Map of life expectancy at birth from Global Education Project.

Tuesday, March 28, 2017

Ratcheting up

Here's a long form piece in the Gray Lady about the history, present and likely future of Medicaid. I think you should read the whole thing but I'll give you a couple of pull outs.

Medicaid started small, as a minor add-on to Medicare. Originally, it was coupled to what was generally called "welfare," Aid to Families with Dependent Children, and hardly anybody noticed. But over the years, bit by bit, Democrats managed to expand its scope to include people with disabilities, elderly people in nursing homes, and low income families that were not on welfare. By now, the assumption that able-bodied adults should be able to afford health insurance is decisively false.

In fact, far from creating a culture of dependency and discouraging people from working, Medicaid makes work possible for people with children with disabilities and/or severe health care needs; or elderly relatives who need care. And it keeps people in the labor force who need health care to be able to work. So part of the cost is recouped in taxes. Anyway, people generally don't seem to understand that government spending isn't like household spending. Every dime spent on Medicaid is income for health care providers, pharmaceutical and medical device manufacturers, and related services; and profit for shareholders.

Medicaid pays for half of all childbirths in the U.S. A large majority of Americans either benefit from it themselves, or have friends and relatives who do. The Republicans' disastrous American Health Care Act would have taken Medicaid away from the population that benefited from the ACA expansion, and then gradually reduced funding over the years forcing the states to spend more of their own money, or drop beneficiaries and services. That turned out to be politically impossible.

The Republicans aren't going to take away Medicare or Social Security either. Once people got these benefits, and realized how much better they made life for everybody, eliminating them became politically impossible. He was obviously lying, as he always does, but when Ronald T. Dump was campaigning for president, he promised to protect Medicare, Medicaid and Social Security, and even to provide health care for all. He knew he needed to speak those lies in order to have a chance. Of course, in reality, he supported Paul Ryan's bill that would have destroyed Medicaid. But they failed. Now we can go about the business of continuing to expand Medicare and Medicaid, providing a public option on the ACA exchanges, and one day --

Universal, comprehensive, single payer national health care. That is our right.


Anna said...

Nice post...

Anonymous said...

Universal, comprehensive, single payer national health care. That is our right.

This is highly entertaining coming from a someone that gets most, if not all, of his health insurance costs paid for by someone else.

Anonymous said...

And who pays for Paul Ryan's health care?

Here's a hint. Congresspersons have access to a civil service-like health plan in which over half of the costs are paid by their employer - namely you.

Anonymous said...

True that...

It's very easy for Congressman Ryan and those in academia who also get a free ride to tell the rest of us how health insurance should work when they are insulated from the burden of paying for it.

I'm with ya'

Don Quixote said...

Nota bena: The blogger (who is a friend of mine), though indeed an "academic," worked for years at a grant-funded foundation, the purpose of which was to obtain health care for members of the Latino community in a major northeastern city. So his insistence on universal, single-payer, comprehensive health care for all Americans--as people have in most other countries--is passionate because he has seen first-hand the results of our country's neglect of its poor populations and minorities.

Anonymous said...

Guaranteed that Mr. Cervantes gets his health insurance either free or very heavily subsidized. He pays little, if any.

But he seems pretty willing to tell the rest of us who *do* pay who, and how much we should subsidize others. Any spending proposal on healthcare would feel better if those who are making the proposal had a little skin in the game.

One way this could be accomplished is to make Cervantes and Paul Ryan subject to the same rules and pay the same amount out of their own pocket as the rest of us.