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What Gives in Virginia? Taxpayers.

By Melanie Scarborough
Sunday, October 10, 2004; Page B08

In a remarkable measure of the dwindling value of personal responsibility, Virginia Gov. Mark R. Warner (D) brags about recruiting more than 100,000 children to the public dole -- and encounters no public outcry. The vehicle for Warner's achievement is the program known as Family Access to Medical Insurance Security (FAMIS), which allows middle-class parents to foist the expense of their children's medical care onto the state's taxpayers.

While considering the governor's boast, keep a couple of things in mind. FAMIS was not designed to help poor children; they are covered by Medicaid. FAMIS is available to parents earning as much as twice the poverty level -- i.e., $37,700 for a family of four. In cases in which household income exceeds the stated eligibility limit, FAMIS encourages applicants to get in touch anyway. Does lenience in extending welfare benefits represent progress?

Moreover, the program wasn't developed in response to parents clamoring for assistance. FAMIS is the consolation prize Congress awarded the Clinton administration after rejecting its proposal for nationalized health care. Hillary Clinton's health care commission had a fallback strategy: If Americans would not accept a government takeover of medicine, the changes would be attempted incrementally, starting with coverage for children. FAMIS was not born of national need; it is political make-nice.

Supporters claim that the program, which draws on some federal money, is necessary because private health insurance is unaffordable for many families. Unfortunately, adding more children to government health care is likely to exacerbate that problem.

One reason health care and health insurance are so expensive is because of the high rate of third-party payment. When the government gets the bill, no one cares how much it costs. Patients may be shocked to realize that a hospital charged $16 for each 10-ounce bottle of water they drank or billed Medicare $600 for a box of eye pads that cost $30, but they rarely consider the one thing that might help change that: transferring more power to patients.

Warner notes that many companies are dropping family medical benefits for employees. That's a consequence of government taking over the companies' role. Many employers don't feel obligated to provide a benefit duplicated by the state. As Virginia encourages more parents to put their children on government health insurance rolls, more companies probably will eliminate family coverage. Is that progress?

Worst of all, no one seems to question whether the additional tax burden is necessary. It has become an article of faith that private health insurance is unaffordable; it has been repeated so often that no one is bothering to check whether it is true. In fact, private insurers in Northern Virginia offer at least 35 policies to cover children, with prices starting at $28 per month per child. Two children can be insured for as little as $53.75 monthly. Is that really beyond the reach of most parents?

Warner boasts that he is making it easier than ever to enroll in FAMIS [Metro, Sept. 29]. He could make it even simpler. Eligibility could be based on the answers to just two questions:

• Do you subscribe to cable television?

• Do you have a cell phone?

If the answer to either question is yes, then the parents are buying nonessentials with money that could buy health insurance for their kids. Why is it fair -- even laudable, from Warner's perspective -- for parents to saddle taxpayers with a bill they are capable of paying themselves?

In better days, Virginians would have been incensed by the recruitment of government wards. Nowadays, the notion of self-reliance, lamentably, is quaint.

Giveaway programs undoubtedly enhance the longevity of political careers. Whether they promote a healthier society is less clear.

© 2004 The Washington Post Company