Is that communism or pragmatism I hear from Governor Dennis Daugaard's Medicaid expansion task force? Either way, I like it:
Dan Ellis, CEO of Coteau des Prairies Hospital, said America's approach to health care is a product of its historic emphasis of individual rights. But compared to other developed nations, nearly all of which have taken a more communal approach to health care, it is clearly not working.
"The fact is we pay more for health care in our country than any other developed country in the world and probably get worse outcomes," he said [Daniel Simmons-Ritchie, "Task force wrangles over policy and philosophy as it looks at Medicaid expansion," Rapid City Journal, 2013.05.15].
Dan Ellis is head honcho at a hospital. Making health care work is his job. Hearing him say the same thing about the failing American health care system since the early days of this blog is like hearing the owners of Eagle Creek Software and Bel Brands say that investment in schools and roads would be better for business than corporate welfare.
Medicaid task force member Senator Craig Tieszen (R-34/Rapid City) sends up some hopeful signals. He appears to recognize that the farther-right wing of his party is peddling misperceptions about "lazy" people in Medicaid and higher costs for the state:
Tieszen said that there is a perception that South Dakota's budget would be taking on extra cost, when it may already be paying for uninsured people in other ways. For instance, many poor people can't afford medical care so they put off treatment until they arrive in the emergency room. That is a significantly higher cost for hospitals than providing preventive treatment, a cost that is borne by insured people [Simmons-Ritchie, 2013.05.14].
Tieszen says we need to put a face to the folks whom we can help by expanding Medicaid. That's a lot of faces: 40,164 uninsured South Dakotans in every county of the state, including 14,231 American Indians whose needs an underfunded Indian Health Service isn't meeting.
By the way, another 45,532 uninsured South Dakotans qualify for the ObamaCare subsidies for health insurance. That's the communal approach at work, helping more people get the coverage they need.
Note the Oregon study that compared people with no health insurance to those on Medicaid. It's findings indicate that access to Medicaid yielded either no statistically significant change in outcomes or worse health outcomes than no health insurance at all.
While it is true we spend more on health care per capita than do other developed nations, whether the outcomes are worse is highly debatable (in part because you'd have to carefully define "worse"). Even if the outcomes are worse, that does not mean expansion of Medicaid, nationalized health insurance, or deepening the present dog's breakfast of competing agencies, regulations, and what not will improve things. There is a huge difference between identifying a problem and identifying a useful or ameliorating solution.
I'd be happy to clean up that dogs breakfast by simplifying the system: single-payer, single-negotiator. It works elsewhere. It holds costs down.
On the good side, the Oregon study also notes that "Findings also show that Medicaid beneficiaries were less likely to go bankrupt because of health care expenditures, reported less depression and overall had better health-related quality of life." Worthwhile policy goals?
A friend works for a non-profit that has high-priced premiums for their group policy (even with high deductibles). He dropped it because of the cost, but many of the people their organization serve get Medicaid (which is pretty decent coverage). It's frustrating for lower-end wage earners who can't afford their own coverage but don't quality for Medicaid.
I find it hard not to roll my eyes at those that look at a system with problems and want to get rid of it by replacing it with a system that works worse but feels better because it enables individuals to offload all the problems onto the government purse and by doing so also hand over all the controls of that system to the government as well. It is easy for some to rant about the evils of a world trade in coffee and champion fair-traded cofffee as worth the higher price to do the right thing, but then the same people don't give a damn about making healthcare a monopolistic intrusive nightmare so long as they can justify it by false claims that it will be cheaper. Cheaper at what cost? There are better ways to make it cheaper by making the free market work, and Cory acting like it's all about practical solutions and theoretical idealism is pointless is either delusional or a lie. The main goal isn't managing cost, it is to engineer a society that takes care of everyone through socialism. aka tyranny.
ps http://files.libertyfund.org/econtalk/y2012/Cochranehealth.mp3