I say that I don’t believe in Medicaid, and people look at me quizzically, so I feel I should explain.
Yes, I believe there IS Medicaid; it’s not like the tooth fairy. The program exists. I believe, however, that it shouldn’t.
Having been in politics for approximately 104 years, I know what saying stuff like that means. I know that the first reaction of most people, when I make a statement like that, is “so you want millions of people to die in agony. I see how it is.” Of course, you all know that I actually DO want millions of people to die in agony, being a heartless, cruel, and sadistic human beingcastic.
Note: my family decided a while back that since there was no designated sarcasm font, that we’d adopt -castic as a sarcasm tag. Anything you want to label as sarcasm, just put the -castic tag at the end of the word or phrase and that tells everyone the tone to use when reading what you wrote. So handy!
So that I can make this post less than 3000 words, which you have neither time nor (probably) inclination to read, I posted my “Why Medicare is a Disaster” explanation here. Suffice it to say in this space that the current system is terrible both for consumers and even more for providers, and that it’s going to go from agonizing to crippling to fatal if we don’t do something about it. And that something is going to be painful in its own right.
Being an astute reader, you are now saying to yourself, “okay, the system sucks, but it is he system we have, and since you’ve paid for it like everyone else, and you genuinely need to use it, why wouldn’t you?” And this is a very good question. I’ll do my best to explain.
Government is broke. Your government and mine, it’s bankrupt. There isn’t money to pay for all the things its trying to provide. What’s consuming our tax money faster than anything else is what are called “entitlements”, things to which we are entitled as citizens. Social Security, food stamps, FHA-guaranteed loans, Pell Grants, Medicare and Medicaid, and several hundred (really) other programs cost huge sums of money and provide relatively small benefits in comparison to the money expended.
I like this analogy: we have cereal on one side and hungry people on the other side. We need to deliver the cereal to the people. The usual implement to use in this case is what we call a spoon. But spoons are small. It takes a lot of them to feed all those people. Some people find that they have to wait to get fed, and they complain, and then the elect representatives with a mandate to feed people faster. So the politicians take the instrument they have – government – and use it to feed people. What government is, is a backhoe. It’s a huge, powerful, and ridiculously imprecise instrument for this purpose, but it does move a lot of cereal really fast. Of course, feeding people by backhoe is insanely wasteful. It’s the wrong tool for the job. But politicians have no other tool. Spoons are private-sector instruments. So government extorts money from those people, and uses it to fuel the backhoe. This means that fewer and fewer spoons are used, because money that would have gone to spoons is now going to government. Why feed people with spoons, anyway? The backhoe will do it.
And then, oh, and then the cereal runs out. Not everyone is fed! We need more cereal! More backhoes! But there comes a point where there isn’t any more cereal, no matter what you do. That is the point we have reached in this country, though few are willing to admit it. There simply isn’t enough money to do all the things government is trying to do. Some people are not going to get fed. Or educated. Or many other things.
Explanatory Note: there is a point where raising taxes does not increase revenue. The math on this is done by what’s called the Laffer Curve, and it attempts to show at what point increasing tax rates actually reduces revenue. There is such a point. You can argue that we aren’t anywhere near that point right now, but I will think you’re wrong, and I have a lot of company. The only way other than taxes to handle government debt obligations is to inflate out of them, because as inflation doubles and trebles the denominated dollars that the debt has to be paid with, so it simultaneously cuts by half and two thirds the face value of those obligations. I.E. if you owe me $50, and inflation makes your $20 bill double in value, you can pay me off a lot easier. Your debt stays constant, and your dollars multiply. There are other consequences, though, and they are not nearly as pleasant. But the government doesn’t have to eat, so inflation is not nearly so harmful to it.
Hence Wisconsin. Governor Walker sees that there isn’t any more money, and tries to reduce what the government has to pay out. This produces a monthlong backlash of violence and thuggery not seen since desegregation, perpetrated by those people who are going to be fed less by the government backhoe, as if they had some right to consume tax money. But folks, that’s only the first of many. Most states in this country are in similar – or even worse – situations. Their turn is coming.
And the federal government is in worst shape of all, and is even more incompetently led. State governments can get themselves squared around (well, some of them can, California, Michigan, New York, probably not), though that turn is painful, but the federal government, even if it stopped right now doing a gigantic volume of things, couldn’t cut enough in time, because we as a people would scream bloody murder. We won’t take it. We’re too soft. We’re too greedy. I get no pleasure from saying these things, but they are true. The “Tea Party” is an attempt by a large group of citizens to say “enough”, and try to get the government appetite down to sustainable levels. It almost surely won’t be enough. But it’s a noble attempt.
This kind of thing, trying to wean people off the government, is the sort of thing that causes strikes, unrest, and in extreme – but by no means rare – cases, civil war. People give up with great reluctance the things they’ve come to expect, and even feel that are theirs by right. They will often do violence to you for attempting to take those things from them. Given, then, that what’s going on in Wisconsin and Tennessee and elsewhere is potentially the great debate of our time, and bears directly on the future of the Republic, if there is one, I feel honor-bound to be on the side I believe in and advocate for. That’s the side that thinks these programs shouldn’t exist.
I also belong to a really radical fringe group that thinks that if you’re going to advocate for removing some federal programs, that you should 1) not be taking advantage of those programs and 2) know what hardships will come to those that do not and 3) be willing to shield others from those hardships insofar as you are able. If I’m going to talk about eliminating Medicaid, and I am, then it would be well for me to know what it’s like to try to live without it. I cannot, therefore, in good conscience, accept any money from any federal programs that I think should be eliminated.
And that’s why I can’t take Medicaid.
Full disclosure: I once did take it, when I was much younger and not as prone to think things through. Alexander was a Medicaid baby. I also took Pell Grants to go to school. Knowing what I know now, I wouldn’t have done that. But I did do it once, and I neither condemn those that do, nor look down on them for doing so, nor do I have any difficulty understanding why most people think I’m nuts for behaving this way. Here I stand, I cannot do otherwise.
The alternative would be a system in which medical expenses were handled by a combination of private insurance and direct-paid medical care, with cash set-asides and tax credits as an incentive to underconsume rather than overconsume. But this post is too long already. Suffice it to say that I support a system that would put spoons in the hands of those that need to eat.