Sorting out the ‘we’ in Medicaid expansionists’ claims
When someone tells me I can get something of value for “free,” I raise an eyebrow. When that “free” thing is coming from the government — and worth billions — I reach for my wallet.
So it goes with the question of whether Georgia should opt into Obamacare’s expansion of Medicaid.
In upholding most of the health reform law this summer, the U.S. Supreme Court did allow one concession to the states that sued to overturn it. The court ruled Washington could not threaten to take away states’ existing Medicaid funding if they declined to expand Medicaid. Each state must now decide whether to take part in the expansion and make anyone earning 138 percent of the federal poverty level eligible for Medicaid.
Georgia Gov. Nathan Deal in August said he would decline the offer on two grounds. First, the state can’t afford its share of the expansion’s cost. Second, Deal doesn’t believe a heavily indebted Washington will uphold its end of the bargain, possibly putting the state on the hook for even more than projected. Medicaid already accounts for more than $2 billion in state spending each year, or almost $1 of every $7 from the state’s general fund — and rising.
There’s no sign Deal is wavering on this decision, but Obamacare supporters keep making their case to the public.
They scarcely try to convince us the state’s portion of the expansion is affordable — though they do argue the state’s projection of $4.5 billion over 10 years is too high.
Instead, they focus on the federal money Georgia will forgo if we don’t participate. A recent study by the Kaiser Family Foundation, reported in the AJC this week, put the figure at $33 billion over the next decade. This, proponents say, is a matter of getting what’s due to us.
The gist of one of their key arguments is: We are going to pay the taxes levied by Obamacare, so we at least ought to get the funding it’s meant to provide us.
This argument assumes Obamacare will actually pay for itself, a dubious proposition given Washington’s history of missing high on revenue forecasts and low on cost projections. But that’s not my point today.
Instead, I want to point out that “we” isn’t always we. Sometimes “we” is they.
In the above example, the payers of the tax are indeed “we.” But “we” are not the beneficiaries. The beneficiaries are the health providers, mostly hospitals, who have their eyes on that $33 billion.
New Medicaid enrollees would gain some benefit, though even that’s limited because the number of doctors who don’t accept new Medicaid patients is large and growing. But many of these potential enrollees already receive care that simply isn’t paid for.
While no one’s calling this a hospital-bailout program, that’s what it boils down to.
But aren’t we already paying for these patients? What about that “care that simply isn’t paid for”?
Yes, we’re already paying for them, in part via higher insurance premiums. But not as much as you think: A study by the Urban Institute found uncompensated care accounts for just 1.7 percent of health premiums. The Medicaid expansion would reduce this by only a fraction. The Obama administration itself has said the Medicaid expansion would reduce the “cost-shifting” from the uninsured to the insured by just $1 billion a year – nationwide.
Compare that $1 billion a year in savings to the estimated $95 billion a year Obamacare would spend to expand Medicaid.
The reduction of cost-shifting may be smaller than one might expect because Medicaid payments often don’t cover the cost of treatment, which explains why so many doctors don’t accept new Medicaid patients. When you lose money on every patient, you can’t make it up in volume.
So don’t expect the Medicaid expansion to lead to smaller premiums in your private insurance. History tells us the opposite will happen. Expanding a broken program is of no real help to the uninsured or to taxpayers.
Perversely, the states that decline to expand their Medicaid programs may actually make Obamacare more sustainable by lowering its costs. But it should keep pressure on Washington to come up with real reform that benefits the uninsured and our health system more broadly.
– By Kyle Wingfield
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247 comments Add your comment
independent thinker
November 29th, 2012
10:19 am
Truly amazing- none of the cons even attempt to deal with the root problem of billions being spent on mandatory free healthcare at any hospital under EMTALA. That law requires that the provider ensure free treatment until the patient is stable. In some cases illegals get millions of dollars of long term care until they can be deported and dumped to die in their home country . It happens in every hospital in Georgia. WHO PAYS??????????
Did you know that EMTALA was proposed by Ralph Nader and Reagan signed it because it was budget neutral. Stick to the states to figure out how to cover it- just do not fund it.
Strange thing is some high priced attorney named Michelle Obama found ways around it so she and the University of Chicago Hospital could make some serious profits after dumping patients, Yhats what happens with unfunded mandates.
Of course no one here wants to admit Romneycare replaced Reagancare. All of this is too complicated for the cons in this state who would rather keep the status quo of sucking up more fed $$$ than we pay in by keeping state contributions and taxes low Who cares if hospitals can’t afford EMTALA? Throw the bums out on the street.
Bye Bye Cheesy Grits
November 29th, 2012
10:23 am
Obama carried 47 percent of the 29 which multiplied together gives you 13.63 percent of the vote. Then he carried 55 percent of the 18 percent which multiplied together gives you 9.9 percent of the vote. His total among people with a Bachelors is 23.53. The total number of those with a Bachelors that voted is 29+18=47 percent. Divide 29.53 by 47 percent and you get 50% which is the total percentage of the voters that hold a Bachelors degree that voted for Obama.
Gonna go right over his head.
Black Label
November 29th, 2012
10:26 am
“Gonna go right over his head.”
He will ignore it or come back with a bunch of nothingness.
yuzeyurbrane
November 29th, 2012
10:28 am
Kyle, I asked you once before to back up your numbers re the state’s contribution over 10 years and received no response to my challenge. The $4.5 billion you cite is a figure the Governor’s press secretary defended as being based on prior experience with Fed. programs. Kaiser and Ga. State public admin. advisors to the State legis. project it in the $1.8 to $2.5 billion range, without taking into account factors such as the new state tax revenues caused by the infusion of $33 billion Federal dollars into the Georgia economy and the reduced state subsidies to hospitals that now provide ER care to indigents. Nor does it factor in the reduced cost to hospitals in ER care they now eat nor the average $1,000, per Kaiser, that is shifted to patients with health insurance because ER’s are so much more costly than planned regular medical care. Of course, you also don’t factor in the human cost of 650,000 Georgians who actually get sicker and die sooner because they have no regular medical care. Also, while Georgia has its budget problems, let’s not lose cite of the fact that Ga. is #50 in per capita average amount spent on Medicaid. Just look in to it with state’s own figures. The right’s propaganda image of “black welfare queens” rolling up to the doctor’s office in their Mercedes is just plain false. Simply put, if you are not a child or in a nursing home, it is not easy to get on Medicaid in this state.
Black Label
November 29th, 2012
10:33 am
How ironic that Romney’s total vote percentage will end up slightly over 47%………
Bye Bye Cheesy Grits
November 29th, 2012
10:33 am
Did you know that EMTALA was proposed by Ralph Nader and Reagan signed it because it was budget neutral. Stick to the states to figure out how to cover it- just do not fund it.
Exactly right. Ronald Reagan.
The same people who are going nuts about Benghazi have no issue with Ronnie cut and running in Lebanon
On February 7, 1984, President Reagan ordered the Marines to begin withdrawing from Lebanon. Their withdrawal was completed on February 26, four months after the barracks bombing; the rest of the multinational force was withdrawn by April 1984.
Can you imagine if Obama did something like that ?
The hypocrisy of the Republican party is truly astonishing.
JDW
November 29th, 2012
10:34 am
@Cheesy…
I know it’s that whole Republican and math dynamic at work.
Gilliigan
November 29th, 2012
10:38 am
Skipper, you say that America doesn’t take care of its poor. The article notes that 1 out of every 7 state dollars spent is on Medicaid. How much should it be and what would you propose cutting to fund the increase (infrastructure, education). Hey, I’m all for reducing the government payrolls….
Black Label
November 29th, 2012
10:40 am
Interesting article on the governors who have decided to pass on the medicaid expansion. We will see how it plays out in the next few years
http://www.politico.com/story/2012/11/experts-governors-wont-resist-medicaid-expansion-for-long-84391.html?hp=l5
Jose
November 29th, 2012
10:43 am
Georgia will spend hundreds of $millions locking up marijuana growers but won’t spend a fraction of that setting up the health care exchanges and restoring the Hope Scholarship.
independent thinker
November 29th, 2012
10:46 am
“”"”"”"”"”"”"EMTALA truly improved a major problem of access to care. It said that no one would be allowed to die or be put in jeopardy in our ERs because of insurance or money. Of course there was no funding for all the uncompensated care that ensued. As a result, EMTALA has been cited as the biggest unfunded mandate of all time. The regulatory power and might of the government has enforced and refined EMTALA substantially since 1986. The hospitals live in mortal fear of $50,000 fines.
By now the full ramifications of EMTALA are well entrenched. The biggest is the “cost shifting” that has resulted because hospitals must charge more from their other paying sources to balance the losses of the indigent care they are mandated to provide for free. All the insurance plans have had to do the same. This phenomenon has been present from the beginning of EMTALA.
Additionally, specialists providing backup care to ERs either resigned from hospital staff or had to be paid to provide backup call for patients during the entire hospital stay. Such payments are routine throughout California for scarce specialties, such as general surgery, neurosurgery, orthopedic surgery, plastic surgery, and cardiology. “”"”"”"”"”"”"”"”"”"”"”"”"”
http://www.marinmedicalsociety.org/magazine/articles/?articleid=470
Sounds very cost effective doesn’t it? And the cons think it is free an they do not pay for it.
Blue coat
November 29th, 2012
10:47 am
‘Crucified’ Obama painting ‘Crucified’ Obama painting- Ain’t you ashamed Obamaphone.
Bye Bye Cheesy Grits
November 29th, 2012
10:50 am
Georgia will spend hundreds of $millions locking up marijuana growers but won’t spend a fraction of that setting up the health care exchanges and restoring the Hope Scholarship.
Don’t get me started on that one.
Another issue Georgia will be last to change on but imagine the revenue generated by selling citizens something that is basically harmless and they are going to get anyway.
Once again the blue states will lead the way.
Bye Bye Cheesy Grits
November 29th, 2012
10:51 am
Not to mention the savings in law enforcement by decriminalizing it.
Black Label
November 29th, 2012
10:52 am
side topic:
I tried to tell you that “Let’s make a Deal” was only playing games about a new stadium and he would be coming around.
Said Deal:
”I think that, overall, if we get a new facility that’s upgraded and meets the current demands and needs of the future, then being on the hook for less than a third – that is repaid from money that comes from outsiders – I think that’s probably a pretty good deal.”
Jenner
November 29th, 2012
10:53 am
Lil’ Barry, you’re incessant ramblings belie your education level. You’ve bought into every one-liner the right ever came up with to get your vote. And you lost. The point of getting Obamacare passed was to get us a little closer to a universal payer system, you know, the one that works incredibly well for all the other advanced nations. The problem is, uneducated dolts like yourself can’t stand change so we have to slowly work our way there. Thankfully most of America is smart enough to move in the right direction or stupid enough to be convinced by those more capable of making a good decision. You are in the latter… and were convinced by the wrong people. But it doesn’t matter, we’re going in the right direction. And you’ll be a beneficiary even if we have to drag you kicking and screaming like the child you are.
Rafe Hollister, dreading the eventual decline caused by Obamanism
November 29th, 2012
10:55 am
JDW
I get what you are saying, that the post graduate degree people also had a college degree and the majority of them supported Barry. Not sure all your math assumptions are valid, but even by your numbers, saying all the uneducated voted for Romney is false.
High School Grads and below 51% O
Some College 49% O
College Grads 51% R
Post College 55% O
http://elections.nytimes.com/2012/results/president/exit-polls
How you can stretch this to say that Romney got the uneducated vote is beyond reaching. Looks to me that this vote went to Barry O. I couldn’t find where it was broken out showing how those with less than a HS degree voted, have seen it before, but it was overwhelmingly for the Mistake.
Bye Bye Cheesy Grits
November 29th, 2012
11:00 am
Some of you have probably already seen this but this was Rachael Maddow’s ( Yes she is extremely biased ) rundown of things after Obama was re-elected. Most of it very true.
So you guys might as well get over it.
(1) “We are not going to have a Supreme Court that will overturn Roe vs. Wade. There will be no more Antonin Scalias and Samuel Alitos added to this court.”
(2) “We’re not going to repeal health reform. Nobody’s going to kill Medicare and make old people in this generation — or any other generation — fight it out on the open market to try to get themselves health insurance. We’re not going to do that.”
(3) “We’re not going to give the 20% tax cut to millionaires and billionaires, and expect [cutting] programs like food stamps and kids’ health insurance to cover that tax cut.”
(4) “We’re not going to make you clear it with your boss if you want to get birth control with the insurance plan that you’re on.”
(5) “We are not going to redefine rape.”
(6) “We are not going to amend the constitution to stop gay people from getting married.”
(7) We’re not going to double down on Guantanamo.
(8) “We’re not eliminating the Department of Energy, the Department of Education, or Housing at the Federal level.”
(9) “We are not going to spend two trillion dollars on the military, that the military does not want.”
(10) “We are not scaling back on student loans because the country’s NEW plan is that you should borrow money from your parents.”
(11) “We are not vetoing the Dream Act, we are not ‘self-deporting.’”
(12) “We are not letting Detroit go bankrupt.”
(13) “We are not starting a trade war with China on Inauguration Day in January.”
(14) “We are not going to have — as a president — a man who once led a mob of friends to run down a scared gay kid to hold him down and forcibly cut his hair off with a pair of scissors while that kid cried and screamed for help. (And there was NO apology, not EVER.)”
(15) “We are not going to have a Secretary of State John Bolton. We are not going to bring Dick Cheney Back. We are not going to have a foreign policy shop stocked with architects of the Iraqi war, we are not going to do it … We had the choice to do that if we wanted to do that, as a country, and we said no, last night, loudly.”
Forward
Black Label
November 29th, 2012
11:00 am
Rafe
Well look at it like this; Obama received 50% of the individuals with a college degree and more of the rest.
If someone is working in a “trade” or even at Walmart, I do not think on them any less because the don’t have a degree or voted for Obama or Romney.
You? You seemed to have touted that degree stat until JDW schooled you.
Romney lost. Moving on now.
An Observer
November 29th, 2012
11:01 am
Governor Deal is correct in his decision and i hope he stands by it. Paying for this expansion is being done on the federal credit card, which is already maxed out for many reasons.
Don't Tread
November 29th, 2012
11:03 am
“Medicaid payments often don’t cover the cost of treatment, which explains why so many doctors don’t accept new Medicaid patients. When you lose money on every patient, you can’t make it up in volume.”
And the same will hold true for 0bamacare. People, including doctors, generally don’t like it when the government tells them “you’ve made enough money” (which is another way of saying “to hell with your freedom”). Wonder what will happen when doctors don’t accept 0bamacare patients? Will the Democrats be sending the “National Defense Force” to the doctor’s office with a gun to force them to obey?
Bye Bye Cheesy Grits
November 29th, 2012
11:04 am
How you can stretch this to say that Romney got the uneducated vote is beyond reaching.
Not really. Because that’s exactly what happened.
Just look at the red states. They all have the lowest percentage of college grads
Now the blue ones. Much higher percentages of college grads
This one is easy.
Here are the 10 states with the lowest percent of college graduates.
1. West Virginia: 25.6 percent
2. Arkansas: 26.5 percent
3. Louisiana: 27 percent
4. Kentucky: 29.2 percent
5. Mississippi: 29.3 percent
6. Nevada: 30.1 percent
7. Oklahoma: 31.3 percent
8. Tennessee: 31.3 percent
9. Alabama: 31.6 percent
10. Texas: 33.3 percent
Mostly red states.
10 states with the highest percentages of college graduates.
1. Massachusetts: 49.6 percent
2. Connecticut: 46.6 percent
3. New Hampshire: 46 percent
4. Colorado: 45.3 percent
5. North Dakota: 45.2 percent
6. Minnesota: 45 percent
7. New Jersey: 44.6 percent
8. Maryland: 43.9 percent
9. New York: 43.7 percent
10. Vermont: 43.6 percent
Mostly blue states.
JDW
November 29th, 2012
11:08 am
@Rafe…”but even by your numbers, saying all the uneducated voted for Romney is false. ”
I did not say that, I said Romney’s dominant demographic was uneducated white males and it was. I further noted that the 10 “most educated states” voted for Obama while 9 of the top 10 “least educated states” voted for Romney.
http://www.happyplace.com/19076/election-infographic-shows-most-educated-states-voted-for-obama
Bye Bye Cheesy Grits
November 29th, 2012
11:09 am
BTW Wanna know why Republicans really have a problem with Susan Rice ?
Because if John Kerry is named Sec of State instead of her.
Then they can pick up a Senate seat with Scott Brown.
Thats what its really about.
GB101
November 29th, 2012
11:15 am
Bye Bye Cheesy Grits
If Ga is the laughing stock of the nation, why are people moving here? The state’s population has nearly tripled in my lifetime. Do people move to places they deem to be a laughingstock? Do you live here? Did you move here from somewhere else? If so, why? Was it in hopes of getting a generous Medicaid program?
Hillbilly D
November 29th, 2012
11:18 am
It doesn’t matter which pocket it comes out of, we all know who is paying the bill.
This is all a political game and I don’t know who will wind up the winner but it’s for sure who is going to be the loser…..same as always.
Oh well
November 29th, 2012
11:19 am
GB
Population in your life time as went up in many states.
Just saying.
I’m a GA native. Thanks for asking
JDW
November 29th, 2012
11:27 am
@GB101…”If Ga is the laughing stock of the nation, why are people moving here? ”
Interesting question…answer…it is happening less and less
http://www.bizjournals.com/atlanta/real_talk/2012/08/city-of-atlanta-population-growth-lags.html
Matz
November 29th, 2012
11:31 am
We should have a single-payer system or a public option. Why didn’t we get that? Because Obama was busy trying to reach across the aisle and get consensus from the Republicans. What we got was much like President Clinton’s “don’t ask don’t tell”: a watered-down compromise that did not sufficiently address the problem, and which people were compelled to come back and fix.
I hope Obama has learned from this mistake, and will stop reaching across the aisle to get this fingers bitten off by people who care only about their own power and egos. If you don’t think poor people deserve access to medical care in this here “greatest country in the world,” then you’re not much of an American in my book, and there’s nothing you can possibly say about anything that I want to hear.
Bye Bye Cheesy Grits
November 29th, 2012
11:34 am
This is all a political game and I don’t know who will wind up the winner but it’s for sure who is going to be the loser…..same as always.
Yup. The poor will probably get screwed again.
Jefferson
November 29th, 2012
11:38 am
Most know it alls appear to be selfish also. You can be mad all day, what about tomorrow?
Bye Bye Cheesy Grits
November 29th, 2012
11:39 am
Part of the explosion in Georgia population is the extremely high teenage pregnancy rate.
Its that way across the entire South.
Of course they just continue along with abstinence programs that dont work.
52 per 1,000 teenagers in Georgia get pregnant.
Compare that with a progressive state like Massachusetts where the number is around 20 per 1,000
Laughingstock.
Bye Bye Cheesy Grits
November 29th, 2012
11:45 am
BTW The Fox News fake “War on Christmas” stuff has begun.
md
November 29th, 2012
11:55 am
The term “greed” is relative to all points on the spectrum…….remember that when throwing it out there.
Tiberius - pulling the tail of the left AND right when needed
November 29th, 2012
11:58 am
Cheesy, don’t even go there regarding what causes population growth rates in states.
The fact is that there are many reasons why people go to one state or another, and why some leave states for others.
Bottom-line is that Georgia’s population is growing faster than states like Massachusetts. We have GAINED Congressional seats while they have LOST them – and continue to lose them following each census.
Why? Climate is a big reason; both meteorological and economic. We’re warmer , and people in colder climates retire to warmer ones, and Florida is getting too crowded and too expensive for retirees. The taxes alone on purchases and housing are miniscule compared to the Northeast. I pay 1/3rd of the property taxes I used to pay in Mass or NH for a bigger and better house here. My food and gas dollars go farther. Then, we add in the cost of freedom. Far less government regulation and intrusion in Georgia. All-in-all, these are why 40% of Georgia’s population in the next 40 years is going to be retirees – because we’re attractive to them, and liberal Northeast states are not.
And why Georgia will likely gain another 3 Electoral votes in that time, while Massachusetts will likely lose the same to us.
Tiberius - pulling the tail of the left AND right when needed
November 29th, 2012
12:01 pm
And JDW, in case you missed it, the city of Atlanta isn’t Georgia.
Nor is it the destination for people moving into Georgia.
Wake up, will ya?
Tiberius - pulling the tail of the left AND right when needed
November 29th, 2012
12:09 pm
Zig Ziglar dies at age 86, even though he was so positive and upbeat that he was going to live longer . . .
Aquagirl
November 29th, 2012
12:10 pm
Far less government regulation and intrusion in Georgia.
How nice that retirees can spend their Social Security and Medicare dollars without the horrible nanny state intruding in their personal lives. Nobody bothers them while they unload their Hoverounds in the ADA mandated handicapped space in front of the pharmacy, roll up the ADA mandated handicapped ramp, and wheel through the extra-wide ADA mandated isles to pick up their Medicare D funded prescriptions.
Live Free Or Die!!!!
Hopeful
November 29th, 2012
12:25 pm
I’m sick right now but I have to take care of my mother I would like to lay in bed and relax ha!ha! That’s not going to happen oh! I’m not rich either no maid service here ! When do the Caretakers get a break huh when !!!!!!!! I wished the wish Foundation would grant me on I would go to fla. to that place that dose react of Jesus and someone would take care of mother !!
Rafe Hollister, dreading the eventual decline caused by Obamanism
November 29th, 2012
12:35 pm
Finn/Cheesy/JDW
Yes, the southern red states have less college graduates as a percentage of the population. The reason for that, is very complicated and has nothing to do with the intelligence of the people living here. As I have said many times, the overwhelming number of under educated/unprepared people, that live here, as a percentage, is staggering. It is a cultural thing, probably left over from the agrarian days. If all these people cared enough to register and vote, Georgia would probably be a blue state. It seems they are pretty apathetic about most anything requiring effort, education, voting, working, child rearing, etc. and this includes both dominant races in the state.
The blue states do not have the agrarian descendants, waiting around for the new season of American Idol.
JDW
November 29th, 2012
12:36 pm
@Tiberius…”in case you missed it, the city of Atlanta isn’t Georgia. Nor is it the destination for people moving into Georgia.”
The Atlanta Regional Commission reported Thursday the 10-county metro added about 37,200 people between April 1, 2011, and April 1, 2012. Metro Atlanta is now home to 4,179,500 people, making it larger than 24 states, according to U.S. Census data. The growth number is higher than the previous year, but it marks a fourth consecutive year of slower-than-normal growth when compared to the region’s population growth from 2000 to 2007, ARC noted.
It’s just where the people are…
Finn McCool (The System isn't Broken; It's Fixed)
November 29th, 2012
12:42 pm
Goldline…The company’s business model was built on systemically swindling and scaring its mostly elderly clientele into purchasing overpriced gold coins, prosecutors in California alleged, leading the company to settle for $4.5 million in refunds to its customer. The City Attorney in Santa Monica, where the company is based, brought 19 criminal fraud charges against the company that were later dropped, but a Los Angeles judge last year instructed the company to foot the bill for a court-appointed monitor, who was tasked with ensuring the company revealed its price markups and stopped misleading consumers.
Thank you Glen Beck and Shawn Hannity! Our grandparents needed to be swindled out of their retirement and savings so you could fly in the private planes. Good job!
http://www.salon.com/2012/11/29/more_legal_trouble_for_beck_backed_goldline/
Finn McCool (The System isn't Broken; It's Fixed)
November 29th, 2012
12:43 pm
“Goldline now is the only gold company I personally recommend to you,” Sean Hannity says. “My choice for buying gold is Goldline,” conservative radio host Mark Levin says.
JDW
November 29th, 2012
12:44 pm
Not sure what that spin buys you Rafe. Simple fact is the more education one has the more likely to vote democratic they are, on a national basis. Not sure if that level of detail exists for states.
JohnnyReb
November 29th, 2012
12:45 pm
“…the 10-county metro added about 37,200 people…”
Would those be Makers or Takers?
Tiberius - pulling the tail of the left AND right when needed
November 29th, 2012
12:48 pm
JDW, in cased you missed it (and notice how I usually preface my remarks to you in this way, as you usually DO miss it), the growth in this area during the dates you cite was spurred by a growing economy and an inflated housing market, neither of which are in place today.
You see, in the REAL world, there are REASONS and EXPLANATIONS behind raw statistics which people of intelligence use to understand the statistics, rather than just spouting them off as the ignorant do.
You’ll also notice that the fastest-growing county in the state (and in the top 5 in the country) during that time was Forsyth county, which isn’t even in the 10-county metro area.
So again, the next time you wish to spout such incredibly ignorant comments about which you really don’t know anything, consult with those of us who do, OK?
Finn McCool (The System isn't Broken; It's Fixed)
November 29th, 2012
12:51 pm
Jon Stewart nails the Cons on their Susan Rice attacks. Remember Condi Rice doing something similar back in 2002? Lookie here:
http://www.thedailyshow.com/full-episodes/wed-november-28-2012-neil-young
independent thinker
November 29th, 2012
12:53 pm
From that liberal bastion of thought , the Cato Institute:
“”"”"”"”"”"” final thought in this “Obamacare-at-the-Court” week: Does the Emergency Medical Treatment and Active Labor Act (EMTALA) make something like Obamacare’s mandate not only inevitable but legitimate? Enacted in 1986, EMTALA requires hospitals to provide care to anyone needing emergency treatment regardless of citizenship, legal status, or ability to pay. It’s often cited as the very reason we have to have Obamacare’s individual mandate, to cover the costs of providing for the uninsured indigent. As the Washington Post editorialized this morning, “If you end up in the emergency room, you will be cared for, as federal law demands. The government, already deeply involved in regulating the health-care market, has a legitimate interest in encouraging you to prepare for such an eventuality.”
Fair enough, but it must do so by constitutional means, and that’s just the problem here. Not every means that would solve a problem is authorized by our Constitution for limited government. In truth, however, the constitutional problem begins with EMTALA itself: neither the taxing nor the commerce power, if understood as the pre-New Deal Court understood it, authorizes Congress to compel hospitals to be Good Samaritans. In a free society, health care is no different than any other product or service: If you need or want it, you pay for it, failing which you don’t get it.
But the Constitution aside, that’s not how, “as a society,” we decided to go about things in 1986. We imposed the burden of providing such services on hospitals, which in turn shifted the costs mainly to those of us who do pay for the services we receive. To that complex system of “private” socialization Obamacare would add yet another layer of even more complex “public” socialization, the individual mandate being only one element in the mix. Needless to say, under neither arrangement is efficiency or the wise use of resources the goal.”"”"”"”"”"”"”"”"
Kyle’s right that expanding Medicaid will direct more money to hospitals. What is the alternative?
an unfunded mandate? less hospitals? People needing more emergency room care because they have no means of getting regular medical care or preventive care? Funny how it was great and fine when pushed through by Romney in Mass. but not here in Georgia.
Waiting to hear alternatives from the cons whose hero passed EMTALA. All we got from Kyle is a critique of a partial solution approved by all three branches of the US government to a problem the Republicans created. Yes that Black Muslim communist better clean up the mess faster and at less cost.
carlosgvv
November 29th, 2012
1:03 pm
Tiberius – 11:58 “we’re warmer”
And, thanks to global warming, we’re geting even warmer every year.
DawgDad
November 29th, 2012
1:10 pm
Medicaire expansion is a key front in the battle for leftist-socialist transformation of our nation with power consolidated into the Federal Government and partner corporations (willing or otherwise extorted) under the control of the Democratic Party. The goal for Medicaire must be CONTRACTION by ensuring as few people as possible need it. That is obviously not what the Democrats are all about.
In May 2012 the State of Illinois CUT $7 BILLION from their State Medicaire funding. Federal money, the funds Illinois will be leveraging, come from ALL of us, including Georgians. All made possible by their minion in the White House and the utter stupidity of the American voters.