Wednesday, February 19, 2014

Accepting the Left's Premises on Medicaid Expansion (Private Option)

If you are already familiar with the background, you may want to skip down to this point "*****".

The Arkansas Legislature is in a dead-lock over whether to fund a key component of Obamacare- the expansion of Medicaid.  In Arkansas, this is being done via a Medicaid plan which routes the Medicaid money through insurance providers first rather than directly to the providers of medical services.  This scheme is deceptively called the "Private Option".  So far it seems to combine the worst of Socialism and Crony Capitalism in one un-affordable package.

All of the Democrats support funding the expansion.   Almost all Republicans were elected on a platform of opposing it, but more than half have caved and decided to vote to fund it anyway.  The federal government has arranged funding to conceal and mis-state the cost of this expansion of government in the short term.    When Gov. Mike Beebe says rejecting the "Private Option" will leave an 89 million dollar hole in the budget here is what he means:  The feds would not borrow 89 million more dollars on the taxpayer's account and give it to Beebe and the legislature to spend on expanding Medicaid, with Arkansas Blue Cross taking a cut on the way.   

Several polls have been cited showing that the public is split fairly evenly on whether to expand Medicaid, even when the poll mentions it is part of Obamacare.  Still, all of the polls on the subject are extremely slanted in favor of the expansion for this reason- none of them mention how the expansion will be paid for.  They all say something like "do you favor expanding Medicaid so that uninsured adults have access to medical coverage?"  

Well, if there is no price tag attached to it, what kind of ogre would be against that? Sure, health care for everyone!  But that is not a fair question because it asks if people want to give someone else a benefit while never mentioning who will be stuck with the bill for it.  If the question was stated giving both costs and benefits rather than just benefits it would be more like "do you favor expanding Medicaid so that uninsured adults have access to medical coverage to be paid for by sending the bill to the next generation via increased government borrowing?"   I am confident that most Arkansans do not want to steal from children to pay for government hand-outs, but the questions are never asked that way.

Fortunately a 3/4ths majority of the legislature is required to pass appropriations bills.  Two votes have been held, and the forces that want to fund it appear to be short and getting shorter of the number required.  The conservative Republicans, the ones who have been keeping their campaign promises, have mostly resisted the pressure.   

They don't have to do a thing other than what they have been doing to win.  Despite his childish threats to hold the same vote over and over until its passed, the clock is ticking against House Speaker Davy Carter.   But unfortunately, the conservatives have recently fallen into a trap.  They have accepted the false premises of their enemies.   Unless they start taking on these false premises instead of trying to accommodate them, they are going to wind up snatching defeat from the jaws of victory.  Oh, they may get re-elected a time or two more, but only by continuing the policies which are destroying the country.  


The question they have been asked over and over again by the media is "what are you going to do for the 100,000 Arkansans who have already signed up for insurance through the Private Option?  Are you just going to take their insurance and leave them with nothing?" Another version of this is "well, you are just saying 'no' to everything, what is your alternative?  What is your plan to make certain that all adults have access to medical care?

Their (Sen. Jim Hendren and Rep. Bob Ballinger did most of the talking for a large group of conservative legislators) response to this pressure can be seen at this press conference held at noon today.   They say they don't want to take any health insurance away from those who have already signed up.  Their solution is to freeze enrollment in June, and fund it at that level until next March, when the next legislature can decide whether to re-open enrollment or defund the program.  This course of action will require a waiver from the feds, which if not granted would result in the defunding of the program after June.

In advancing this proposal, they have walked into a policy trap.  The left started by making an unreasonable demand, fund this all now, and they feel like they have to "compromise" and offer something in the middle (fund much of this now and decide later whether to fund the rest of it).  They have basically surrendered to negotiating on a Hegelian basis, which cannot produce an end result of truth.

I negotiate for a living, and they are doing this wrong.  They are doing this wrong if the goal is to defend conservative principles.  If they have a goal of rescuing a floundering gubernatorial candidate of their political party then they may be doing it right.   But that would just be more fodder for the idea that all legislators should be elected as independents rather than go through a D.C. based party.   That way they would owe only the people in their districts, not a party label. Instead of changing their views to do whatever is in the interest of the Governor when he is in their party, they can just worry about what their constituents want.

Reporters immediately asked Ballinger and Hendren about people who had not signed up by the end of June.  Why leave them without health insurance? And if they did not want anybody to lose their health insurance then why only fund it until this time next year when, presumably, if the legislature fails to re-fund it, then all those same people who will lose their health insurance this July (when current funding runs out) would lose it just the same next March?

All good questions if one accepts the premise that the government should provide health insurance to every able-bodied adult.  But that's the problem.  It is a false premise.   It's not up to them to provide an alternative way for the government to provide able bodied adults with health insurance, because it is something the government should never be doing for many reasons.   

What is the conservative alternative to "ensure" people have health care?  We have no plan to do that, nor should we have a plan to do that, because it is a plan which cannot be done without taking money and freedom from whoever we force to pay for it all (in this case, the debt for the next generation, stealing from children with no vote to defend themselves).  

What's my alternative? Freedom, that's my alternative.   I will take it further because the choice is not really between government provided health care and freedom.  The long term choice will be between the illusion of government-provided health care and freedom.   Choose the former and you will lose freedom, but in the long run you will not gain health care.   Europe and Japan are broker than we are after one generation of trying it, and that was with us shouldering most of what should have been their defense spending.   We are even not paying for the government health care we have now- Medicaid and Medicare are drowning us in debt.  

Something is going to ration scarce resources, and no man-made law can undo that iron law of economics.   With government health care, instead of your family budget deciding how much health care you will have, a government bureaucrat will decide.  When scarce resources are being allocated, there will be a rationing process.  That may be painful, but its reality.  Lying, thieving politicians sell people on the idea that they don't have to face that reality if they just give up their freedom, but its another lie.  Reality will have to be faced - either now or once our national credit card is maxed out and we are in an even worse position to deal with it.

Some people are complaining that we can't give 100,000 people health insurance and then take it away from them when the funding runs out in June.  It was written right into the law that it was not an entitlement and they could lose it, so why can't we? Plus, it never should have been given in the first place.

If every day I take a dollar from you and give it to Joe, am I doing Joe wrong by telling him that come July I am going to quit taking a dollar from you and giving it to Joe?   Of course not. Joe had no right to your dollars in the first place.  Joe gets six months worth of benefits from the deal.  If he loses them, well, he is losing something that he never should have gotten in the first place.  Not that we are denying one single person health insurance,  What we are doing is denying them access to other people's earnings to pay for health insurance.

It never should have been funded in the first place.  The answer is not to freeze it in place for a year, the answer is to undo the mistake and de-fund it.   By accepting all of the left's premises, they are going to wind up snatching defeat from the jaws of victory.  Government does not have the means to fulfill their promises of what they will do for you if only you give them control of your health care.  And they don't care that they can't keep the promises they are making, they are just saying whatever they have to say to get control.

This thing was sold with lies ("if you like your plan, you can keep your plan. Period"), it was passed in Arkansas with lies ("a vote for the Private Option is a vote against Obamacare") and now it is being sustained with lies as they tell us we just can't simply end a program that did not exist six months ago even though they assured us then that it was written into the law that it was not an entitlement and could be ended at any time.

I urge conservatives in the legislature to re-consider and reject this path to defeat whereby you want to freeze enrollment but continue to fund it.  Once you surrender on the premises you surrender on the argument.   Instead, if you must offer "compromise", delay all of the funding until March of 2015.  That is, when it ends in June it ends for eight months.  We stop stealing dollars and giving them to Joe.  Then the next legislature can decide in Jan. and Feb. of 2015 if they wish to resume stealing dollars and giving them to Joe.

Obama himself has unilaterally delayed certain aspects of the law with his name on it for a year.  He delays implementation whenever he wants.   The Legislature should do the same and defer this decision until after the elections so that the people, the real rulers of this state, can break this dead lock in a way that will have some legitimacy.  


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