So we vote next week on whether or not to expand Medicaid according to Obamacare’s provisions. A vote “Yes” on State Question 802 would expand Medicaid to able-bodied adults above the poverty line. A vote “No” would keep the status quo, with taxpayers buying health care under Medicaid mainly for poor children and pregnant mothers.
But as with just about anything proposed by initiative, State Question 802 is not really that simple. For one thing, it forever entrenches a federal program, which can be changed by Congress at any time, in our state’s constitution, which is not so easily amended. Obviously, the proponents of SQ 802 want to set the terms of the Medicaid expansion permanently, sidestepping our constitutionally instituted legislature, which is supposed to react and adjust to existing circumstances. SQ 802 would take that flexibility away.
A consequence of that reduced flexibility will likely be sacrifices in other state-financed programs such as public education, both in the near term and during inevitable future economic downturns. That’s because Medicaid will be an absolute entitlement ensconced in our constitution. Funding for public education, roads, parks, prisons, courts, and other purposes is not constitutionally protected, which means dollars that could fund them will be forced to flow to Medicaid, buying health services for able-bodied adults above the poverty line. And with prices in health care continuing to rise faster than prices of everything else, there will come a day when cuts to everything our state provides, except for constitutionally-protected Medicaid, will be deep and painful.
The commercials in favor of SQ 802 would have us all believe that Medicaid expansion is a pure financial windfall. They never say that to get the billion dollars for Medicaid from the feds, we have to put up $100 million of our own money, and they never say that the legislature has not determined a source for that money. If the legislature cannot agree on a separate source, the money MUST come from the rest of the state’s budget, and the biggest single item ripe for picking is – public education.
Proponents of SQ 802 act like Medicaid expansion is all about helping poor people. But who is funding the commercials? Obviously, it’s not poor people. It’s the big “non-profit” hospitals, with their million-dollar salaried CEOs who are funding the commercials. And that should give you a strong hint of who really benefits from Medicaid expansion.
Low-income individuals are already getting the basic health care services they need, and hospitals are making money hand over fist. If they weren’t, new hospitals and hospital expansion construction projects would not be a constant fact of life, as they are now and have been for decades. When health care industry spokespeople claim financial hardship due to poor people not paying their bills, don’t buy it. It’s a lie. Even with the grossly inflated prices they claim on the books that, in turn, are used to exaggerate losses from charity and unpaid bills, both charity and bad debt are minor expenses for the big hospitals.
Medicaid expansion is just about making very wealthy people in the healthcare industry even richer. The rest of us will see that money only when we serve these rich people their meals, sell them a car, or add a new room to their already-opulent homes. Odds are, most of that money will just grow their stock portfolios. And that includes our $100 million, not just the billion from the feds, which is all borrowed in the name of a national government that is effectively bankrupt. At some point, we’ll be stealing from our schools to pay the big-city hospital administrators so they can buy a better model of Mercedes or yet another vacation home that’s not in Oklahoma.
But, some no doubt object, what about all those rural hospitals? They need the money!
Well, I recall a hearing in the state capitol where some nurses testified about how their rural hospital was made financially sound. They stopped operating wastefully like the big-city hospitals and stopped trying to provide services better suited to big hospitals. Then, their board was suckered into a contract where a management company used the hospital to defraud Medicare and also drove the hospital financially into the ground. No doubt, lots of equally incompetent hospital board members are all in for Medicaid expansion. Certainly those who would steal from taxpayers by defrauding Medicaid would be happy to see it grow, too. What pirate doesn't want a bigger treasure?
Health care is almost 20 percent of our economy, but that industry clearly isn’t satisfied. At what point are we going to question the wisdom of institutions that have government and insurance companies pay the bulk of medical bills while patients pretend health care is nearly free? Most of that 20 percent is a pure transfer from everybody else to wealthy health care providers and insurance companies through grossly over-priced services in an industry where competition mostly does not exist. Competition doesn’t exist because patients don’t pay their own bills; they often don’t even see them.
But, you might say, health care is a right. We all need it, not only for good health, but for dignity and life itself. You can make the same argument about food and housing, and indeed, these are often provided by government. But the problem with saying any one person has a “right” to something another person must produce is that you are also saying you have a right to another person’s labor. Paying them with taxpayer money only means you have a right to taxpayers’ labor, without recompense.
There’s a word for when a person has a “right” to another person’s labor without recompense – it’s “slavery.” Keep that in mind while casting your vote on SQ 802 on June 30.
Byron Schlomach is 1889 Institute Director and can be contacted at bschlomach@1889institute.org.
The opinions expressed in this blog are those of the author, and do not necessarily reflect the official position of 1889 Institute.