle is that Republicans, who now exercise control under the Gold Dome, come in all stripes. Getting them all together on any rock-the-boat legislation is no small feat. Visionary, committed leadership is essential.
The PeachCare debate in this year’s General Assembly is illustrative. The obstacles to reform, however slight, are so deeply embedded in defense of the status quo that it’s not the work of the weak, the queasy or the timid.
PeachCare, as proposed by then-Gov. Zell Miller in 1998, was a distinctly different concept. Miller would have expanded Medicaid coverage for children under 6, and offered low-cost coverage to children 6-18 whose parents earned $32,100 or less, and coverage for slightly higher premiums to children 6-18 whose parents made more than $32,100. Private insurance companies would sell policies on contract with the State Merit System.
The House, which had by then fallen under the dominating influence of its more liberal wing, stripped away Miller’s name for the proposal (Children’s Health Insurance Program), dubbed it PeachCare for Kids and turned it into a wholly taxpayer-funded expansion of Medicaid with free coverage for eligible children.
“PeachCare is a huge, new entitlement program,” said Miller at the time. “And I thought we had learned our lesson long ago that when it comes to entitlements they are impossible to control and the costs skyrocket over time.”
Oddly enough, PeachCare is not an entitlement. It simply behaves as one. Any attempt to manage its growth — something most taxpayers would want and expect — is treated as a visitation of the plague. House Speaker Glenn Richardson (R-Hiram) was accused here of using “boogeyman scare tactics and gross mischaracterizations” to bully his colleagues into “gutting” PeachCare. Gutting was essentially to align its future eligibility with plans in surrounding states.
By its nature, the media are most often a proponent of more government. As problems are defined, the solution is invariably a more active and expansive government. It is the simple, easy solution. Asking parents to be responsible for their own children, for example, or to marry so that children are given a fair shot at a loving, healthy and protected childhood, infringes on the free-spiritedness adults claim as a divine right. So if children are neglected, it’s because too few government agents were on the payroll or because those who were lack competence.
Conservatives in public office have to become smarter, and more media savvy, in explaining and defending actions that are bound to be unpopular.
A symbiotic relationship often exists between the interest groups that promote bigger government and the media. Interest groups conduct “studies” and commission polls, spin stories, find and offer access to individuals or families they wish to represent as typical of beneficiaries.
Effecting change is tough. It requires a governor leading. And it requires capable, committed legislators who are comfortable explaining and defending the need for a different approach, whether that is tax revision, PeachCare reform, vouchers, spending caps or health care reform. Otherwise, they’ll always be on the defensive trying to explain why they’re out to punish children.
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