Elmer Smith | The marketplace is not a healthy locale for kids

GEORGE BUSH is all for helping poor kids get health insurance - as long as it doesn't disturb the ecology in a wondrous environ he calls the marketplace.

The marketplace is a delicately balanced ecosystem where bulls and bears roam unfettered and fertilize a lush landscape with their droppings. It is a place with no fences or barriers, a place where unseen market forces are mobilized to meet every need.

If the elderly are forced to make choices between food and medicine, they must make a pilgrimage to the marketplace. If millions of children are without health insurance, there is a balm in the marketplace.

But a lot of Americans are in a different place. They work hard to provide for their families and still can't afford to insure their children's medical care without help from the government.

That's where S-CHIP, or State Child Health Insurance Programs, fill a gap for 6.6 million children in the U.S. S-CHIP provides $5 billion a year in federal aid for families who are not poor enough for Medicaid or rich enough to buy insurance.

The 10-year-old program comes up for reauthorization this year and in a rare exercise in bipartisanship, Senate D's and R's have fashioned a compromise to extend S-CHIP to 3 million more children. It would cost $60 billion over five years, twice as much as a Bush administration proposal that would effectively reduce the number already served.

A version making its way through the House of Representatives would expand the program even further. Both houses envision financing their plans with a new excise tax on cigarettes.

The president vigorously opposes the cigarette tax. Go figure.

But his opposition to the S-CHIP expansion plans is not money. It's about the marketplace. "My concern," the president told reporters this week, "is that when you expand eligibility, you're really opening up an avenue for people to switch from private insurance to the government."

Heaven forfend!

It's the proverbial camel's nose under the tent. Next thing you know, people will want government "to provide for the general welfare," as the founding fathers wrote in the preamble to the U.S. Constitution. Of course that was written before we buried the "W" word, before market forces were as potent as they are now.

The president sounded an alarm by noting that families that make as much as $80,000 a year might be eligible for help under the expansion. In the circle he runs with, $80,000 is just enough to keep all their vehicles in tires.

But for a family with three children and two working parents, the added cost of health insurance can turn that lofty sum of $80,000 into subsistence pay.

It's not that the president can't feel their pain. I've seen examples of sincere compassion in some of his domestic policies, most recently on immigration.

But this is his faith walk. His slavish reliance on the magic of market forces is the one tenet of the conservative creed that he never violates.

Even if they could come up with a way to finance the expansion that did not hurt the tobacco industry, he'd still threaten to veto it. He won't go down in history as the president who left a door open for the forces of socialized medicine to rush into.

So with the American Medical Association, the American Hospital Association, the American Cancer Society and the American people favoring an expansion of the program, even with the leaders of both parties pushing him, George Bush will not be moved.

Republican Sens. Charles E. Grassely and Orrin Hatch tried the old "good cop, bad cop" ploy on the president. If he vetoes this compromise, they told him, those dreaded "tax-and-spend" Democrats may seek an even wider expansion of the program.

But you can't beat this guy for drawing a line in the sand. He'll do anything in his power to help poor children, as long as it doesn't disturb the sanctity of the marketplace. *

Send e-mail to smithel@phillynews.com or call 215-854-2512. For recent columns: http://go.philly.com/smith