Friday, September 14, 2018

Gov. Walker (partly) confused about Medicaid expansion?


Psychologists (and economists) tell us we feel twice as bad about losing $100 we had – than we feel good about finding $100 we didn’t have – even though the economic equation is exactly the same.

A similar psychological puzzlement may underlie 19 Republican governors’ refusal to accept Medicaid expansion – even though the Medicaid will put up $9 for every $1 states pony up for low income health coverage; or I should say $900 million for every $100 million.

Suppose the fed gov were someway able to penalize states $900 million for every $100 million the states did not pay in for low income health care or any other worthy enterprise – what governor, Republican or otherwise, would not come up with the pump primer?  Exact same equation … except Medicaid takes taxes the $900 million first and tries to hand it back later … exact.

Many or (more likely) most of those uninsured patients are going to show up in somebody’s medical offices and hospitals anyway (many by then sicker, requiring even more care) – ultimately uploading their costs into private insurance premiums and local gov spending -- at 100% share of costs.

Wisconsin governor Scott Walker is perhaps partly confused: keyhole-focused on the portion of every $100 million Wisconsin saves by keeping Medicaid income requirements higher than federal standards allow – all the while not accounting (what many Repubs seem to need are accountants) for the state losing exactly the same portion of the $900 million.

Almost forgot: aren’t those Repub govs forever hollering how tax cuts will pump their economies (not true if that just diverts purchasing power from public to private choices – true in recession)?  Wouldn’t dumping $900 million extra purchasing power into their states truly expand their economies -- or not shrink them?
       
Almost forgot: a billion dollars will cover health care for something like 140,000 needy patients for a year.  Almost forgot.