It sounds like opting out of Medicaid is going to get some serious support in the Texas legislature, even though other states that have studied the issue point out the bloody obvious:
The strain that will ensue should Wyoming determine to opt-out of participating in Medicaid without a solid plan to replace it is truly immeasurable. Further, Wyoming residents will be paying Federal taxes for services that residents of this state will never benefit from.
Texas has 3.1 million people on Medicaid. 2.3 million of them are children, and 60,000 of them are elderly in nursing homes. I don’t know what it would take for Texans to re-evaluate the wisdom of electing a moron like Rick Perry, but it might start with bedridden old people being thrown out of nursing homes and emergency departments clogged with kids with the sniffles.
Redhand
Texas today is hopeless. LBJ must be rolling over in his grave.
PeakVT
It’s a win-win for Texas Repukes at this point. They can either succeed at fucking the poor to the cheers of adoring campaign donors, or they can fail and run against “big Washington gubmint” to the cheers of adoring voters. Either way, Johnson is certain to be spinning in his grave.
bkny
elections have consequences.
it was amazing watching governor goodhair making the teevee rounds pimping his book, and raving about texas life and not once challenged on the state’s health, uninsured, educational rankings.
stuckinred
@Redhand: Fuck LBJ
Keith
If turnabout was fairplay, Texas Dems would be screaming from the hills that this is putting us on the road to eugenics experiments on children and relentlessly refer to the whole thing as “Perrycare”.
geg6
I have always said that I’d rather be dead than live in Texas as I have found it to be the worst sort of arrogant wingnut hellhole I’ve ever had the misfortune to visit. But now that we have Governor Tom “the unemployed are just lazy” Corbett, I can only say that we’re all Texans now.
Napoleon
I was under the impression that they wanted to cut out the childern’s program and keep the old folk’s program.
JPL
Hospitals can not turn away patients. Can we say sky high insurance payments to cover the costs that hospitals have to pay for the uninsured?
Triassic Sands
Ordinarily, this might be a compelling argument, but in this case it is cast against the vastly greater horror of…taxes, and worse still the possibility of increasing taxes, not just on the super rich, but on the well-to-do also.
In Washington State faced with the prospect of devastating cuts in education and health care for the poor and children (which will come on top of previous damaging cuts), the steely-spined voters cast their ballots 2 to 1 against creating a 5% state income tax on wealthy Washingtonians. So, in the state with the most regressive tax system in the country, Washingtonians voted to protect the rich rather than address the needs of its children, poor, and disabled. Why? Simple…taxes. Governor Gregoire, who is never going to win any medals for either progressivism or political courage, says she gets the message — the people want “an all cuts budget.” And by gum, that’s what they’re going to get, gift-wrapped and delivered by a Democratic governor and Democratic legislature. Washington’s Republicans should be ecstatic they didn’t win a majority in either house in the state legislature. Now, they can sit back and chuckle while the Democrats do their work for them.
If that can be done in Washington, imagine what is possible in Texas.
Grover Norquist is on the verge of achieving his grand goal. The country, state-by-state, is being shrunk to the point where drowning in a bath tub will be feasible. Apart from a few isolated politicians, no one, from the president down is putting up an adequate fight to prevent this from happening.
There is lots of suffering already in this country, but it is reasonably well-hidden from most people. If a relatively small number of poor, elderly people is tossed out in the streets, I doubt if most news organizations will cover it, and most Americans will remain comfortably oblivious.
Napoleon
Reading that article shows this is just more typical rightwing fantasy land magical thinking. Somehow the conservatives in the state legislature think they can conger up out of thin air $16.6B to replace what the feds put into the system.
Davis X. Machina
This is what happens when your state doesn’t have an active volcano into which to toss virgins, so as to appease the gods.
Throwing old people out of nursing homes is a poor second best, but under the circumstances the gods — the market, the invisible hand, Ayn Rand, the ghost of Herbert Spencer — surely will understand. And be appeased.
And then prosperity surely must follow.
The Grand Panjandrum
What next? Opting out of child labor laws so those lazy kids can get a job to pay for healthcare instead of soaking up all those tax dollars?
Shalimar
@Triassic Sands:
I knew there was a reason conservatives love waterboarding so much. They must think of it as drowning practice for when their nirvana/apocalypse comes and they can really do what they want to all the heathens.
Dennis SGMM
“If I owned Hell and Texas, I’d live in Hell and rent out Texas.”
Quoted by Andy Adams in his Log of a Cowboy, pub 1903.
I agree with those above who commented that this would be a win either way for Texas Republicans. “Look what you made us do!” has joined “Cut taxes!” as a GOP fave.
cmorenc
Part of the idea of opting out of medicaid is to force a considerable number of poorer Texans currently using its benefits to move to other states who have not opted out of medicaid. The ultimate idea is to create a domino effect, a “race to the bottom” in which the residual states still opted-in can no longer afford to do so, else they will incrementally accumulate ever-larger shares of migrants from other states. Texas (and other opt-out states) wouldn’t need to push all, or anywhere even close to a majority of its current medicaid recipients to migrate out of the state in order for this dynamic to take hold; all it would take would be a large enough, measurable enough flow to visibly affect the finances of other states still opted-in and struggling with their respective budgets.
The sort of politicians pushing opt-out frankly don’t give a shit about the people they’re depriving thereby, just like they don’t give a shit about other people’s schoolchildren as they go about cutting public school education budgets so they can lower taxes on wealthier residents. The whole design is to destroy as much of the welfare state as possible. They’re perfectly content with shoving poor elderly out of nursing homes and poor kids getting sick because they’ve successfully ended a government welfare program they think was a disastrous idea to ever implement in the first place, and that the vast betterment to society by its absence in the long run justifies infliction of some short-term pain upon poor people.
marion
Is there any way Congress can say that states can only have Medicare if they have Medicaid? You can opt out, of course, but if you want us to help take care of your middle class, you must allow us to help take care of your poor too.
arguingwithsignposts
I am glad I moved out of Texas when I did. That is all.
Nick
This is part of the reason I want to get rid of the filibuster. We shouldn’t be trying to stop the damage Republicans want to do. We should welcome it. The reason Republicans try to stop us is because they know if we succeed, they’d be politically dead.
If we truly had faith that the American people would wake up, let the Republicans inflict as much fucking damage to the country as they can, and then let the people decide if that’s what they want.
Triassic Sands
@Nick:
That seems to be the current plan. Unfortunately, that damage is going to be measured in dead bodies, terrible suffering, homelessness, and a host of other tragedies much, if not all, of which will be kept out of sight of most people.
Since the suffering will be fall most heavily on the poor, it won’t be big news, so it won’t really force people to choose.
One of apparent responses to the November 2 election in Washington State seems to be the state ending prescription drug coverage for Medicaid recipients. Does anyone doubt that the result of that will be some poor people dying because they can’t get the medications they need?
Napoleon
@Nick:
Bingo – this is the entire arguement against those on the left that are against filibuster reform. Well put.
chopper
@The Grand Panjandrum:
don’t give them any ideas.
“here in texas, we’ve decided to opt out of ‘the weekend’. everybody now works 7 days a week.”
WyldPirate
Neither one of these would cause a re-evaluation. The Texans that for Perry would call the old folks out on the street “buzzard bait” and the kids freeloaders.
Texas is on my list of states I won’t live in.
Jinchi
but it might start with bedridden old people being thrown out of nursing homes and emergency departments clogged with kids with the sniffles
They’ll just claim that it’s Obamacare.
chopper
@Triassic Sands:
forcing all the poor to move out of your state due to a lack of basic healthcare, food, etc is a feature, not a bug.
Nick
@Triassic Sands:
Then if that’s the kind of stain the American people want on their reputations, then so be it. We fought the good fight and lost, we’ll keep fighting, but the American people have spoken, lets see if this is truly the language they meant to speak.
WyldPirate
@stuckinred:
Yep. Asshole escalated an idiotic meddling in a civil war into a war that got a shitloads of Americans killed.
Fuck LBJ with a Huey helicopter–sideways.
chopper
@Jinchi:
you know that shit we made up about ‘death panels’? well, turns out it had a really good ring to it, so…
never realized that the whole ‘death panel’ thing was a tell. foreshadowing from the GOP. it is SOP with these guys that they accuse the other side of doing the shit they themselves do or plan on doing.
BDeevDad
Hell, this includes kids with serious medical issues. You’ll see kids not
getting nursing care, medical equipment, surgeries, medications, therapy, etc.
cleek
@Jinchi:
precisely
arguingwithsignposts
@Nick:
The problem with that statement is that “the American people” didn’t speak at all. two years ago, Obama kicked McCain’s ass in the polls, and that was the only national election we had. And it didn’t impact the GOP one bit.
The narrative says the American people spoke, but that’s a bullshit narrative.
Suffern ace
@Napoleon: The magical thinking is that children get sick because there is Medicaid. No Medicaid means no sick children.
WyldPirate
@Nick:
You know, a lot of people give me shit here because I criticize the craven and spineless nature of the Dems and Obama, but this is why I do it.
I think our system is so far gone that it is going to have to completely crash–with an enormous amount of suffering—before some things change.
When you have a bunch of old fucks–who are to goddamned stupid to realize that they would be either destitute or dead if not for their Medicare benefits–much less screeching “keep your gubmint hands off my Medicare” from the seat of their Hoverround with their oxygen tank attachment–then things are too far gone.
I deal with this shit from my Rethug Dad all the time. Thinks he is some rugged individualist, but he reaped the benefits of a UAW job for 44 years as a skilled tradesman and then for a long time as a maintenance supervisor. Never went beyond high school, but maxed SS contributions for the last 20 years of his work career, had gold-plated health insurance benes including dental, vision, pharmies, etc., stuck options and a load of other stuff.
But he hated the very union that gave him the stuff. Calls Medicaid patients a bunch of freeloaders and doesn’t have the sense to realize that he and my Mom would be destitute now from dealing with her massive health problems without the Medicare.
Holidays visits can get ugly sometimes…
Mumphrey
“I don’t know what it would take for Texans to re-evaluate the wisdom of electing a moron like Rick Perry, but it might start with bedridden old people being thrown out of nursing homes and emergency departments clogged with kids with the sniffles.”
It would take a lot more than that. If everything you listed above happens, the Republicans will find some way, plausible or not, to blame Obama and the Democrats. And Perry’s base will eat it up. Perry could shoot a cute little orphan girl on live television and eat her heart, and his base would find a way to blame Obama. Or the orphan. Michelle Malkin would be breathlessly telling us that the orphanage had marble countertops, so the girl deserved it.
There’s a big, big, chunk of Americans who are just sociopathic. It scares me. I don’t doubt that there are people like this in every country, but, damned if they don’t seem to have a lot more clout here…
timb
@PeakVT: No offense, but if you anything by Robert Caro, you’d know LBJ would be applauding Perry for this “win-win” move. LBJ’s biggest donors were the super-rich oil goons who basically still run Texas and LBJ was all about anything that would win him an election
chopper
@Nick:
easy to say when it’s the poor that will be dying in droves.
Mumphrey
@stuckinred:
Well, Johnson gave us the big civil rights laws and Medicare, so let’s not spit on his grave. He made an awful lot of awful mistakes, but he did some great things that have helped untold millions of Americans who would have been fucked up the ass otherwise.
Napoleon
@WyldPirate:
Sadly, and reluctantly, I agree with this.
jwb
@Nick: Perhaps, but the advice runs counter to the other scenario you spin around here, the one where the media would just make the Dems own the Goopers failures no matter what.
Personally, I don’t think things will change much until our corporations start going belly up at an alarming rate due to our corporate overlords having fucked their customers to such an extent that no one can any longer afford to buy what they are selling. My prediction is that this collapse will begin to accelerate next summer once all these gooper controlled state legislatures get done gutting state governments and we head into a new spending-cutting induced recession. The only good news that will come out of this: many of our corporate overlords will soon be on suicide watch.
chopper
@WyldPirate:
problem has always been, the poor and stupid are basically held hostage in this whole struggle.
jwb
@Mumphrey: The whole point of floating this opting out of medicaid is so Perry and the Goopers can blame Obama for their mess—whether they ultimately decide to keep medicaid or not. I doubt very much that they will opt out, if only because there is very big money to be lost by gooper donors if they do. But that won’t keep the goopers from demagoguing the issue in order to deflect responsibility from the problems their policies caused.
Nice story in the paper this morning about how higher education in Texas may be looking at a 30% cut in state spending.
WyldPirate
@Napoleon:
I hate that I have gotten so pessimistic. My sanity nearly didn’t survive the Dubya years and it started almost immediately when he found a work around to give hundreds of millions to the fundamentalist religious whackjobs. It turned out to be a minor foreshadowing of the horror to come.
I was overjoyed to see the Dem gains in 06 and then Obama getting elected. I bawled like a baby with tears of happiness and had so much hope of things changing.
Not much of shit has changed. There are a lot of criminals–very rich and powerful ones–that are going to walk away with their blood-soaked hands, millions upon millions in their pockets from outright theft and fraud. What has changed going to be “compromised” away piecemeal before it is ever implemented or ripped apart in the next couple of years.
Then the real madness will start in ’12 with Rethugs holding the White House, Senate and House.
Marci Kiser
“I don’t know what it would take for Texans to re-evaluate the wisdom of electing a moron like Rick Perry, but it might start with bedridden old people being thrown out of nursing homes and emergency departments clogged with kids with the sniffles.”
To be fair, we already have the latter (though I’d replace ‘kids’ with ‘ingrates and idiots’). The real crunch would fall upon the hospitals, who would go from wasting time treating low-level illnesses in emergency rooms for crappy reimbursements to treating low-level illnesses in emergency rooms for no reimbursement at all.
Speaking as a physician, Medicaid is the democracy of health care plans: worst in the world except for all the others. Its highest externality, and the reason ERs are in the situation they’re in today, is because Medicaid creates a sense of entitlement among its participants, who drop by the ER for every headache, every fever, every stubbed toe and phlegmy start to a day.
I always find flu season particularly amusing for this reason, as save in the most severe of circumstances, an ER will do nothing for your child that you couldn’t do at home – give them fluids and manage any fever with Tylenol. But guess what? If your child didn’t have flu before waiting three hours in my waiting room, they do now! That will be two thousand dollars, please.
WyldPirate
@chopper:
I dunno know about that, chopper. There was a lot of labor activism back in the early part of the 20th century. There was a shitload of violence and protest. People died for the labor laws and protections that we take for granted now. We also had the threat of Communist and socialist party activism during this time.
Many of the things that ended the laissez-faire capitalism that caused the Great Depression were put in place because the a.)economy was wrecked, but also because b.) there was a lot of fear of civil unrest..
Many of the people that benefited most from this change–“the Greatest Generation” and the early Boomers, were or would have been poor to middle class poor. Now, they are the “I got mine so Fuck you crowd”.
In general, though, the poor and stupid do get screwed.
Marmot
@WyldPirate:
Well, at least I can thank my lucky stars for that.
WyldPirate
@Marmot:
You can have that shithole. I’ve been all over it and didn’t like anything I saw or most of the arrogant fucks who thought that Texas was “all that”.
Steve
@Nick: I will never understand this argument that we should let Republicans ruin the country so that they’ll be politically discredited. We let Republicans run everything until 2006 and we still can’t get a consensus that the resulting problems are their fault. It would be nice to get some political benefit in exchange for having a ruined country; better still would be not to have a ruined country in the first place.
I’m reminded of the argument that we should bring back the draft because there won’t be any more stupid wars if the public knows their kids will be drafted. Well, what if there are?
PeakVT
@timb: I don’t think LBJ would want to see his signature program dismantled if he were still alive. If he had been born 50 years later? That’s a different story.
cckids
I haven’t seen anything from Perry about his plans (or make that “plans”) when/if Texas opts out of Medicaid. Is he proposing some state plan that can “do it cheaper”? Does he realize that Medicaid is not only the icky poor, but the seriously disabled? Suppose he has ANY concept of the medical costs of those people? And, of course, that there is no way they are insured by anyone else?
Plus, the idea that cutting benefits will drive people to other states. . . . really? Aren’t they, you know, POOR? Most of them will not be able to afford to move–the cost of getting a household from A to B, new deposits on apartments, new job (ha ha), etc. Just can’t happen.
jcricket
As some have pointed out up-thread, whatever negative consequences occur will only hit the poor (read: they deserve it) and elderly (oops, collateral damage).
And the Republicans will still blame the dems for this. If only regulations and taxes were cut to zero, revenue would have rained from the sky and not forced Republicans to fuck the entire economy.
I predict a California-style future for all of us – massive budget deficits, endless calls for new services and almost no recognition of the need for taxes to pay for it. And then when Dems deliver the cuts (like those in WA state are about to do), the Dems will get voted out of office.
We are truly and deeply fucked
Elie
Just remember, Medicaid reimburses providers (institutional and professional). Not only would folks not get service but a lot — a LOT of particularly hospital and nursing home providers would not get paid.
It would be catastrophic for the state to disperse all the people already in nursing homes, hospitals, receiving dialysis — to what? Many could not be cared for anywhere else and there would be no money to pay other providers..
Texas is a big state and my guess is that its providers are a pretty powerful bunch. Perry and his bros would learn the meaning of the stick, all right.
Trust me — aint gonna happen but it makes for entertaining bravado talk and keeps the hits up on blogs..
Elie
@Elie:
And lets not forget the pharmacy providers and the medical supply vendors, etc (though these are less prominent in Medicaid). And then, all the state employees in the Medicaid program (texas is one of the largest), that would then be unemployed. Think of the multiplier effect of there not being able to consume, nursing homes laying off people, hospitals laying off people —
You get the picture.
Elie
Why on earth am I being moderated?
PeakVT
@Elie: Just say FYWP and move on. It’s not personal.
Elie
@PeakVT:
I have. Just wondered
ThresherK
Part of the idea of opting out of medicaid is to force a considerable number of poorer Texans currently using its benefits to move to other states who have not opted out of medicaid.
Isn’t it just time to “build the dang fence” around Texas?
Luthe
@cmorenc:
This is like the “poor people knew that Katrina was coming, why didn’t they evacuate?” argument. Moving is *expensive*. Just where are the poor going to get the money to find new housing in another state, cough up for the security deposit/mortgage down payment, and obtain a car/hire a moving company? Not mention the people who *can’t* move due to physical problems or family reasons.
Texas is getting nothing out of this aside from a new way to screw the poor.
fourlegsgood
Let me just add that Texas is the home of the asshat who said, “people do too have health care! they have access to emergency rooms!” (chimpy)
Rethugs here aren’t just stupid, they are mean. As for fencing the state in, please wait until I escape.
kaithxbai.
Oh, and if you’re wondering why they’re so callous to the poor here – it’s a product of prosperity theology – i.e. if you’re poor, it’s probably because “you ain’t right with jesus!!”
Mnemosyne
@Marci Kiser:
Um, how many doctor’s offices do you think are in poor neighborhoods? They’re lucky if there’s a clinic anywhere closer than the ER.
People don’t like to go sit in the ER for three hours, but they don’t think they have any other choice, because there’s no doctors nearby. Or at least none that accept Medicaid.
Barbara
If Medicaid is discontinued, people really won’t have health care even in the Republican sense because a lot of emergency rooms would close. And that would hit not just the poor but the rest of us too (if you live in Texas, which I will make sure I never do). The only ERs that would remain open are those in public or publicly funded hospitals. Dumping all poor people onto private ERs is simply not a plan that will work even if Texas were willing to try it.
To the person upthread who asked, it is not possible to opt out of Medicaid just for “poor people” (whatever the fuck that means). Note carefully for planning purposes: the elderly who qualify for Medicaid also qualify on the basis of income, which is to say, there is no part of Medicaid that is NOT made up of poor people. That the elderly and their children can’t admit they are poor isn’t my problem, but I do have a term for them that is a useful term as it applies to most of us:
Medically indigent.
We are all one tragic event, one job loss, one chronic disabling disease, one near-the-end-of-life inability to care for ourselves, away from being indigent. Medically indigent.
Marci Kiser
@ Mnemosyne
Considering I live four blocks away from the largest indigent care clinic in North Carolina, I’m not the best example for your point.
And it’s clear you’ve missed mine. The point is not that health care is inconveniently located if you’re poor. It’s that those on Medicaid (or who otherwise have no intention of paying) use the emergency room for things that not only aren’t emergencies, they’re not anything a doctor whom you see once is going to able to help with. Colds and other viruses, congestion, various aches (I cannot tell you how many people have come in to the ER because their back has been hurting for “over a year”), etc.
For some people, being on Medicaid means having a free pass to use services like the ER because they can. Or in Paine’s other, better words: what we obtain too cheap, we esteem too lightly.
And what we get for free we care bugger all if we abuse it every day.
Ash Can
@Marci Kiser: Why don’t these ERs redirect these people to the clinics?
Elie
@Marci Kiser:
There is an ongoing meme about ER use that follows like this:
The poor, the working class, anyone, go to the ER for routine care willingly because they like sitting in an ER all day waiting for care for their low priority condition.
In fact, if anyone bothered to find out, many do not have alternatives. Either there are no free clinics, or also importantly for those who actually have medical coverage, the after hours or emergent care providers are inadequate or non existent.
If you are not feeling well, if you have a high temperature, if your child has problems breathing from an asthma attack, and you have no alternative to assess the situation, you are going to go to the ER. Some private docs, in fact, instruct their patients to go to the ER for certain things like high fevers for children, etc — esp towards the end of the day.
If you have ever sat in an ER all day or night, and that is what happens if you have non emergent care in a busy ER, you are not going to want to repeat that any time soon.
I think that there would be more real knowledge around this rather than speculation if we actually did surveys of people in ERs and asked them why they were there and what were their alternatives. Might be some eye opening answers
Lurked
@Marci Kiser:
You’re apparently a physician so you know that medicine can’t do a lot for viral illnesses, but it’s pretty clear that relatively few people in this country understand that–they are all just “germs” to most people. The poor as a whole have less education so will have an even lower probability of understanding it. We would have had much less of a problem with antibiotic abuse if their limitations were clear to the general public, but obviously they are not.
So patients show up in whatever medical venue they know about for illnesses that are self-limiting anyway.
And sometimes it’s just a matter of education; we’ve used the ERs as primary-care centers for the poor for a long time now, and often they may not know any better. Do Medicaid patients get referred to a more appropriate location? If they are, do they go there?
Barbara
But people who are insured also use the emergency room for things doctors can’t help them with because they aren’t doctors and so don’t exactly use medical care in the wisest fashion.
And the reason many of these people — insured and uninsured alike — go to the ER even for the little things a doctor can help you with is because many doctors do an awesome job of keeping them out of their offices by screening them for source of payment or simply not being available when actually needed, or both.
Once you go to an ER, the ER must screen you and for most people, that screening (nothing wrong with you!) replaces the visit to the clinic that might otherwise be suggested.
We keep trying to blame people as if seeking medical care were a moral failing or as if we should all know when we do or don’t need to see the doctor. The moral failing is the fact that medical care is set up in such a way that it is grotesquely expensive and inaccessible for too many people. Those people are not responsible for limiting their own access to an ER, nor are they responsible for how expensive it is to get care in an ER.
Elie
@Barbara:
Very wise comment, Barbara.
I would add this: the nursing home benefit for the elderly with the appropriate infirmity in health or ability to care for themselves, accrues hugely to the middle class. How? The elderly person or their surviving spouse (they can exempt the home the spouse is living in), must spend down through all their assets before Medicaid picks up the tab. That means, granny and grandpa must first impoverish themselves before they get the nursing home benefit. Just so you know, that benefit is not obtained by anyone who can take care of themselves anymore, but only by someone with either major health, motor or cognitive problems.
People must think that the support for major health care institutions like hospitals and nursing homes come from those who can pay. Just so you know who that would be, the average annual fee for nursing home care is around $24,000 — hear average — it can be way more. Who could pay that? Not too many. Lots of folks would just die in their homes half starved and in horrible, heart breaking condition. That STILL HAPPENS y’all. A lot of people do not know or use the benefit… And for the young or people with borderline incomes, if you get in a severe accident, get severely burned, need prolonged care such as dialysis, this is a program that helps you. Its either Medicaid or charity care and bankruptcy.
We have lost the understanding of community and safety net and all in this together. Our health care and social service institutions are here to benefit all of us. We pay for these through our taxes because we value taking care of the ill and infirm… we are not yet fully in the social Darwinist model where we will allow our elderly or the severly impaired to just rot. At least not yet.
and PS — finally – Medicaid does not cover all the poor. The main part of the program covers about half of the poor and most of them are the elderly and children.
Christian nation, right.
Bull!
Elie
@Elie:
Woops, the block quote completely broke down —
sorry!
Triassic Sands
@Nick:
Is that what the American left has come to — in the face of injustice, suffering, stupidity, greed, etc. we say “the people have spoken?” Where would African Americans be today if that had been the response to racism? Is there no fight left among Democrats, liberals, progressives…decent people?
@Marci Kiser:
A physician, huh? I’m curious, do you accept Medicaid patients? Surely, being close to poor people might get you dirty or make your office smell. In my life I’ve known doctors who went into medicine to make money and others who did so to help people (while making a fine living). I can guess which category you’re in. Your lack of empathy is, sadly, common in this country today.
I’m not sure if you are aware how bigoted you sound. Surely, the Americans who have the greatest sense of entitlement are the wealthy (including many physicians), not the poor.
The behavior you describe, to the extent it is characteristic of some Medicaid patients, is not limited to poor people. Anyone with really good insurance in this country, especially if it is provided by an employer, is insulated from the costs of their care. Do they think twice when taking a brand name drug when a generic would do just as well? Not if their co-pay makes the brand name drug easily affordable. Are the poor the only ones who show up demanding antibiotics for viral illnesses? Hardly. If the problem were limited to the poor, the problem of drug-resistance wouldn’t be nearly as serious as it is.
No one is his or her right mind would choose Medicaid over good private insurance if they could afford the latter. If nothing else, the smug superiority and disapproval you (and many Americans) exhibit, makes Medicaid unattractive.
Dr. Kiser, I apologize for the personal nature of this comment. Normally, I prefer to discuss policies, not personalities, but I found your comments objectionable — both in content and tone.
rikyrah
don’t let the relatively small number of elderly fool you.
a bad nursing home in my area runs 4k a month. I’ll take off a thousand because it’s Texas. so, 60,000 at 3k a month, that 180 million per month and over 2 billion a year. good racket if you can get it. and the persons who pointed out that the Medicaid in nursing homes is for the MIDDLE CLASS, are on the money. don’t tell me that those folks all vote Democrat, I’m willing to bet a good chunk voted for Perry and his ilk. so let their asses come up with the dough every month for Mom and Dad.
as far as Texas being able to decouple the kids from the old folks – FUCK THAT. thatt’s what the Fed Govt is for. they don’t want the dough, then throw out Mom and Pop into the street.
timb
@PeakVT: Possibly, but, as a guy who ran for Congress with the slogan “Roosevelt, Roosevelt, Roosevelt,” he didn’t have too much trouble stacking regulatory agencies with the kind of industry stooges his backers demanded, New Deal be damned.
Then again, Medicare was his baby, as were the 64 and 65 Civil Rights Acts, so he would probably be personally offended
Nick
@Triassic Sands:
You can only push the people so far. As for African-Americans, it took decades of lynchings before they were even given some rights. Sometimes you need to hit rock bottom.
Triassic Sands
I just read the whole article in the Star-Telegram (link above) and Representative John Zerwas (a physician) who is sponsoring the study to have Texas opt of Medicaid says:
Make no mistake, this is also directed at destroying the HCR legislation. Remember, expanding Medicaid is a significant part of that reform, so with a state the size of Texas opting out and then receiving a block grant to pay for its own program this would just be the federal government aiding and abetting the destruction of Medicaid. That sounds remarkably like the voucher programs that suck money from public schools and funnel them into private or charter schools. In the end, the idea is to dismantle public education.
While Democrats have been fairly sanguine about the likelihood of Republicans succeeding in killing the HCR legislation, I’d say they have a pretty good chance of succeeding if the get control of the Senate and White House in 2012. Especially since some of its major provisions don’t go into effect until 2014. I always thought it was a terrible idea to delay changes (for electoral purposes?) for so long. The idea that it couldn’t have been done faster is belied by what other countries have done — although it is true that this country has become so dysfunctional and incompetent that what other countries can do is probably irrelevant for us.
Zerwas is a physician, so he probably wants higher fees for service than Medicaid pays. It’s difficult to see how a Texas-go-it-alone program is going to pay doctors more, since there would likely be less money available, rather than more. That would probably mean significant cuts in services for the poor, which is probably what Zerwas really wants (if he can’t get paid more).
I don’t understand what people like Zerwas have against “death panels.” Wouldn’t they be a great way to just kill off the poor and disabled?
Triassic Sands
@Nick:
Sometimes you need to fight. African Americans didn’t “hit” rockbottom — they started there. But they never would have achieved anything if the people who supported them said “You can only push the people so far.” I’m really mystified by this approach, Nick. Are the poor and disabled worth going to the streets for? I guess not.
Kathy in St. Louis
And wait until the Tea Partiers who have taken Mom and Dad’s money and hidden it away, then thrown them in the nursing home, have to go retrieve said Mom and Dad, quit a job and start emptying those bedpans. Yep, let’s see how much they like the “opting out” of Rick Perry.
What an A-hole this guy is.
Nick
@Triassic Sands:
we didn’t
The fact that I don’t see mobs of people going to streets for them is why I we need to hit rock bottom.
Mnemosyne
@Triassic Sands:
Actually, you’re both wrong (how’s that for diplomacy? ;) African-Americans were able to make their biggest gains post WWII partly because they had already gotten pretty far and became frustrated at the slowness of their progress.
It’s pretty well proven in sociology that you don’t get revolutions when people are completely ground down and hopeless. You get them when conditions improve a little and people start to feel like they can change things. Why do you think the Republicans are so terrified of letting the Democrats improve things even the tiniest bit?
Sorry, Nick, your advice is exactly ass-backwards.
Triassic Sands
@Mnemosyne:
I’m not sure how what you wrote makes what I wrote wrong.
Otherwise, I agree with what you wrote.
Nylund
I met a guy in Amarillo who told me that because of “Obamacare,” ERs in Texas now have signs that explain how the hospital now has the right to determine your worth to society before deciding whether or not you are worthy of treatment. He told me he knew it was true because he read the entire health care bill. This guy is hardly one lone nutcase. I meet many here now that I’ve moved to Texas.
I have a neighbor, a pregnant woman with no job, not even a bank account (she mooches off her musician boyfriend). I asked her how she was going to pay for all the health care associated with pregnancy and motherhood and she said Medicaid. She cried when I told her that I voted for Obama because he’s a socialist who will destroy America. I told her about the GOP plan to opt out of Medicaid and how she shouldn’t vote for them. She told me that everyone in her family is a Republican and she was raised to be a Republican, and will always vote for the Republicans.
My point, Texas is screwed and should Texas Healthcare get even worse, I have no doubt that it will all be blamed on “ObamaCare.” The vast majority of people get most of their “political” information from right wing chain letters. Reality plays no part in most people’s thinking here.
Barbara
Nylund, life must be pretty desperate if your means of survival is mooching off your musician boyfriend.