Refusing Medicaid deal punishes poor

Chuck, your insurance agent, calls.

"We're running a special offer on health care insurance — three years for free," he says.

"What's the catch?" you ask.

"Nothing," he says, "other than that the price will go up in three years."

"Hmm," you say. "Three years for free? Then the price will go up?"

"Sorry, Chuck. I'd rather have no health care insurance for the next three years if that's the deal."

The only person likely to make that argument with a straight face would be a person who already has health care insurance, like the governor and members of the Legislature.

But that's what Paul LePage and minority Republicans seem to be saying to thousands of uninsured people in Maine.

Refusing to accept an extension of Medicaid, as they are now doing, is like Bath Iron Works turning down a lucrative federal contract because it will end in three years.

Three years means 36 months of better health care for thousands of Mainers. If Maine doesn't accept this money, it will simply go to other federal priorities, like providing the same care to poor people in other states.

The governor says he is bargaining with the federal government to get a better deal for Maine. But the governor's track record of obtaining special deals for Maine is dismal.

There is no reason the governor cannot take the first three years and continue to bargain. Is his bargaining chip that he will deny his own people health insurance if he doesn't get his way?

That's no bargain; that's like holding your own family hostage. But this governor's stock and trade is threat, bluster and force.

We suspect the governor's refusal to accept this money to benefit poor people is really based upon his personal distaste for the Affordable Care Act and ill will toward Democrats in the Legislature.

The governor has said several times that he hopes the ACA dies and he is willing to do anything in his power to kill it.

Republicans in the Legislature now complain they feel too rushed to understand how this program works.

Actually, it's more like the governor and legislative Republicans have simply refused to prepare or do the homework.

When the governor came to office, Maine was well on the way to implementing the Affordable Care Act. The governor ended that preparatory work, hoping the Supreme Court would kill the ACA.

The court didn't kill the program, and that was a year ago. Republican have had 12 months to think about this. If they don't understand it, it's their own fault, and they shouldn't punish uninsured Mainers for their failure to prepare.

Part of the problem is that the governor and the Republican legislative press office have defined health care as welfare.

Mainers who are not able to afford medical care should just quit being so lazy, get off their butts and earn more money.

The price of their "failure" could be steep, but the Republicans seem willing to accept that they will die of an undiagnosed cancer or be bankrupted by an extended illness.

But we suspect Gov. LePage is beyond his rational argument stage, if he ever had one on this issue.

The man doesn't compromise, doesn't back up, doesn't back down, doesn't change course, is immune to new information, contemptuous of contrary views and comfortable with chaos and bitterness.

Republicans in the Legislature have been far less dogmatic when they see the public's interest is at stake.

They should take a fresh look at the Medicaid extension, think about the thousands of Mainers who have no health care at all, then do the right thing.

rrhoades@sunjournal.com

The opinions expressed in this column reflect the views of the ownership and the editorial board.

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Comments

Jonathan Albrecht's picture

There are some people you can't train

The United States of America - its a country, a nation, governed by a Constitution the establishes governmental power and the shared responsibility of its citizens. Oh! responsibilities. Can't be. Well gentleman this is not the lawless wild west of the 1880's. This is not anarchy.
The ACA is a Republican proposal. They only oppose it now because it took a Democrat to get it passed after 100 years of failures.
But the anarchists, the "small government", sound money men (that means they want and appreciate a depression every few years to raise the value of money and give them a nice increase in their assets without any work), and the confederates still in America want to see us fail as a Nation. Killing the ACA is just one step in their agenda to wreck America.

MARK GRAVE's picture

How can holding the status

How can holding the status quo be punishing the poor? Nothing is given, nothing is taken away.

MARK GRAVE's picture

What will it take to teach

What will it take to teach people there is no free lunch? Those federal dollars come from somewhere – your fellow Americans, Maine inclusive.

Bob Stone's picture

3 Disagree?

Wow. How brain dead do you have to be to think that federal dollars don't come out of the pockets of tax paying Americans? No wonder 6 out of 10 people in this area voted for Obama. To them, federal dollars grow on yum yum trees it appears.

DONALD FERLAND's picture

Well obviously our governor

Well obviously our governor doesn't think the federal dollars come out of the pockets of Mainers....he doesn't want to accept them.

MARK GRAVE's picture

Since Maine already receives

Since Maine already receives $1.41 dollars for every dollar sent to Washington DC, it is correct to say the money does not come out of pockets of Maine residents.

DONALD FERLAND's picture

What part of MaineCare don't

What part of MaineCare don't people get. The expansion would cover WORKING people who cannot afford to purchase their own insurance. The state sets the price MaineCare pays for services and providers agree to accept what the state sets as a price. Many seem to have the misconception that this is for able bodied unwilling to work people when it is not. MaineCare is NOT the reason the hospital debt is so high. It is politicians not paying the bills over a long period of time. And blame the governor for not paying the debt this time....the bill was passed to pay them, deal with the liquor contract and expand MaineCare....our temper tantrum throwing governor vetoed it.

PAUL ST JEAN's picture

"MaineCare is NOT the reason

"MaineCare is NOT the reason the hospital debt is so high. It is politicians not paying the bills over a long period of time."
There, you just said it yourself. If that statement is true, then why are the democrats attempting to connect MaineCare expansion to the same bill that covers the making of payments to the hospitals? If they are two separate issues as you suggest, then, should they not be treated as such?

MARK GRAVE's picture

You mean like the money

You mean like the money coming from the Federal government that is piled on to the National debt.

DONALD FERLAND's picture

Does that mean you would

Does that mean you would rather that money paid by Maine taxpayers is better spent on people in Florida or any of the other states accepting the healthcare expansion? I would rather money paid by Mainers come back to Maine thank you very much.

MARK GRAVE's picture

Why do we send money to

Why do we send money to Washington DC in the first place? Why not just lower federal taxes and keep the difference in Maine?
At best, a state sends X dollars to Washington and gets back X-p dollars in return, where the bureaucratic machine consumes p dollars.

The takeaway is that Maine is already getting some other states tax dollars; isn’t that enough greed already?
As many said in this post, those dollars are not free. Most likely, that are contributing to the national debt.
Do you think this country can keep borrowing $0.40 on every dollar? God help us all if you do!

PAUL ST JEAN's picture

The parrot sez he thinks the

The parrot sez he thinks the feds are guilty of money laundering.

Andrew Jones's picture

We should take a hard look at

We should take a hard look at where every dollar is currently being spent in Medicaid before they get even a whiff of expansion. Make it lean and efficient before throwing more money at it.

and pay the god damn hospitals. Services have been rendered, now the bill is due.

 's picture
staff

BOO -- You left out the important part

It's an accepted fact that Medicaid does not pay the full cost of billed care (often cited as 80%). If you expand Medicaid coverage who ends up paying the difference?
Answer: The people who are still left. The more Medicaid grows, the higher the medical bills become for the people who remain left out -- which happens to be the self-employed and the working poor.
By stifling self employment and cheating low wage workers in this way you force people to choose between poverty and wage-earning for large companies. The economy you wind up with gets slowly eviscerated as the two most important routes to independence and prosperity are shut off from anyone who does not have already have a lot of money.

Jason Theriault's picture

Not true

Insurance companies, just like Medicare/Medicaid, negotiate rates. Alot of them get the same rates as Medicare. The reality is that hospitals doesn't lose money on care, they lose money when the uninsured and under insured skip paying their bills.

Mark Wrenn's picture

agreed

And when the uninsured and under insured skip out on paying the bill, everybody else pays for it through higher private insurance premiums.

Jonathan McKane's picture

Inaccurate

Our MaineCare expansion has done nothing to alleviate charity care.

Jason Theriault's picture

But we suspect Gov. LePage is

But we suspect Gov. LePage is beyond his rational argument stage, if he ever had one on this issue.

The man doesn't compromise, doesn't back up, doesn't back down, doesn't change course, is immune to new information, contemptuous of contrary views and comfortable with chaos and bitterness.

Bravo.

DONALD FERLAND's picture

Since republicans, democrats,

Since republicans, democrats, and the governor are covered by STATE paid for health care we should take their health care away and let them see if they can afford health insurance without help. This governor and the republicans have a narrow focus on anything to do with state aid to the poor. They believe it is all welfare for able bodied lazy people. This is NOT the case. The expansion would cover the WORKING poor who once qualified for Mainecare but now do not. Mainers need to remember that come the election...if you are not in their elite group you will get NOTHING from them. They took from the poor, they gave to the rich. They took from our children and gave to the rich children. They took from our elderly and lined the pockets of the rich. Wake up Maine, if we put any of these selfish people back in office it will only get worse for those that really need it and for those that have no say.

Jonathan McKane's picture

This bill was not a compromise

It was extortion. Everybody wanted to pay the hospitals. Only the Dems wanted to expand our already bloated MaineCare program, the one that caused the hosptial debt in the first place, the one that all programs and departments are subservient to, the one that causes budget shortfalls year after year.

It would be reckless and irresponsible to expand this program and Republicans said no. That you Governor Lepage.

FRANK EARLEY's picture

Educate yoursel on the facts..........

Mainecare is not the reason for the hospital debt. Medicaid has been around a long time, believe it or not, it does work in other states. What happened is the States share of Medicaid was not paid, this creates a domino effect. The cause was poor management. Who ever was in the drivers seat, and decided the money was needed elsewhere, is to blame. As with any household, if you start skipping payments, the bill gets larger. It doesn't take long for the bill to become unmanageable, at which time it was probably just "Shelved", or "Tabled" as they like to do with anything that requires some hard thinking.
I will admit, MaineCare could use some work, but it is indispensable for the poorer folks. Medicaid is needed to offer health care to those who can't otherwise afford it. Without insurance, a much larger problem exists . The emergency room is not a doctors office. They may get stitches, or a cast on their leg, but they won't get that diagnoses that may save their life.
LePage's actions are not only immature, illogical, and totally inappropriate, but will prove to be deadly. Anyone reading this could have an immediate family member, who may die as a direct result of LePage's ignorance. I feel it's time this State enact a "Recall law", for the health and well being of everyone.......

Jonathan McKane's picture

Maine's expansion caused the debt.

Maine has 2nd highest (was the highest for quite a while) percentage on Medicaid. It was and is unsustainable. Medicaid is not "mainstream health insurance." It is medical welfare.

RONALD RIML's picture

At least it is Medical Care. Republicans offer nothing.

So what's your Republican remedy, Jonathan??

- Standing out in the street and chanting: "Bring out your Dead, Bring out your Dead!"

PAUL ST JEAN's picture

Any port in a storm? No, but

Any port in a storm?
No, but we have three barrels of great Chianti.

MARK GRAVE's picture

We need more free market

We need more free market competition to drive prices down. Look at elective procedures, such as cosmetic surgery as compared to insurance-based or government-based paid procedures. Prices increases for the former have been less than CPI, whereas price increases for the latter have been substantially more than CPI.

http://www.ncpa.org/pub/ba731

So the remedy is free markets.

AL PELLETIER's picture

Word of advice

All you republican and democrat representatives who are backing Larage with his veto and his twisted logic pack your bags in Nov. 2014.
This health care insurance money, the fed is offering, is our own tax dollars. If we refuse it, as this veto has done, we are totally ignorant of good fiscal management.
Lets negotiate a good liquor deal and pay the hospitals. Lets take OUR OWN MONEY from the fed and provide health insurance for our people who need coverage.
Three years from now if we have to pay the 10% for the health care program we can always look at a 6% sales tax and many other options to pay for it.
This is not rocket science. This is common sense.

Steve  Dosh's picture

ed. Thursday 18:45 LePage

ed. Thursday 18:45
LePage wasted no time vetoing bill linking hospital debt , Medicaid , didn't he ? This has got to make ME people angry . Why does your Governor inevitably continue to shoot himself in - your - feet ? When you find yourself in a hole , stop digging , Govs Lepage and Perry ( TX ) . Stop hitting your heads against the wall . You'll feel much better when you do
Prevention is the best cure [ also think about that again next election season ] Everyone knows that . Equal access to preventative health care is a basic human right in any civilized and rational 1st world nation or state , regardless of political persuation , sexual - marital orientation , or curent health status . It is our right , role , and civic responsibility to - e n s u r e - this , †yvm LSJ ® We go to hospitals to get better , not to die , as they do in 3rd , and 4th world countries . i digress
i had my physical exam today ( i did ) with a fine young new doctor ( to me ) and her assistant RN Betty . No one knows what will take place when the Affordable Health Care Act kicks in o/a August of this year , but we all agreed that whatever happens will be better than what we had . [ HIPAA aside -- i.e., sharing patient information -- but in fact , front and center , Google® it }
Gov. LePage is beyond the rational argument stage, if he ever had one on this issue . Who is his Mainecare ® , Maine taxpayer supplied doctor for life , anyway ? No • We really do not want to know . It's none of our business andi t's merely a rhetorical question
The guy is a few fries short of a happy meal , that's for sure ?
hth ? Steve

PAUL ST JEAN's picture

He's got plenty of company.

He's got plenty of company.

MARK GRAVE's picture

“Equal access to preventative

“Equal access to preventative health care is a basic human right”

No it is not. Where is that written? It certainly is not in the Constitution. Perhaps one should say: I feel ... it is a basic human right. It is especially not a right when you must take money from someone else to pay for it. Where is that individual’s right to keep their labor?

LePage and a few of us who post here are fully aware of Medicaid expansions financial impact on this country. Anyhow, let the Federal government step in and manage its own program. Good for LePage.

RONALD RIML's picture

And he's a few LDL points short a happy constituency.....

But perhaps some more fries and happy meals can sort that out for us...... ;)

PAUL ST JEAN's picture

Be nice.....0O:-)

Be nice.....0O:-)

Fred Stone's picture

Thanks Steve

Finally a comment from you that people can read and understand, no hieroglyphics stupid fonts that make absolutely no sense.
Hope to see more of the same.

AL PELLETIER's picture

Gee Fred

I thought Steve's comments crossed so many time zones, they got scrambled on the way, but, still comical common sense comments.

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