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Lowe Attacks Daugaard: Medicaid Refusal Is “Double Standard” That Hurts Hospitals

I don't see him doing any push-ups, but Democratic candidate for governor Joe Lowe is pushing his opponent, Governor Dennis Daugaard, on his treatment of hospitals and poor folks who need health coverage. Lowe opens the week with a press release decrying the Governor's refusal to take a huge infusion of federal cash to expand Medicaid.

Lowe opens not with the moral argument, but a practical market argument: pay people for the work they do!

I have the quaint opinion that doctors, nurses, and hospitals should be paid for their work. Dennis thinks they should just expect that they'll get stuck with the bill a certain percent of the time and should hope they can make up for it by overcharging someone else [Joe Lowe, press release, 2014.01.20].

Governor Daugaard claims that we don't dare expand Medicaid because he continues to "have doubts about the federal government’s ability to deliver on their promises." Lowe says that claim is inconsistent Tea-Party pandering:

If you follow that logic, South Dakota should not accept highway funds, school funds, college funds or any other billions in federal money that flow through the state budget. He's using a double standard.

That double standard points to another big difference between Dennis and me. He's apparently afraid of the Tea Party. I'm not [Lowe, 2014.01.20].

Lowe is hoping any Tea Party vote for which Daugaard may be angling will be neutralized by the 48,000 South Dakotans he's trying to help:

We have 48,000 people left in the cold by Dennis's double standard. It's mean-spirited and short-sighted. It's damaging to people's health, it's damaging to our medical providers, and in the long run it's more expensive [Lowe, 2014.01.20].

Governor Daugaard, you and the Legislature have two months to take this issue off the election table. Expand Medicaid, and you help people, pay hospitals, stimulate the economy, and take a really useful argument away from your political opponents.


  1. Vincent Gormley 2014.01.20

    Only corporations believe Daugaard can deliver, after all they already own him and his party.

  2. owen reitzel 2014.01.20

    The more I hear Lowe the more I like him. He's exactly right.

  3. chris 2014.01.20

    Stay strong, Dennis! Just remember when you hear harsh criticism like this, that there are still hundreds of registered South Dakota voters living in their motorhomes in Florida and Texas parking lots,who love you and support your policies, even if they can't remember your name as the governor of their official state of residence.

  4. Jerry 2014.01.20

    What they want to do Larry is to means test the working poor. What a cruel bunch of nitwits. I am sure they must practice their evil by tearing wings from butterflies and scorching ants with magnifying glasses. There is a reason these working poor qualify for Medicaid, it is because they are working poor and cannot even make enough money to qualify for a damn subsidy. What kind of society have we become? When is it that if you make less than 11,500 bucks a year for a single or twice that for a family, you make too much for assistance. We will punish you for that until you are dead broke and then we will give you assistance. These twits all live in the republican ivory towers, and speak of "let them eat cake". The sin of it all is that we have the more than enough money to completely fund this thing.

  5. interested party 2014.01.20

    Exactly, Jerry: Pierre is a meat-packing factory pushing pink slime into intestines making laws to make the product look just like Sarah Palin's lipstick.

  6. interested party 2014.01.20

    The agenda is so extreme it makes the skewed 'compromise' look sane.

  7. Jerry 2014.01.20

    So then, what do we citizens of the state of South Dakota get out of the shady dealings our governor and his minions put on the table? Do we get lower taxes? Hell no. Do we get better infrastructure? Are you kidding What do we get for screwing our working poor? What do we get for screwing our children s education? We get nothing. The politicos get there kickbacks and perks and then move on to more lucrative positions. The manipulators get more and more and our people, less and less. There is a redistribution of wealth alright, it goes from the peoples pockets to that of the politicos and there bosses.

  8. interested party 2014.01.20

    Brendan Johnson for Attorney General.

  9. Anne Beal 2014.01.20

    First of all, the Hill- Burton Act guarantees emergency medical services for everybody without regard for ability to pay. So cool it with the histrionics; nobody's left out in the cold. Secondly, the hospitals are making money hand over fist, to the point that they have to go looking for projects to spend it on. When they have marble floors with sparkles which look like lapis lazuli, huge fountains and statues in their lobbies and halls, and have to build wellness centers with Olympic sized heated swimming pools, you know they're really pinching the pennies. Open your eyes and look around the next time you go to a hospital. They are rolling in money.

  10. interested party 2014.01.20

    catholics: jesus, mary and joseph give me strength.

  11. caheidelberger Post author | 2014.01.20

    Let me add to Larry's reheating of the "out in the cold" histrionics: sure, anybody can stumble into the emergency room and beg for uncompensated care that will be cost-shifted to patients. Lowe would apparently prefer that we provide affordable coverage that lets lower-income folks get better care before they need the emergency room and share that cost through the broader pool of all taxpayers. Seems reasonable.

  12. Anne Beal 2014.01.20

    Anybody who thinks the hospitals are hurting for cash should tour the Avera Cancer institute at the Prairie Center. You can take a virtual tour. Actually you can take virtual yours if all their facilities. But to really appreciate all the beauty and grandeur you should go there in person

  13. caheidelberger Post author | 2014.01.20

    Sure, hospitals are wasting money on fancy digs and sports arenas that I'd rather see go toward lowering the cost of my check-up.

    But the GOP leadership hears the drums beating: Sen. Tim Rave is saying they are looking for a way to do at least a partial expansion (because it would be a darn shame if we gave in to President Obama and helped as many people as possible and didn't get our fix of telling at least a few people, "You're not worthy of our help!"):

  14. Roger Cornelius 2014.01.20

    And when those uninsured or under insured stumble in to the emergency room and get the treatment they deserve, they are billed for it. Of course these people will never have the resources to pay their bill and the interest will continue to accrue.
    Soon the debt collectors will start the harassing letters and phone calls demanding orange juice from apple. Eventually the patient will succumb to bankruptcy or just ignore the demands.
    In the meantime, the hospital has either written off the debt or is in process of it. Some patients will actually make an effort to settle the debt by making a monthly payment.
    I know a guy that had needed back surgery, his bill was upwards of $20,000, with an income of $750 per month. He couldn't afford to file bankruptcy so agreed to pay the hospital $25 a month. Given his age, the bill will never be paid.
    There are literally 1,000's of situation like this across the state, this is what medicaid expansion is about. Poor and working poor should not have to be saddled with this burden when there solutions available.

  15. grudznick 2014.01.20

    Why shouldn't he pay the hospital $25 a month?

  16. Winston 2014.01.20

    You watch, if Daugaard is re-elected, he will back Medicaid expansion for the working poor in SD next December during his budget message. He just does not have the political guts to do it now, because he fears the Tea Party element of his Party.

  17. Joan Brown 2014.01.20

    Anne, the Hill-Burton Act usually runs out before the end of each year.

  18. Roger Cornelius 2014.01.20


    I didn't say he should or shouldn't pay the hospital.

  19. grudznick 2014.01.20

    You said the poor and unworking poor should not be burdened with bills.

    I say the unworking poor need to get jobs and the poor need to work harder, more, or smarter.

  20. Tara Volesky 2014.01.20

    Winston is exactly right. DD has a primary against Lora Hubbel so he is going to wait. He is bought and paid for buy the health care industry, just follow the money. Ann is right about the millions of dollars these so called charitable hospitals are making. Expanding health care is not going to fix health care in SD as long as we allow hospitals to be monopolies.

  21. grudznick 2014.01.20

    Lora Hubbel is insaner than most and should be running on a 4th party ticket.

  22. Deb Geelsdottir/ 2014.01.20

    Grudz, you never seem to have any compassion for all the people unable to work. Why is that? You are aware there are hundreds of thousands of such people. I've written about them many times here. But you continue to lump them in with people who don't work but game the system instead. All your self-righteous, judgmental scorn will send disabled folks out into a world they are unable to cope with. I'm talking about the ones with FAS, Downs Syndrome, head injuries, schizophrenia, etc.

    No, there is no guaranteed safety net for them. The more you pare away at services they need, or refuse to offer the services at all, the more they suffer. Is that the kind of society we want in SD? That's what we've got. A GOP-led SD culture that is cruel to the weakest ones. How Darwinian.

  23. grudznick 2014.01.20

    I have much sympathy, Ms. Geelsdottir/, for those people with disabilities. I happen to have one myself. Maybe more.

    But I cannot abide the lazy poor who game the system.

  24. Roger Cornelius 2014.01.20

    Is Lora insaner than grudz?

  25. interested party 2014.01.20

    Grud is a coward who made his money paying minimum wage and was sued by at least one employee over a surgery bill.

  26. Roger Cornelius 2014.01.20

    A reminder grudz, I said the poor and working should not be saddled with that burden when there are solutions available.

    "But I cannot abide the lazy poor that game the system". grudz, does that sentiment apply to the working wealthy that game that same system when they have substantial resources?

  27. Deb Geelsdottir/ 2014.01.20

    Grudz, you said, "But I cannot abide the lazy poor who game the system."

    Neither can I, nor, probably anyone else. But those are the last ones you'll get. You will inflict great hardship and suffering on the woman with Downs and the man with schizophrenia long before the cheaters feel a thing.

    That's the part you continue to pretend is not real. The terrible harm in your plan/Republican plan is skin and bones real. It's happening right now. Every time you speak up in support of such misery-inflicting policy, YOU are a responsible party. You. As is every like-minded individual.

    How can you live with that?

  28. grudznick 2014.01.20

    Calm down, Ms. Gellsdottir/

    You know little about my plan or to whom I am inflicting misery, save yourself.

  29. Roger Cornelius 2014.01.20

    Never calm down Deb. Never!

  30. Deb Geelsdottir/ 2014.01.20

    I am not calm when it comes to innocent people deliberately and cavalierly being made to suffer. I certainly do know who you're hurting, and so do you. Be a man, accept responsibility for your actions.

  31. Chris Francis 2014.01.20

    South Dakota morals, where we single out the lazy poor, but adore the lazy rich.

  32. Thad Wasson 2014.01.20

    Medicaid expansion will pass this year in South Dakota. Hospitals in and around Rapid City need the $$$.

  33. Roger Cornelius 2014.01.20

    I certainly hope Thad is right, although it seems like a long stretch.

    At any rate the vote will tell us whether we have a Republican legislature or a Tea Party legislature.

  34. Jana 2014.01.20

    Roger, I don't think the people in our legislature are smart enough to figure out where they stand. Sad, but true.

    They seem to fall more in line with the ovis aries party...following whichever shepherd seems to be the most convenient.

    Maybe they should be renamed the GOA party.

    Baa. Baa. Baa.

  35. caheidelberger Post author | 2014.01.21

    Thad! Where you been, man? I hope you're right. .. and I hope you're finally running for office. Kristi needs a primary! Are you game?

  36. caheidelberger Post author | 2014.01.21

    Some poor people are lazy. Some rich people are lazy.

    Lazy poor people generally don't have power. They take advantage of a system we create to help folks in need. The only way to eliminate all of that advantage-taking would be to eliminate assistance for the poor, which would hurt more deserving people than it would punish cheaters.

    Lazy rich people have power. They rig the political system to work in their favor and screw everyone else. Eliminating their advantage-taking would punish them and benefit darn near everyone else.

    Do you understand where I'm headed with this argument, Grudz?

  37. Nick Nemec 2014.01.21

    Grudz either doesn't know who Medicaid expansion will help or is trying to shift the focus of the argument on purpose and all the commenters are playing into his hand. The Medicaid expansion doesn't help the so called "lazy poor", they already are covered. The expansion covers those people who make sufficient income that they aren't covered under current Medicaid guidelines, in other words they aren't lazy, they have jobs sometimes more than one, they just don't have a job with health benefits. A sadly all too common state of being in South Dakota. Instead of demonizing the hard working poor by calling them names we should do something about the tragically low wages so many South Dakota jobs pay.

  38. mike from iowa 2014.01.21

    Maybe wingnuts in South Dakota,with advice and consent from Money Boo Boo and dumb bass dubya,can pass a law that says all future children born have to be born affluent beyond the Koch Bros. wildest dreams. That should do it.

    If all states adopted Medicare/Medicaid,the hospitals and doctors would get paid sooner and less wealthy people wouldn't be in danger of losing their only assets to pay too high medical costs. And no,Obama is not redistributing wealth from the top to the bottom.

  39. Jaka 2014.01.21

    where are all these jobs that the tax cuts for the rich "job creators" were supposed to create for these poor people to take and start working??????!!!!!!!!!!!!

  40. barry freed 2014.01.21

    When you have US Senators and Representatives who seem proud they have not "read one page of the Bill" because it is "too big"*. A governor who publicly derides the working poor as being lazy, and Lawmakers who make their living from Healthcare doing nothing, a Lawsuit appears to be the only solution that might force them to accept reality.
    That lawsuit should include Johnson too. He has done nothing after voting for the ACA. I called his office and the help told me: "those people should go get jobs that provide insurance". Nice.

    * The Farm Bill is ten times as large as the ACA.

  41. John Tsitrian 2014.01.21

    I doubt that Lowe will get much traction from bringing the Tea Party into the conversation. Yes, it'll fire up his supporters but won't win many Republican converts. This debate should stick to its issues.

  42. caheidelberger Post author | 2014.01.21

    Nick makes a great point. The Medicaid expansion is about helping folks in the middle of the lower end, folks busting their chops at minimum wage, making just enough not to qualify for Medicaid at pre-ACA levels but who can't work any harder at crap wages to make enough to qualify for the ACA premium subsidy assistance, which assumed the new, expanded Medicaid would apply to workers in all states, not just those whose Governors find President Obama tolerable.

    People who need help shouldn't have to prove their moral worth. But the 48,000 whom we would help by expanding Medicaid are not the morally worthless that Grudz and other distractors want us to believe.

  43. caheidelberger Post author | 2014.01.21

    John, is the Tea Party still a thing? Or is it just a convenient label for folks we think are too conservative?

  44. mike from iowa 2014.01.21

    Jana-I suspect legislators in your state stand where their korporate lobbying masters tell them to stand. After that,it is up to the pols to articulate(I said that with a straight face,he-he) the why of it.

  45. Douglas Wiken 2014.01.21

    Anybody here think there might be even a tiny little problem with 85 people having more wealth than half the world population?

  46. John Tsitrian 2014.01.21

    Cory, I think it's the latter here in SD, not that I follow that wing of my party all that closely. I know at the Bosworth-Nelson "debate" I attended in Rapid City last November that most of the crowd was affiliated with a TP-esque group that had another name (I've forgotten it) and the people close to me invited me to attend one of their regular meetings.

  47. Roger Cornelius 2014.01.21

    What the grudz's of the Tea Party and the Republican Party intentionally never mention is that medicare expansion is for the many that fall through the cracks and don't qualify for other available healthcare programs. Those that fall through the cracks are likely to be the greatest contributors to unpaid debt at hospitals and clinics.

    grudz's "But what I cannot abide the lazy poor who game the system" is typical tea party blathering. Guess what grudz, you don't have to abide them.

    What I can't abide is the self-righteous Christian right that in the name of God are obsessed with hating the poor and declaring war on them at every opportunity. These are same people that illogically think that the poor add more to the national debt than the military.

    Republicans continually lump the poor into one group of beggars that "game the system" when in fact poverty has no one clear distinction.

    My mother was raised in the Badlands of SD in the early '20's and of often said, "we were poor but never knew it". There are 1,000's of people that fit that designation and don't receive benefits from the government or a minimum of services. They are not the lazy poor, they are poor by circumstance and because we have a state government paying homage to grandiose get rich schemes called economic development.

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