A majority of South
Dakotans does not support Obamacare (Affordable Health Care Act) and did not
support it when it was passed.
Senator Tim Johnson this
past week in his letter to Governors reaffirmed his support of socialized
medicine when he wrote to urge States including South Dakota that have chosen
not to increase Medicaid coverage to do so.
Just a little history –
Politically the nation was divided on the issue when Obamacare passed. It
passed the U S Senate by one vote. Senator Johnson voted Yea, Senator Thune and
Representative Herseth Sandlin voted Nay.
In order to receive the
necessary votes to pass the bill a few controversial deals were made.. Senator
Landrieu (D, Louisiana) got an additional $5 Billion in relief for Hurricane
Katrina (the 2nd Louisiana Purchase), Senator Ben Nelson (D.
Nebraska) got special additional reimbursement for any additional Medicaid cost
for his State, Nebraska, (the Cornhusker Kickback which was later taken out of
the Act when his Constituents revolted), and Senator Bill Nelson (D. Florida)
also received for Florida full federal reimbursement for any additional
Medicaid cost. Florida of course is a leading State in the number residents who
are senior citizens. Note Florida pays nothing for additional Medicaid costs
for its eligible residents.
Sidebar –
the obvious question here if this was such a good deal why didn’t Senator
Johnson get an exemption for South Dakota?
(more history) Several
States litigated Obamacare regarding the so called individual mandate. The U S
Supreme Court ruled that it was not a mandate but a tax but additionally ruled
that the federal government could not force states to participate in the
Medicaid expansion.
Medicaid expansion is what
Senator Johnson, Democrats in the South Dakota Legislature, the South Dakota
Democrat Party, and several Democrat candidates support. Last year the South
Dakota Legislature did a summer of study of Medicaid expansion and determined
that while expanding Medicaid eligibility had some merit it was not something
that state government could afford in the out years when federal funding would
decrease. In fact it was an unfunded mandate (if the State chose to
participate).
I too oppose Obamacare but
as a pragmatist believes it will not be repealed. We currently have a President
who would veto any repeal and currently a U S Senate (with a slight chance of
change with the mid term election) that will not pass repeal. It would be very
un characteristic of Washington officials of either party to vote to dis
enfranchise any group from existing benefits. Rather we will see reform. Will
they be Democrat or Republican or some compromise? I guess time and which
political parties are in power will tell.
While I am sympathetic to
the feelings of those who are preaching repeal, the horse is out of the barn.
Promising repeal is just pandering.
Healthcare affordability
can’t be addressed by only figuring out who pays. The real problem is fixing
why it costs so much? This is much harder because instead of spending money we
don’t have, we have to ask providers, insurers, trial lawyers, and others to
take a hit.
Democrat U S Senate
candidate Rick Weiland proposes fixing Obamacare by rolling it into Medicare.
As a Medicare participant I will say it works well. What Weiland won’t tell you
is that it is very expensive.
Currently the Medicare tax
is 2.9% of ALL wages paid in our Country plus an additional 0.9% on all wages
paid by those earning over $200,000 annually. That is a really big number. Having
said that, Medicare is not paying its own way now and the Medicare trust fund
is being drawn down and expects to be insolvent by 2026. Under the Weiland plan
far many more people will fall under Medicare. What Rick Weiland needs to tell
us is how does he propose to pay for this gigantic expansion of a broke system?
The fact is Medicare and
Medicaid is already increasing our deficit. These promises cost money. Lots of
it!
From a public policy
perspective government health care systems are neither responsive nor efficient.
Having government make personal decisions does not work well. Government and
bureaucracies must make rules that treat everyone the same. This leads to less
personal decision (in this case on one’s own health.)
To reverse current cost
escalation and make health care more affordable people must first take primary
responsibility for their health. We must become more self-reliant and less
reliant on government. The current Veteran’s Administration scandal (not the
first one) points how a socialized system works (or does not work.) In this
case administrators receiving bonuses for seeing patients timely. When in fact
records are being falsified so that bonuses are paid. It is frequently heard
that the Indian Health Service, another socialized system does not work well.
Liberals cry that these
systems don’t work because they do not receive adequate resources (funding). It
is not the funding that needs reforming, as much at it is the cost.
Personal note – I support and believe there is a role to collectively help those
that are unable to help themselves; particularly veterans with service
connected disabilities, children from poor families, and the disabled.
We are not going to fix
these problems by spending more.
