Friday, February 26, 2016


For decades, Democrats have said Republicans are heartless. Statistics show that conservatives are some of the most charitable people in the country. Yet they can sometimes appear heartless when it comes to such things as Medicaid.

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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