The GOP leadership keeps trumpeting work requirements and fraud when asked where they'll find $880 billion in cuts to health care programs. That's nonsense.
Bottom line. You take away medicine from the seriously ill, they die. You take away medical support from this nations elderly, they die. Defunding Medicaid is a crime against humanity.
The Wall Street Journal ran an excellent piece about the expansion of Medicaid under the Biden Administration into areas well beyond its traditional scope. These can be rolled back without jeopardizing the program’s core mission. In addition, as is always the case, the term “cuts” is misleading as the reductions are to projected baseline 10-year projections, not to actual historical expenditures.
In a health insurance system based on the idea employers provide coverage, covering those who work at companies that fail to meet that responsibility require government assistance. That's why the Affordable Care Act (not the Biden administration) expanded Medicaid, which the Supreme Court made optional for the states. Rolling that back would eliminate millions of workers from the ranks of the insured, raise the level of uncompensated care, and raise everyone's premiums and every other employers' costs. That's why expanding Medicaid to cover the working poor is "common sense." As for cuts off projections, that's what the CBO does and every budgeteer does. To pretend that a dollar in ten years is going to be worth what a dollar is worth today is absurd -- the very opposite of "common sense."
I have watched the cost of healthcare grow over the last few decades. I( (I had the funds then) I should have invested in the healthcare industry.
The percentages of increase in cost are phenomenal. One drug which I am familiar with is Rituxan. According to the ICER, the cost of Rituxan from the fourth quarter of 2016 to the fourth quarter of 2018 was 17%. Allow me to put this into a dollar amount for you. One dose, is an ~$30,000 which is 2020 pricing.
There appears to be no limit on what healthcare costs in the US that one might find in Europe or Canada and even Mexico. We have a dilemma. Do we whack Medicaid and its availability which already is stiff on prices or do we start to look to the costs of healthcare in the US? I vote for the latter. It is a bigger gain rather than going after people who can least afford it which is going to be the outcome as it has been so in the past.
In 2017, our president with the orangish face passed a tax bill under reconciliation which has yet to pay for itself. $2 trillion reduction in revenue. The 2001 and 2003 Repub tax breaks are problematic also. And you wish to go after Medicaid? Yes, it has some issues which can be refined. Those are small in comparison to the tax breaks. Yet, you wish to whack them rather than work to lower the commercial costs of healthcare. The common sense is to go after the industry pricing rather than the users. Sermon done.
By the way . . . I get four does or Rituxan which Medicare and Supplemental pay for today. The VA and I are having discussions about my 2+ years in and out of Camp Lejeune.
It is true that most states tax providers and then use the money to pay their share of Medicaid. This raises the "cost" line for providers, which raises state submissions to the Feds, which in turn raises the Fed match. In short, it's a way of switching some state taxation to federal taxation (no state has 100% federal match). But the important to remember about this alleged "scam" is that it doesn't raise spending one dime. If the Republicans remove this "loophole," all they will be doing is switching from federal taxation to state taxation and/or put the onus on the states to cut benefits and/or people from the Medicaid rolls. That's not "common sense." That's a cruel political maneuver to pretend they're offsetting the tax breaks they're going to give to big corporations and the rich.
Arguably, Medicaid should be more of a state than a Federal responsibility. Some states are wealthier than others and certainly cultural and political attitudes toward public financing of means-tested care vary.
That fits with the conservative philosophy of devolving as much power and money as possible to the states. Progressives are starting to unknowingly come around to this line of reasoning as they discuss withholding taxes from the Feds to stymie Trump now that the shoe’s on the other foot so to speak.
If things go in that direction, blue states will become magnets for tax takers, while red states will attract taxpayers. If conservatives retain long-term control of the Federal government, blue states will become economically non-viable.
The answer of course is to grow the economy so that fewer people are dependent on anti-poverty programs like Medicaid. The public policy goal is to enable people to take care of themselves so the government doesn't have to take care of them at taxpayer expense. This objective requires comprehensive public sector reform starting with our corrupt, ineffectual public education system.
Should progressives regain national power, it would make sense to combine Medicare and Medicaid into a hybrid program. In retrospect, the division of care for the old and the poor in 1965 had substantial downsides. Medicaid is the long-term care funder of last resort, which consumes over half of program resources, so in effect, it is largely an eldercare entitlement.
Integrating the two programs would involve setting a level of care somewhere between current Medicare and Medicaid quality and access levels, perhaps providing Medicare Advantage for All. This means testing would apply up to a certain age. All government health programs would negotiate unitized volume purchasing. States would pay the Federal government an amount based on their legacy Medicaid funding.
"If the Republicans remove this 'loophole,' all they will be doing is switching from federal taxation to state taxation and/or put the onus on the states to cut benefits and/or people from the Medicaid rolls. That's not 'common sense.' That's a cruel political maneuver to pretend they're offsetting the tax breaks they're going to give to big corporations and the rich."
And some states will cut benefits more than others.
Arguably, Medicaid should be more of a state than Federal responsibility. Some states are wealthier than others and certainly cultural and political attitudes toward public financing of means-tested care vary.
That fits with the conservative philosophy of devolving as much power and money as possible to the states. Progressives are starting to unknowingly come around to this line of reasoning as they discuss withholding taxes from the Feds to stymie Trump now that the shoe’s on the other foot so to speak.
If things go in that direction, blue states will become magnets for tax takers, while red states will attract taxpayers. If conservatives retain long-term control of the Federal government, blue states will become economically non-viable.
The answer of course is to grow the economy so that fewer people are dependent on anti-poverty programs like Medicaid. The public policy goal is to enable people to take care of themselves so the government doesn't have to take care of them at taxpayer expense. This objective requires comprehensive public sector reform starting with a corrupt, ineffectual public education system.
Should progressives regain national power, it would make sense to combine Medicare and Medicaid into a hybrid program. In retrospect, the division of care for the old and the poor in 1965 had substantial downsides. Medicaid is the long-term care funder of last resort, which consumes over half of program resources, so in effect, it is largely an eldercare entitlement.
Integrating the two programs would involve setting a level of care somewhere between current Medicare and Medicaid quality and access levels, perhaps providing Medicare Advantage for All. This means testing would apply up to a certain age. All government health programs would negotiate unitized volume purchasing. States would pay the Federal government a levy based on their legacy Medicaid spending or experience equivalent cuts to Federal subsidies.
Such a maneuver would face fierce political opposition from the senior lobby and conservatives in general, but it's probably the most logical approach for the entitlement state to continue.
None of this is a question of cruelty or kindness. Charity is the platform for compassion, not public policy. In a democracy, the question is what role should the public sector play in addressing the needs of the electorate, and what is the appropriate division of responsibility among the various levels of government. Since the US obtained the exorbitant privilege of the dollar reigning as the world’s reserve currency, the ability of the Federal government to essentially create money out of thin air has given it the de facto financial power to fund exorbitantly expensive entitlements, which is why so much of the responsibility has fallen upon the national government. However, that has racked up a $36 TRILLION debt that is being viewed on a more widespread basis as unsustainable. Something must change.
The baby boomers will pass within the next generation, and baby busters that follow will be less of a burden on the Medicare side of the equation as well as long-term care Medicaid costs. Economic development if successful may reduce poverty-driven Medicaid demand.
All parties involved should support making healthcare entitlements and in fact the entire public sector more efficient and effective and reforms that reduce demand for publicly funded healthcare. Emotional appeals chastising reformers as cruel and unusual punishers are not helpful.
Is there any reason the Dems are not running ads in the Red States to raise awareness of what is being proposed?
Bottom line. You take away medicine from the seriously ill, they die. You take away medical support from this nations elderly, they die. Defunding Medicaid is a crime against humanity.
Thank you for the great article 🙏💙
The Wall Street Journal ran an excellent piece about the expansion of Medicaid under the Biden Administration into areas well beyond its traditional scope. These can be rolled back without jeopardizing the program’s core mission. In addition, as is always the case, the term “cuts” is misleading as the reductions are to projected baseline 10-year projections, not to actual historical expenditures.
In a health insurance system based on the idea employers provide coverage, covering those who work at companies that fail to meet that responsibility require government assistance. That's why the Affordable Care Act (not the Biden administration) expanded Medicaid, which the Supreme Court made optional for the states. Rolling that back would eliminate millions of workers from the ranks of the insured, raise the level of uncompensated care, and raise everyone's premiums and every other employers' costs. That's why expanding Medicaid to cover the working poor is "common sense." As for cuts off projections, that's what the CBO does and every budgeteer does. To pretend that a dollar in ten years is going to be worth what a dollar is worth today is absurd -- the very opposite of "common sense."
Those aren't the Medicaid expansions the Journal cited.
You keeping us in suspense?
Here's a link to the WSJ article:
https://www.wsj.com/opinion/medicaid-reform-republicans-democrats-entitlement-healthcare-40fc7701?st=BaLy8L&reflink=article_copyURL_share
George:
I have watched the cost of healthcare grow over the last few decades. I( (I had the funds then) I should have invested in the healthcare industry.
The percentages of increase in cost are phenomenal. One drug which I am familiar with is Rituxan. According to the ICER, the cost of Rituxan from the fourth quarter of 2016 to the fourth quarter of 2018 was 17%. Allow me to put this into a dollar amount for you. One dose, is an ~$30,000 which is 2020 pricing.
There appears to be no limit on what healthcare costs in the US that one might find in Europe or Canada and even Mexico. We have a dilemma. Do we whack Medicaid and its availability which already is stiff on prices or do we start to look to the costs of healthcare in the US? I vote for the latter. It is a bigger gain rather than going after people who can least afford it which is going to be the outcome as it has been so in the past.
In 2017, our president with the orangish face passed a tax bill under reconciliation which has yet to pay for itself. $2 trillion reduction in revenue. The 2001 and 2003 Repub tax breaks are problematic also. And you wish to go after Medicaid? Yes, it has some issues which can be refined. Those are small in comparison to the tax breaks. Yet, you wish to whack them rather than work to lower the commercial costs of healthcare. The common sense is to go after the industry pricing rather than the users. Sermon done.
By the way . . . I get four does or Rituxan which Medicare and Supplemental pay for today. The VA and I are having discussions about my 2+ years in and out of Camp Lejeune.
Here's an example of some of the games that are being played with Medicaid:
https://apple.news/AJHEpaUsRTcqfVhWY-tFFog
It is true that most states tax providers and then use the money to pay their share of Medicaid. This raises the "cost" line for providers, which raises state submissions to the Feds, which in turn raises the Fed match. In short, it's a way of switching some state taxation to federal taxation (no state has 100% federal match). But the important to remember about this alleged "scam" is that it doesn't raise spending one dime. If the Republicans remove this "loophole," all they will be doing is switching from federal taxation to state taxation and/or put the onus on the states to cut benefits and/or people from the Medicaid rolls. That's not "common sense." That's a cruel political maneuver to pretend they're offsetting the tax breaks they're going to give to big corporations and the rich.
Arguably, Medicaid should be more of a state than a Federal responsibility. Some states are wealthier than others and certainly cultural and political attitudes toward public financing of means-tested care vary.
That fits with the conservative philosophy of devolving as much power and money as possible to the states. Progressives are starting to unknowingly come around to this line of reasoning as they discuss withholding taxes from the Feds to stymie Trump now that the shoe’s on the other foot so to speak.
If things go in that direction, blue states will become magnets for tax takers, while red states will attract taxpayers. If conservatives retain long-term control of the Federal government, blue states will become economically non-viable.
The answer of course is to grow the economy so that fewer people are dependent on anti-poverty programs like Medicaid. The public policy goal is to enable people to take care of themselves so the government doesn't have to take care of them at taxpayer expense. This objective requires comprehensive public sector reform starting with our corrupt, ineffectual public education system.
Should progressives regain national power, it would make sense to combine Medicare and Medicaid into a hybrid program. In retrospect, the division of care for the old and the poor in 1965 had substantial downsides. Medicaid is the long-term care funder of last resort, which consumes over half of program resources, so in effect, it is largely an eldercare entitlement.
Integrating the two programs would involve setting a level of care somewhere between current Medicare and Medicaid quality and access levels, perhaps providing Medicare Advantage for All. This means testing would apply up to a certain age. All government health programs would negotiate unitized volume purchasing. States would pay the Federal government an amount based on their legacy Medicaid funding.
Merrill:
Exactly,
"If the Republicans remove this 'loophole,' all they will be doing is switching from federal taxation to state taxation and/or put the onus on the states to cut benefits and/or people from the Medicaid rolls. That's not 'common sense.' That's a cruel political maneuver to pretend they're offsetting the tax breaks they're going to give to big corporations and the rich."
And some states will cut benefits more than others.
Arguably, Medicaid should be more of a state than Federal responsibility. Some states are wealthier than others and certainly cultural and political attitudes toward public financing of means-tested care vary.
That fits with the conservative philosophy of devolving as much power and money as possible to the states. Progressives are starting to unknowingly come around to this line of reasoning as they discuss withholding taxes from the Feds to stymie Trump now that the shoe’s on the other foot so to speak.
If things go in that direction, blue states will become magnets for tax takers, while red states will attract taxpayers. If conservatives retain long-term control of the Federal government, blue states will become economically non-viable.
The answer of course is to grow the economy so that fewer people are dependent on anti-poverty programs like Medicaid. The public policy goal is to enable people to take care of themselves so the government doesn't have to take care of them at taxpayer expense. This objective requires comprehensive public sector reform starting with a corrupt, ineffectual public education system.
Should progressives regain national power, it would make sense to combine Medicare and Medicaid into a hybrid program. In retrospect, the division of care for the old and the poor in 1965 had substantial downsides. Medicaid is the long-term care funder of last resort, which consumes over half of program resources, so in effect, it is largely an eldercare entitlement.
Integrating the two programs would involve setting a level of care somewhere between current Medicare and Medicaid quality and access levels, perhaps providing Medicare Advantage for All. This means testing would apply up to a certain age. All government health programs would negotiate unitized volume purchasing. States would pay the Federal government a levy based on their legacy Medicaid spending or experience equivalent cuts to Federal subsidies.
Such a maneuver would face fierce political opposition from the senior lobby and conservatives in general, but it's probably the most logical approach for the entitlement state to continue.
None of this is a question of cruelty or kindness. Charity is the platform for compassion, not public policy. In a democracy, the question is what role should the public sector play in addressing the needs of the electorate, and what is the appropriate division of responsibility among the various levels of government. Since the US obtained the exorbitant privilege of the dollar reigning as the world’s reserve currency, the ability of the Federal government to essentially create money out of thin air has given it the de facto financial power to fund exorbitantly expensive entitlements, which is why so much of the responsibility has fallen upon the national government. However, that has racked up a $36 TRILLION debt that is being viewed on a more widespread basis as unsustainable. Something must change.
The baby boomers will pass within the next generation, and baby busters that follow will be less of a burden on the Medicare side of the equation as well as long-term care Medicaid costs. Economic development if successful may reduce poverty-driven Medicaid demand.
All parties involved should support making healthcare entitlements and in fact the entire public sector more efficient and effective and reforms that reduce demand for publicly funded healthcare. Emotional appeals chastising reformers as cruel and unusual punishers are not helpful.