The Health Care Debate Debate

I just posted a Medicaid expansion op ed that argues, pretty effectively I think, against Governor Bullock’s plans to expand Medicaid eligibility to 138% of the federal poverty level. Those things are limited to 700-800 words, though, so I couldn’t include anywhere near all of the reasons that this is a bad idea, both for taxpayers and for potential enrollees.

The moral case against expansion is that the preponderance of literature indicates Medicaid patients have worse healthcare access and outcomes than the privately insured.

This is primarily because Medicaid reimbursements often don’t cover provider costs, so fewer providers are accepting Medicaid.
That means Medicaid recipients have insurance but not necessarily care, and so they end up in emergency rooms sicker and with more serious conditions than those with access to care through private insurance. Obamacare’s planned cuts to both Medicaid and Medicare reimbursements will only exacerbate this problem.

A few states like Florida and Rhode Island have tried consumer-driven Medicaid reforms that have actually decreased costs and increased access to care rather than simply drive more people into an unhealthy system. What a concept, except that those options were pretty much cut off from other states under Obamacare.

As for the impact on taxpayers, the Heritage Foundation has a good report for state lawmakers outlining the hidden costs of Medicaid expansion. Give it a read, and then contact your Representative or Senator to let them know how you feel.

And then, if all this piques your interest about consumer-driven healthcare reform, consider that if Switzerland can do it to great effect so can we.

It’s really pretty simple. As a society we’ve made the correct decision that we’re not going to step over bodies on the way to the hospital. So we subsidize those who need it, but we still offer them choices in what care they receive and how they get it. That results in insurers and providers competing for their business, which results in better service, better care, and lower prices. It works for virtually everything else we purchase, so why not healthcare?