Map of life expectancy at birth from Global Education Project.

Tuesday, September 02, 2014

The real problem with Medicaid expansion

As you may have heard, the Republican Governors' united front against Medicaid expansion is fracturing. They never had a really good explanation of why they would not accept free money from the federal government to cover their uninsured working poor, except that ideologically it's just wrong to spend tax money to make people's lives better and  they'd have to kick in a few percent down the road. But now Pennsylvania, Arkansas, Arizona, Wyoming and others are implementing Medicaid expansion in one form or another.

Many observers considered this inevitable in the long run because a) people can see that neighboring states are better off, not worse off, when they accept Medicaid expansion, b) hospitals and other health care providers are a powerful constituency in favor of Medicaid expansion and c) so are employers with low-wage work forces. There doesn't seem to be any way, politically, for Republican politicians to get away forever with screwing their citizens and major employers.

But now Dylan Scott, in TPM, drawing on an observation by Nelson Lichtenstein of UCSB, explains why many states still resist: they are the former Confederate States of America and the large majority of beneficiaries of Medicaid expansion would be African Americans (and Latinos in many cases, I might add). Arkansas and Kentucky are expanding Medicaid, but they have Democratic governors.

Let's face facts here folks: the reason that many low and moderate income white folks are opposed to government programs that would benefit them is that they think more of the benefit goes to people who are unworthy, and said people's unworthiness is predicated on their pigmentation. It is because racism divides our working class that we have the stingiest social welfare state among the wealthy countries, and that is why we have so many people who vote against their own self-interest and are seduced by the unalloyed bullshit of libertarianism.

Oh yeah. That's also why we have a War on Drugs. And  a whole lot else that's wrong.


1 comment:

Don Quixote said...

BRAVO! Testify!