This one seems interesting in that it deems the 1996 Welfare Reform program a failure, and compares the latest GOP Senate Healthcare reform Hail Mary to it. Thoughts?
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5 comments:
If you're modeling health care reform after welfare reform, it ain't gonna work.
Well, I guess I should amend that. It will work if your goal is reducing the amount that the federal government will spend on health care.
But if your goal is making sure that people have reliable, affordable access to health care, it ain't gonna work. The one thing that welfare reform hasn't done is create a wave of innovation by the states. No state has gone out there and developed a fundamentally different model of moving people from welfare to work. Could it be different in health care? There's no reason to think that it would be at this point.
For that matter, we don't need to look at welfare reform. We can look at how states have treated Medicaid. 19 states turned down the Medicaid expansion, which was free money from the feds to provide health care to poor people. Go back, for instance, to the post 9/11 years when many states faced budget deficits. States didn't reinvent the wheel to ensure that people got healthcare -- they slashed the programs instead. Arkansas kicked some disabled children off of Medicaid. Florida and Indiana cut dental care, reduced coverage for prescriptions, and cut nursing home reimbursements. Texas cut mental health counseling, dental care, hospice care, and substance abuse treatment.
I think the goal of Welfare, Medicaid and ACA subsidies is always the question...
Is it to keep certain people safe, warm, fed, secure and cared for no matter what they choose to do or not do forever?
Or are they safety nets with time limits, behavior and performance expectations?
In essence an investment by the people of America to give these citizens a second or third chance to become educated and hard working citizens who make good decisions?
If they fail to step up to their responsibilities as citizens of the USA, when do we stop subsidizing their choices and leave them to the mercy of our charities?
By the way, now I am in lovely Ningbo.
The goal of the ACA is for everyone to have adequate health care which they can afford. If others want to argue that the goals of the ACA are affected by other things the government does, I am certainly open to that discussion.
I am often a bit surprised by the arguments some people find convincing. Lots of people argue that policy considerations applicable to life insurance should be equally applicable to health insurance. Our president has said things that suggest he believes that. I find it astonishing that people believe and argue that.
--Hiram
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