Yesterday, Tea Party darling and Republican U.S. Senate candidate Rand Paul told Kentucky voters that Medicaid is “intergenerational welfare.” In an interview with local chamber of commerce leaders, Paul implied the program reaches out far beyond the truly needy and has loose eligibility standards. Medicaid assists nearly 20% of Kentuckians.
I would be interested to see exactly how a man who nets over $200,000 in income and has a robust stock portfolio goes about identifying the “truly needy.” Are pregnant women without health insurance needy? How about dependent children under 19 or the disabled? For example, a single mother in Kentucky with one child cannot earn more than $851 a month to qualify. In other words, if she’s working part time for minimum wage, she can’t work for more than 29 hours for fear of losing her health benefits. When many employers don’t offer health benefits for part time work or keep their employees at part time levels in order to avoid providing health insurance options, staying on Medicaid becomes the only option. Unless one is willing to gamble on one’s health.
Rand Paul’s statement on the matter echoes the same Reaganite talking points Republicans use to scare the public into believing the poor, disabled and anyone else barely scraping by on the lower rungs of the economic ladder are lazy leaches. The only difference between Ronnie and Rand is the tri-corner hat on Rand’s head. Thanks to decades of hateful rhetoric towards lower economic classes, millions of voters who have more in common with someone struggling to stay afloat in the roughest economic waters since the 30’s will send a guy like Paul to DC. Thanks to decades of corporate lobbying and big campaign spending, the folks in DC need only keep their sponsors happy, rather than the public they supposedly serve.
We can gut services to the poor and chant “personal responsibility” until John Galt’s ghost rides down from the clouds on an Eagle and economic misery and inequality will continue to increase throughout America. Sadly, we still haven’t realized our neighbor next door isn’t sucking money out of our pockets, but rather large corporate sponsors and wealthy individuals who have a vested financial interest in deregulation and tax cuts. So long as we keep our faith in Horatio Alger and welfare myths, more of us will continue to fight each other over who has less.


Salon.com
Comments
There's no law that says we have to believe every lie spoken to us and nothing prevents anyone from knowing the truth - except their own wilful ignorance.
Exchanging Russ Feingold for Rand Paul in the Senate strikes me as the essence of the insanity that's going on around us.
Feingold is an independent thinker. Paul's philosophy comes from a White Russian emigre turned fascist author of turgid third rate polemical novels....and I really have to wonder if Paul's supporters know that his political philosophy was lifted whole cloth from works of fiction written by an atheist, who opposed the war Vietnam, opposed the draft, supported abortion rights while decrying homosexuality, and continually espoused a philosophy that called for a virtual dictatorship of the intelligentsia - the exact opposite of the current wave of populism.
Why doesn't this turn the stomachs of the religious right I will never understand.
Sorry. I got carried away again.
It sure as hell turns mine.
Would someone like Rand Paul want to trade places with a single mother working a minimum-wage job? Does it rankle him so much that she should have access to medical care that he can't sleep at night?
Does he not realize that, the more people who are unemployed or underemployed, sick, hungry, uneducated and hopless, the more dangerous it becomes for people like him? Does he really think that people won't reach a breaking point and storm the Bastille again? How many missed meals are we away from anarchy ?
While personal attributes are sometimes considerations in a discussion, we have far too much ad hominem in our politics; indeed, that's virtually all there is of it anymore.
I sometimes wonder what would happen if all the money (billions), human effort, media coverage, etc., we now have in our (practically non-stop) political campaigns were instead targeted directly at helping those in need. I also wonder about the lost world of intimate community, of family and neighbors helping each other, not to mention the inefficiency of directing everything from Washington.
I could be wrong, but I get the impression that the politicization of, well, just about everything has more to do with power grabs and putting it to the other side than it does with actually making a positive change in the world.
"Why doesn't this turn the stomachs of the religious right I will never understand."
I think most of them did not read Ain Rand and do not know where Paul's philosophy comes from. Wouldn't it be great if someone crafted a political ad around these facts that you listed?
Paul's convictions are absolutely despicable, but they make him a perfect puppet for championing the interests of big business and the defense industry behemoth.
And Horatio Alger HATED the stock market and rightly called it for what it is--a shell game for the wealthy.
When the American public sits passive in front of the flickering screen of their TVs being hypnotized by corporate ads, we are lost.
It is a shame we cannot simply drive away all doubt as to who is who an what is what over insurance, health care, our poor, the state of welfare in the states.
What is to become of me and those like me in future hinges on how quickly this is resolved.
Nice update to this story.
Rated
First, it is an intergenerational wealth transfer. Might not be what people want to hear, but it is reality. Public education spending is just such an intergenerational transfer. Empty nesters pay property taxes with a lot of that local tax funding education. Parents of school aged children rarely, if ever, pay property taxes in excess of the education money spent on their children's behalf.
It's an intergenerational transfer payment built on the very early social construct we had in this country of recognizing the value of an educated citizenry. Today we recognize the value, too, of a healthy citizenry.
And medicaid has hidden taxes hammering business.
1) Medicaid utilizes what are called DRGs which translate into flat rate fees given out in exchange for the services rendered. These do not, oftentimes, meet the true cost of the service delivery, but they are a government mandated payment cap. On tap of that, medicaid, offers very stretched out payment terms impacting receivables for service delivery providers.
2) The shortfall in government mandated payments drives up the private side. It has to be made up somewhere, and it is made up with rising payments on the other side. A hidden tax through cost shifting.
3) Government aggregating health service buyers comprise almost 50% of the purchasing power in the health care service provision market. When half the buyers are not paying the true cost of the delivery based on their ability to legislate mandates, it means, by definition, the rising costs get borne on the other half.
4) It is why the mantra of "medicare/medicaid for all" that was in Obama's State of the Union Speech ignores the economic reality of one of the principle drivers to private side cost premium increases in the market today.
5) I was on the phone just the other day with my healthcare insurance agent for my small business in MA, and he was talking how the MA mandated health plan has kicked the daylights out of private premiums. I asked him to explain and delve into it, and he offered the following. (Again, an extreme example coming, but illustrative, just as it is to talk of the single working mom on minimum wage, etc used in the post above.)
a) government mandates around portability shifts and spreads out risk pools. It adds higher folks into plans and thus, when spread across all participants folks with higher than average expenditures, it is going to drive costs up.
b) new enrollees into the system consume a lot of services from pent up demand. Furthermore, the MA plan underestimated the amount of new enrollees by a factor of 2.5. No government enacted plan has ever come in under forecast. Never. Medicare cost projections several decades out have been off by a factor of 10. A factor of 10. Prescription drug has been a mess. The MA plan was off by a factor of 2 in the first year.
c) the pent up demand example he offered was simply this. A person comes in with an aching joint. Dr. prescribes an $15 anti-inflammatory. Patient pushes back demanding an MRI. Fearful of being villified for withholding medical service, and the ensuing bad press for a system already demonized as evil and not giving people what they need, the Dr. relents and a $1,500 procedure gets prescribed. Further still could come the demand for a prostethic. An office visit and diagnosis of several $100 and then a custom device running around $1,000 when the need was for a Naproxen prescription and time for the inflammation to abate.
d) We don't have a connection between our medical decisions and our costs. The costs are not there and the decision making does not factor it in. It adds to the risk pool cost, gets spread out over the private pays due to new mandates imposed from public policy legislators, and the the public servants and the angry citizens demonize those accommodating cost increases imposed on them.
A hidden tax and a wealth transfer not even done out in the open through higher taxation for which open debate can be held, but through hidden measures. Medicaid costs are more than what show up on the public sector books. Medicaid for all is not at all a workable program, and it is an out and out distortion when not acknowledging that "medicaid for all, but at a higher cost" is what the reality happens to be.
The duplicity is akin to an old adage in over stretched business of "sell it first; implement it later" and it is what has been done with the current policy legislation that kicks the can on cost issues down the road about 4 years while enacting immediately universally accepted items around portability and extension of minor coverage to the age of 26. It is the hamburg wrapped around the pill to get the dogs that are the electorate to swallow it.
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Perhaps faith in the Bible resigns the poor to their condition. Certainly, that is what those in power count on.
It's an intergenerational burden to have the present-day people and their children do without ... tho maybe outsourcing medical care will be the 'answer' as it is for so much else.
Oh, and thanks a lot, overlords of OS for picking this. Made my day!