Obamacare

Welcome to the Rest of the Decade: Fiscally Strained States All Want More Money for Medicaid

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Is it finally handout time for the states? They're certainly hoping so. The Washington Post reports that the National Governors Association is still calling on Congress to extend the temporary funding boost for Medicaid included in the stimulus. As I pointed out a couple of weeks ago, issues like this and the "doc fix" reveal the problem with "temporary" funding bumps; once a revenue stream is established, no one ever wants to give it up. With a massive expansion of Medicaid on the way, we can look forward to a lot more of this. Yet as Tennessee's 2005 decision to scale back its Medicaid program—after a a radical expansion of the program swelled its budget —suggests, scaling back can be the best choice for long-term fiscal stability. Scaling back, though, is always tough in a political system that rewards legislators who focus on providing easy goodies at the expense of long-term stability. In some ways, it's similar to the problem that Massachusetts is facing in reforming its fee-for-service health care payment system:  just about everyone pays lip service to the idea that we need to cut medical spending, but no one wants their services or payments to be cut.

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  1. [Checks pockets] Sorry, all tapped out. Move along, please.

    1. Oh yeah? How did you buy those pants with pockets?

      1. Chinese slave labor?

        1. Beg/Borrow/Steal?

          1. I’m just kidding. Like most good capitalists, I exploited the entire working class to achieve pocketed status.

            1. And then you burned a bunch of ants with your monocle and the sun, right?

              1. The Sun? No, he’s got this big HeNe laser powered by a giant treadmill full of Chinese kids. THAT’S how you burn ants with your monocle, Big Capitalist Sty-lee.

    2. Time to raise the Hoover flags?

  2. “In some ways, it’s similar to the problem that Massachusetts is facing in reforming its fee-for-service health care payment system: just about everyone pays lip service to the idea that we need to cut medical spending, but no one wants their services or payments to be cut.”

    But if you cut medical spending, people will die. How is that not murder?

    1. That’s completely wrong. You have absolutely no empirical/historical evidence to support that claim, because none exists.

      1. Might want to recalibrate your sarcasm detector.

  3. When Tennessee first announced that it was cutting back on TennCare, there was a huge uproar from the progressive types in Nashville. They talked about people suffering and dying because they weren’t going to get any medical care at all and how inhumane and selfish the whole thing was.

    Five years later and there hasn’t been a peep about these predictions coming true.

    1. The lack of peeping is proof positive of the deaths that have resulted.

  4. In the spirit or RC’s Iron Laws:

    If you subsidize demand, and limit supply, prices go up.

    No ‘reform’ effort that has ever been proposed has been concordant to this rule – to the contrary they have all tried to violate it.

  5. “Gimme fitty bucks.”

  6. If only there were a way for people to get the care they wanted from the providers they wanted at a price they agree upon…

    1. Like some sort of marketplace where they were free to make those choices…

      1. In this “market” of which you speak, could insurance companies offer policies against catastrophic losses ?

        1. Are you holding each others dicks when you made those comments?

          1. Just your mom’s.

        2. Yes. You could also price based on risk so the single 25 year old guy doesn’t pay the same rate as the 60 yr old smoker who weighs 400 lbs.

  7. everyone pays lip service to the idea that we need to cut medical spending, but no one wants their services or payments to be cut

    Don’t cut payments, then. Just increase deductibles.

  8. I’ll gladly pay you Tuesday for a massive entitlement program today.

  9. Not to mention scare tactics like “we’ll have to cut back on state troopers and that will lead to mayhem on the roads.” Yet Penna.’s recently passed “austere” budget managed to find $20,000,000 to fund libraries to honor Sen. Specter and Rep. Murtha.
    Didn’t there two turds have enough friends to put up the money? They gathered honors and awards from hundreds of organizations which, apparently, don’t mind giving out some cheesy plaques but don’t ask us to give donations.

    1. Well, back to directing an asteroid towards Earth with my mind. Live it up guys.

  10. By the way, the people at the Free Talk Live forums made a response to that 24 types of libertarian cartoon:

    24 types of authoritarian

    1. Seems accurate enough.

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