Just want to make sure you don’t miss Cindi Scoppe’s column today. The headline in the paper was “The anti-Medicaid argument unmasked.” It’s a bit more descriptive online: “What does it mean that SC Gov Nikki Haley’s chief anti-Medicaid lobbyist has changed his tune to match his new job?” (Which, of course, would not have fit in the paper.)
An excerpt:
THE POST and Courier had an article the other day about the conversion of Tony Keck, who served as Gov. Nikki Haley’s chief Medicaid-expansion opponent before he left last year to take a job with a Tennessee hospital system that, like pretty much any hospital system in the country, supports the Medicaid expansion that he worked so hard to block on this side of the border.
Under the headline “Former Haley health care adviser says Medicaid expansion might work elsewhere,” the article noted that Mr. Keck’s new employer supported the recent attempt to expand the program in Tennessee, and it quoted Mr. Keck as saying that expanding Medicaid to cover more people under Obamacare “might be the best choice for some states, and it might not be in other states.”
And you could just feel Medicaid supporters in our state rising up in smug unison to cry out “Hypocrite!” Sort of like they did when he first landed his new gig, only louder…
You have to understand that Keck was important to selling the completely bankrupt notion that South Carolina shouldn’t expand Medicaid, and get a huge windfall from the feds to provide medical care to South Carolinians — not to mention providing a lot of good jobs at hospitals.
Keck was portrayed as this whiz kid who could back up the Tea Party article of blind faith (and blind hostility to anything branded “Obama”) with what sounded to a lot of people like compelling fact.
But now that his bread is buttered on the other side, he has discovered that Medicaid expansion is a good thing for “some states.” Such as the one where he’s working now.
Yep, it’s a good thing for “some states,” all right. Such as South Carolina, and the other 49. And it always was.
“Some states” and not others? Really? What a bunch of hooey. Another excerpt:
… Mr. Keck was the respectable face of Gov. Nikki Haley’s purely partisan, and tea-partian, opposition to a program that, by any honest analysis, would be good for our state. Maybe not for our nation — and maybe that’s how we ought to look at it — but clearly good for our state, which is how our legislators normally look at such things.
Mr. Keck was the outside expert, the wunderkind our governor wooed away from Louisiana Gov. Bobby Jindal’s administration, who understood public health and public-health finances. The person who could make a respectable argument that didn’t sound like warmed-over talking points from the National Republican Committee or FOX News. Certainly that’s why I always liked and respected him, even though I disagreed with him.
But it turns out that for all of his expertise, he was, first and foremost, a hired hand. The guy hawking Big Macs not because he liked them best but because he worked for McDonalds. The guy waving the pom-poms for Medicaid rejection not because that was what was best for our state — or at least not primarily because of that — but because that’s what the boss was selling….
But that’s not the bad part. You know what the bad part is? That now that there is no pretense about the fact that the anti-Medicaid emperor never had on a stitch of clothing, we are still stuck with no Medicaid expansion.
Why? Because Nikki Haley, and too many of her allies, don’t care what the facts are. They don’t want South Carolinians receiving this benefit, and that’s that.
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It’s a good thing for those states who pay him to advocate for it.
… and he’s got the numbers to back that up!
Although, just to be technical about it — it’s not the state of Tennessee, but a hospital system there…
It’s a good thing for those states where someone pays him to advocate for it.
And yet you are okay with businesses in Columbia that make their money off spinning the same lies and hypocrisy. What’s the difference?
What Doug means by that is that he wants me to say that Wesley Donehue, who hosted me more on his show than any other guest, is a terrible person because he works for GOP candidates who say this same kind of nonsense.
Hey, when I have a problem with something Wesley says, I say so in no uncertain terms. Doesn’t mean I’m going to say he’s a bad person.
You support the businesses that propagate this behavior. Doesn’t matter who is running them. They are all tasked with lying for the sole purpose of winning elections. If you think that is good behavior, so be it. Sometimes it’s not just a system that is bad.
Point of order: there is actually a rational argument for not expanding Medicaid.
No, Bryan, you must not speak of the future cost to states. You know, the costs that hit after Obama leaves office. Those are imaginary.
You mean the 1/10 of the cost that states would have to pay eventually?
Yeah, boy — the states are really getting shafted on THAT one!
and the savings from early intervention?
And the infusion of money into the medical sector of the state’s economy, paying for lots of good jobs.
Do you have any evidence of job growth in the state’s that accepted Medicaid funds versus those that didn’t? That would be seen already, right? Certainly by the middle of this year. The State jobs site shows 221 Healthcare positions open right now in the Columbia area alone.
What about the rural hospitals in poor counties that have and are closing, with more on the precipice? Not only are the working poor not gaining Medicaid coverage, they aren’t eligible for subsidies because of the state’s not expanding coverage. More uncompensated care.
When will we see savings in healthcare? Is it cheaper this year than last year? Will it be cheaper next year? I know I’m paying more for prescriptions (10%).
You’ve been duped. Let me know when you think healthcare costs as a percentage of GDP will decrease.
My wife’s plan now has a provision for FREE diabetes drugs and supplies. It’s saving us $$. Not sure how much credit goes to the ACA but it does suggest some slowing in the growth rate of medical care.
Define “free”, bud. Are they left on a counter for people to pick up?
Doug you cite an example from your own healthcare experience that supposedly supports your argument. (It doesn’t). I cite an example from my own healthcare experience to rebut that argument. Frankly my point is anecdotal, just as is yours so it doesn’t add much to the overall argument. But your counterpoint demonstrates just how utterly out of touch you’ve become with this issue. Pretty much all the non-partisan evidence suggests the ACA has helped reduce the uninsured rate in this country, the primary goal of the law. It also suggests the cost curve is bending to some extent. Please no more anecdotal crap to suggest otherwise it only shows your inability to craft a meaningful argument.
Doug: Your interlocutor is in favor of the single-payer model. You’re not going to convince him that an expansion of Medicaid to cover able-bodied people is a bad thing.
There is no evidence you can present that will change his mind.
and vice versa
Of course more people are covered. They aren’t paying for most or any of their insurance. Someone else is. That’s why it’s “FREE”. You are always in favor of that model. it’s a good thing the poor ate lucky enough to have people who can Lau for their coverage. Lucky stiffs, if you ask me.
Rather than playing the “it’s only a penny” game, why don’t you tell us how much 1/10th of the cost is in real dollars and where you would expect to raise the funds to cover them. And is that 1/10th guaranteed forever?
Let’s see: States that go along with expansion initially pay nothing, but after several years have to pay 10 percent of the cost.
States that refuse to expand don’t ever have to pay that 10 percent, but they miss out on health care for their citizens worth 10 times that.
Golly, this is a toughie…
Point of Order rebuttal: I haven’t heard one yet.
“They have eyes to see but do not see and ears to hear but do not hear, for they are a rebellious people.”
The thing about not having access to regular healthcare is not that it means near-term societal costs are avoided, but that when those chronic conditions become acute, they become situations which must be treated in the most expensive way possible – through the ER.
There is absolutely no disputing that children, the disabled and the elderly accumulate healthcare costs; the only question is whether we want to acknowledge that their treatment needs to go on the books now or whether we are going to “silently” incur the delta between low cost, regular care and high cost, acute care. Because today all we do is force hospitals to provide this acute care, who then force the insurance companies to pay, who therefore charge the rest of us a premium for our healthcare to cover this societal cost; all we have today is a back-door subsidy system. The problem with the idea that we can somehow just say “no” now and then not incur greater costs down the road is intellectually disingenuous and self-delusional.
As an accountant Nikki Haley should know better. Instead, she believes that South Carolinians would rather put their politics before their pocketbooks. Were the general citizenry to understand that they are just paying more this way, I think they would change their politics.
This is one of those issues where the conservative economic action is to provide the compassionate liberal access to services. It is less costly to all involved. I know that’s a mind-bender for many, but there it is.
It seems pretty obvious to me, Mark, and not mind-bending at all. But thanks for setting out the argument so clearly, because lots of people still claim that they don’t get it.
One seldom, if ever, encounters a starker example of allowing actions and policy to be dictated by blind ideology — and animus toward the president — rather than by facts.
Access to a lousy insurance policy doesn’t improve overall health. Would you accept Medicaid over your current health insurance? Are the poor eating better, avoiding bad food, alcohol, drugs, and cigarettes? Are they exercising regularly? Does increasing the lifespan of someone living in poverty cost more or less for the government in the long run?
Dou you are tilting at windmills again, and looking for strawmen to beat up.
These questions are immaterial to the issue under discussion.
We have a system where we have created a mandate that everyone must receive hospital care regardless of ability to pay – care of some sort at some hospital, to be sure. So you could say we should not provide that opportunity, or you could say that we should cap end of life (and beginning of life) services at a low $ threshold – since these two situations account for the majority of healthcare expenditures. That’s a social and civic argument to make. However, if you are going to accept compassionate care, than the questions are only how to pay and how to provide the care?
I would argue that providing the most social good actually occurs at the lowest cost if we were to move to a preventative care model and away from our current acute care disfunctionalism. To me, this is an economic issue before it is a social one. And I would personally be okay with capping end of life care for Medicaid and Medicare recipients (knowing full well that this would spill over to private plans quite quickly, too, were this to be the case). But I don’t believe an intellectually dishonest three-card Monty game which provides the least benefit at the greatest cost makes a lick of sense. It’s only politically expedient as out of sight out of mind, I guess. Sort of like that guy in the Upstate saying “keep your government hands off my Medicare!”
We can do a lot better. In every way. Politics is first and foremost about offering leadership and articulating a vision of an improved civic order. We all deserve that sort of rational dialogue; and we should demand it.
The famous Oregon study that conservatives love to cite suggests large financial benefits to the group who received the Medicaid money. The non-Medicaid group suffered significant hardships and mental trauma as a result of their inability to pay for necessary medical care. That’s the part of the study that is ignored by the right.
I remember Haley’s (and Keck’s) original argument against expansion. They touted better ideas locally that would provide coverage without the federal money. Where is it. Where are the new clinics they promised? The most realistic prospect for better coverage is in the quick-care clinics opening in Walmart, etc providing lower cost (mostly practitioner) coverage for common ailments and diagnosis and referral for more serious stuff. The Medicaid funds that would support those is seriously curtailed – and the ones missing out are working poor. Non-working are already Medicaid covered.
They also argued that Medicaid was a broken system. If it’s broken, it’s the state’s fault. It’s a state-run, federally-funded program. The feds pay for most of it and set eligibility guidelines, but the state runs it. Did Mark Sanford and the legislature (who chronically left federal money on the table) break it?
We are reaping the results of doctrinaire anti-government and anti-Obama posturing. At least the Republican governors of several other states have changed to more sensible positions and moved on – with sizable drops in their uninsured rates and no hole in their own budgets.