Wednesday, August 8, 2012

Stunning feats in false economy

   Don't you hate freeloaders?

   Those who won't carry their weight?

   Those who cost others because they don't use common sense and available resources to best possible uses?

    Me, too. That's why I was bothered recently to hear from people incensed by the prospect of having to have health insurance under the Affordable Care Act.

    Stinking freeloaders. They think it's a horrific affront to have to pay for cut-rate health insurance. But when they have a bad break  — a broken arm, a splinter that festers — they think it's fine that others pay for their health care. That's the way it's been for generations, of course. For, as then-President George W. Bush pointed out, uninsured have access to health care. "They just go to an emergency room."

    Recently an analysis showed that hospital care for the uninsured cost an average privately insured family in Bush's home state $1,800 per year in higher premiums.

    The sad thing: Texas policy makers, as with others in this nation's red-state resistance bloc, are just fine with that.

    Texas leads the developed world in uninsured people, and wants to expand its margin. It is refusing — no way, no how, can't make me — to expand Medicaid as is incentivized by the Affordable Care Act. It is refusing to create health-care exchanges under the act to make health insurance affordable.

    The fact is that the federal government can't make Texas, or Florida, or Arizona, or Georgia, or any of the Republican-controlled states expand Medicaid, pursuant to Chief Justice John Roberts' decision upholding the act's individual mandates.

    They don't have to, even if doing so is in their best interests, which it is.

    What these states are doing in resisting Medicaid expansion is, in fact, a stunning piece of false economy, something at which Republican legislatures tend to be masterful.

   The phrase "penny-wise, pound foolish" has never been more apropos.

    How foolish? Under the Affordable Care Act, the federal government will pay 100 percent of the costs of the expanded coverage for the first three years, and overall, states will never pay more than 10 percent of the costs for the extra people served.

     How many people? The Center for Public Policy Priorities projects coverage for 1.5 million to 2 million Texans.

     Ann O'Leary of California's Center for the Next Generation writes in the Huffington Post how the nation is about to get a stark demonstration in the false economy of red states holding their breaths in protests while blue states take advantage of this new program.

    As O'Leary points out, California has gone all in on taking advantage of the Affordable Care Act since 2010, already extending coverage to 400,000 individuals.

    The benefits? What might inure with preventive health care for people shy of keeping the lights on at George Bush's friendly ER?

    The obvious result is healthier people who require fewer catastrophic procedures, healthier children who miss less class, healthier parents who miss less work. Not only that, but a study by the Bay Area Council in California projects that full expansion of Medicaid under the Affordable Care Act will create jobs and boost the state's gross state output, as was seen in Massachusetts when then-Gov. Mitt Romney did for that state what he says is so bad for America.

    One other thing, says O'Leary: "On every single health-care measure, California outperforms Texas": blood pressure, smoking, better diets, more physical activity, most important, better access to preventive care.

    All of these lower general costs and pressures on the private insurance market we all hold so dear (wink, wink).

    But let's face it. Some states would rather save a penny than bend toward a dime's worth of common sense when it comes to health care.

    Longtime Texas newspaperman John Young lives in Colorado. Email:

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