Yet Another Reason Why Nobody Has Any Business Voting for Republican Politicians
Jonathan Cohn:
The GOP's Strange Ideas About Helping the Poor: Rep. Bill Cassidy of Louisiana is not just a Republican. He's also a doctor. And that means he has not one but two reasons to dislike Medicaid. Not only does it cost the government a lot of money. It also serves a lot of its beneficiaries poorly. Cassidy explained in a Dec. 16 column for Politico that Medicaid is the stingiest payer in our health care system.... [P]eople who have Medicaid frequently end up at places like Earl P. Long hospital in Baton Rouge -- a public hospital where, I gather, Cassidy has worked. "The hospital has dedicated and caring doctors, nurses, technicians and support staff," Cassidy writes, "But its physical plant is in disrepair." Four patients to a room, asbestos in the structure, missing doors -- the people of Baton Rouge only go there if they have no other option, according to Cassidy. And that means people with Medicaid....
Cassidy tells us this story because the new health law is expected to increase Medicaid enrollment by about 16 million people. Cassidy thinks this is a terrible idea.... I don't actually disagree with the underlying assessment of Medicaid.... But I have a question for Cassidy, Perry and all the other state officials who oppose expanding Medicaid and, in some cases, support getting rid of it once and for all: What do you propose to do instead? The answer, as far as I can tell, is to do nothing....
Medicaid may not provide great access to care. But it does provide access -- access its recipients very much need.... Janet Currie and Jonathan Gruber found large expansions of Medicaid during the 1980s and early 1990s "significantly increased the utilization of medical care, particularly care delivered in physicians' offices," leading to "significant" reductions in both infant and child mortality....
Could the program be better? Absolutely.... But, by far, the best way to improve Medicaid would be to give it more money per beneficiary -- so that it pays providers something closer to what Medicare and private insurance pay.... Is this what Cassidy, Perry and the other Medicaid critics want to do -- to spend more money on the poor? It doesn't appear so. In general, the people attacking Medicaid want to spend less....
Sure enough, Cassidy's protest against expanding Medicaid includes no proposals for other ways to cover the 15 million people the program will take in under the new health law. And when Perry threatened to withdraw from Medicaid, he wasn't terribly specific about how Texas would provide health care to the roughly 4 million residents now on the program. Of course, we don't need them to tell us what the world would look like without government health care programs for the poor. We need only look at what happened before Medicaid came into existence...
