Medicaid is a cruel program

“If we wish to be compassionate with our fellow man, we must learn to engage in dispassionate analysis. In other Walter E. Williams

Would you believe that many politicians over-promise and under-deliver? They promise you that a new law will fix some terrible problem, but usually it does not fix the problem, and often it makes the problem worse.

Too many politicians look only at the stated goals of a program. They believe so much in the goals that they refuse to believe any harm could result. They don’t look beneath the surface for possible unintended consequences. Even when other people do find bad side-effects in the bill, the true believers ignore the potential problems.

Thus is the case with expanded Medicaid. The same politicians who thought ObamaCare was a good idea and promised us that “If you like your health insurance, you can keep your health insurance”, those same politicians now tell us that expanding Medicaid is a good idea.

Sadly, Medicaid is a cruel program that hurts the very people it’s meant to serve. One commentator wrote: “Imagine a government-run health care program in which medical access is severely limited, that is racked by uncontrollably rising costs, and that in many instances results in demonstrably worse health outcomes than having no insurance at all. Such a program isn’t a mere hypothetical; it already exists, and it’s called Medicaid.”

More and more doctors are refusing to accept Medicaid because the system doesn’t pay enough to cover their expenses. Would-be patients spend hours on the phone trying to find someone willing to treat them. If they do succeed in finding a doctor, the appointment is, on average, three weeks later than someone with private insurance.

And it gets worse…, multiple studies have shown that Medicaid patients are more likely to die from surgery than privately insured patients and sometimes even more likely to die than uninsured patients. A Univ. of Pennsylvania study of colon cancer found that the mortality rate for Medicaid patients was 27% higher than for uninsured patients. A Florida study found that Medicaid patients were more likely than uninsured patients to have late-stage prostate cancer, breast cancer, or melanoma.

On broader measures of health, the Oregon Medicaid health experiment found no significant difference between Medicaid patients and uninsured patients in objectively measured physical health outcomes. Put simply, Medicaid did not make patients any healthier, though it did make them feel more financially secure.

Expanded Medicaid has been tried and has failed. The state of Maine expanded their Medicaid program ten years ago. Every predicted benefit failed. Politicians said it would reduce the number of uninsured. Wrong. Politicians said it would reduce emergency room visits. Wrong. Politicians said it would relieve uncompensated care. Wrong. The only significant change was that thousands of Mainers switched from private insurance to Medicaid.

There was one absurd result from Maine’s Medicaid expansion: Since the eligibility rules differ for expanded Medicaid and regular Medicaid, 10,000 able-bodied, childless adults received benefits while 3,000 elderly and disabled were put on a waiting list.

A pernicious aspect of Medicaid is that it traps people on the edge of poverty. The eligibility rules make it very difficult for someone to escape poverty and move up the ladder of success. A young person entering the workforce, earning $14,856 gets free health care. But if he or she earns just one dollar more, then that same young person not only loses the free coverage, but becomes obligated to purchase coverage or else face a penalty. This is a terrible incentive that encourages people to stay poor.

Isn’t it a good thing to learn more skills, get a better job, work more overtime, earn more money, save toward the future? Medicaid and similar entitlement programs punish people who try to better themselves and become self-sufficient, not dependent on government. Why should we encourage people to be involved in such a terrible system?

Proponents of expanded Medicaid rarely, if ever, discuss the adverse health outcomes for people on Medicaid. They never talk about the perverse incentives that can keep someone trapped in near-poverty forever.

What proponents mostly talk about is getting “free” money from the federal government. It is as if the poor are mere pawns for collecting more money. But does anyone really believe that the money is “free”? The federal government is running gigantic deficits. It has borrowed trillions and trillions of dollars. Our children, grandchildren, and their grandchildren will be stuck paying off this debt.

And the money isn’t free even in the short term. The feds talk about paying 100% of the cost for two years, but can we really believe that promise? And the federal budget negotiators are already talking about reducing the 100% promise because the costs keep going higher and higher and higher.

Many opponents of expanding Medicaid worry that the ever-increasing costs to NH taxpayers will lead us inevitably toward a sales or income tax.

The ObamaCare Medicaid expansion is bad for the people it claims to help, bad for the taxpayers, and bad for the future of New Hampshire. We should fix the broken system, not expand it.

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