A health system of winners and losers is not greatness
Regarding “Fear-Mongering: Hot Rhetoric Impedes Health Reform” (June 30 Perspectives):
Charles Blahous laments that “explosive rhetoric” with regard to the Republican proposals to replace the Affordable Care Act “makes it impossible to make policy with appropriate reflection and care.”His apparent concern is the reaction to proposals that would have an effect on Medicaid. I suggest that if the rhetoric has been explosive, it is not because of the lack of appropriate reflection and care by those who find the Republican proposals with regard to Medicaid frightening. Rather they reflect an unwillingness of the drafters of those proposals to admit to the effects of whatthey propose.
Mr. Blahous reminds readers that those who were covered by Medicaid prior to the Affordable Care Act would still be covered, even if those who received coverage under the ACA's expansion of Medicaid would no longer be covered under the Republican proposals (unless individual states chose to continue such coverage without additional federal dollars). Dropping such federal coverage, as the Republican bills propose, would reduce federal expenditures. Those removed from the Medicaid rolls would be “losers,” but as Mr. Blahous notes, in any policy change there are winners and losers. Who would be the winners? The Republican proposals would use the money the federal government would save on Medicaid expenditures to cut the taxes imposed in the Affordable Care Act, taxes that fall on the highest income groups in the country.
Another provision of the Republican proposals with regard to Medicaid is to change the rules for federal funding from payment of a fixed share of total expenditures on Medicaid to a system of block grants to the various states. Under a block grant system, a state that reduces its own expenditures on Medicaid can reduce taxes on its own citizens without losing federal funds. Since lower taxes are a draw to people and businesses, switching to a federal block grant system will put states in competition to see which can squeeze its Medicaidprogram the most.
Once again, there will be winners and losers. Medicaid recipients would be the losers. Those of us who are more fortunate will be the winners. Is this how we want to “make America great again”? JACK OCHS Point Breeze