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Should Have Nationalised Medicaid to Start With

Barack Obama would do well to take a hint from the “Duck Dynasty” candidate’s victory:

Medicaid expansion is popular, even if Obamacare isn’t. Riser was a Jindal acolyte in the state legislature who saw first-hand the governor’s approval rating dip as he opposed the expansion of Medicaid. That’s the dilemma Republicans face: As unpopular as the president’s health care law is, even Republican voters like the free benefits that come with Medicaid expansion.

That’s why most swing-state and blue-state Republican governors have jumped aboard the Medicaid expansion bandwagon, and Democrats have used the issue as a cudgel against those who haven’t. Ohio GOP Gov. John Kasich’s support of Medicaid expansion back home has become Obama’s new favorite talking point, a political necessity for him as he faces a competitive re-election next year.

As I noted in early 2010:

Here’s a suggestion: nationalise (or more accurately federalise) Medicaid.  Currently a joint venture of the states and the Feds, making it an entirely Federal program would have many possibilities:

  1. It would relieve the states of their largest running budget headache.  That would insure the support of all fifty governors, Republican and Democrat alike.
  2. It would enable the Feds to set a uniform standard for eligibility, etc.   That problem has bedevilled the current process, and led to the more egregious payoffs (LA, NE, etc.) we saw in the Senate process.
  3. It’s already a government program, so this (in principle) doesn’t “expand the role of government.”  That would put the small-government Republicans in a box.
  4. It addresses the medical insurance issues of the portion of the population least able to afford it.  Isn’t that what social welfare is all about?
  5. It would end the “health insurance shopping” that helped turn TennCare into the disaster it became before the state pared down the eligibility requirements.

If there’s one thing that Social Security and Medicare should have taught us, it’s that a free (well, consistently taxed and doled out) government benefit is popular, whether conservatives like it or not.  It’s interesting that the more “conservative” Republican won in part because he wouldn’t go along with Bobby Jindal’s stalling on Medicaid expansion.

Expanding Medicaid would have been a lot easier if Obama, instead of wasting time, money and political capital on the kludge we’ve got now, would have simply nationalised Medicaid and expanded it to taste.  It would probably have been cheaper as well.  But that’s a major reason I have so little use for American liberals; not only do they reject basic economics, but they can’t even put their own principles into action without making a complete mess out of it.


2 Replies to “Should Have Nationalised Medicaid to Start With”

    1. Back when Obamacare was being debated, we were presented with a more “authentically” market solution. But the powers that be on the left trashed it, and those on the right had as their only objective derailing what those on the left wanted.

      To use a Biblical phrase, Obamacare has the form of a market solution but denies the power thereof, which is why we’re in the mess we’re in.

      My idea is that, since we didn’t have the option of doing it right, someone should at least address the problem directly using an existing solution. We all know that the result of this will be: rationing, which is what you’re referring to re medical school admissions. But, as I’ve said before, if we can at least get crappy, mediocre health care at 10% of GDP as opposed to 18%, perhaps we can afford the plane ticket to somewhere else to get it right.

      When you live in a country that wants to have it all but won’t do what’s necessary to achieve it, you get messes like we’re in with health care.


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