Medicaid Expansion: Déjà Vu All Over Again

 

 

 

” Republican governors are following the script of Obama and Clinton in their campaign strategy for the Medicaid expansion that is needed to implement ObamaCare: The cast of earnest white coats and tearful upstanding, hard-working patients with hard-luck stories. Statements that sound as though they were written by the same PR firm. The same dire consequences of inaction.

“It’s just the right thing to do,” is a favorite concluding sentence.

What “it” basically means is to get the “free” federal money before somebody else does. Since it doesn’t cost “us” anything, at least not at first, it’s a “no brainer” to just grab it. It means billions of dollars, and thousands of jobs, for “us.

But if we exercise our brains for a minute, we see that in reality the billions go to “them,” not “us.” They are the ones in the expensive suits lurking in the background and attending the closed-door meetings. They are the million-dollar-a-year executives of managed-care companies or administrators in big hospital chains. They get the billions and trickle a portion down to people in scrubs and white coats who do real work, for the care of approved patients. They are the real players; the visible ones are props, shills, or camouflage. They are the decision-makers, who decide who is eligible for what.

They don’t think like doctors. Doctors ask, “What is the best way to help this patient with hepatitis c?” Rather, they ask, “Is this person with a certain set of social characteristics worth spending some of ‘our’ resources?” ”

 

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