The conflict between small government
and Medicaid is clear, but at this time, there is no alternative.
Presidential candidate Donald Trump came under attack after saying he
was for cutting government, but he wouldn't let people die in the
street. That means he has no current plan to cut or reduce Medicaid
other than the forced expansion found in the Affordable Care Act.
The ACA tried to force states to expand Medicaid programs with little
to no financial backing.
For now, let's look at this as if the
ACA doesn't exist, and just at Medicaid. There are millions of people
who might otherwise be dead if not for the program. Republicans would
prefer that the poor and unfortunate receive help through charity
organizations. In the Carolinas there are some excellent programs.
There are a number of hospitals owned by religious organizations.
There are also private organizations that help people with medical
bills. These are wonderful tools, but they aren't enough.
Citizens of states have elected
officials to create the Medicaid program to help those who can't get
help anywhere else. We all know that a government program of this
type is fraught with fraud. No one is saying that Medicaid doesn't
need fixing, but at the end of the day, despite some federal funding,
it's a state run institution.
Jack met Jill who once had breast
cancer. They fell in love and moved in together. Because South
Carolina is a common law marriage state, Jack was allowed to add Jill
to his insurance. There was a three week waiting period for
preexisting conditions and just days before it ended, Jill had once
again been diagnosed with cancer.
At first, the insurance company paid
for a few procedures, but eventually stopped paying and demanded to
be paid back for what they had paid. From that point on, Jack, the
only one working, paid for as much as possible out of pocket. For
months her doctor treated her for free, but that didn't help with all
the tests and hospital visits. One medication cost over $125 a month
and this was in the 70's. The doctor gave her as many samples has he
could get from the pharmaceutical representative, but that was little
relief.
Medicals bills had reached the point
that Jack didn't even think about trying to pay them because it was
an impossible task. One visit to the doctor changed everything. He
had been in touch with officials and she was set to go on Medicaid.
All she had to do was visit the local government office and sign all
the paperwork. This was only possible because Jack and Jill had never
been officially married. Had they been married, Medicaid wouldn't
have been possible.
A decade later, Jill died, but in the
years leading up to her death, she received some of the best medical
help available. During the 70's, Medicaid was as good as some
premium insurance policies. Today, it provides minimal help. This is
why fraud must be eliminated so that patients with real needs can get
the necessary treatment.
It's cases like the one above that
fuels Democrats to say Republicans are heartless when they talk about
cutting or eliminating Medicaid without offering an alternative.
Because there is no immediate alternative, politicians like Donald
Trump and John Kasich are attacked when they don't call for the end
of Medicaid. The next time you, a Republican, conservative, or
Libertarian attacks Medicaid, make sure you have an alternative plan.
Health savings accounts are a good idea, as is deregulation. I have
suggested health cooperatives. A few doctors have started membership
systems for free office visits, but all of these things combined will
not eliminate Medicaid.
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