In case you missed it, former Gov. Steve Beshear gave the Democrats’ response to President Trump’s recent address to Congress. His selection was predictable given Republican disarray on health care policy and Democrat disarray in the heartland. Democrats are lately losing big among drawling, white men like Beshear.
It has been beaten into our heads that Kentucky has been an Obamacare success story. Beshear was even President Obama’s guest of honor at the 2014 State of Union Speech. Why? Because Steve Beshear’s website actually worked. That, and he expanded Medicaid.
The former governor is proud that 500,000 people now have health insurance in Kentucky. But let’s be honest. Nearly all of those people, including childless, non-working, able-bodied adults, are now on Medicaid. People rightly question why the nation’s individual health insurance market was blown up to have a massive Medicaid expansion. If the Democrats had initially proposed higher taxes and a stand-alone Medicaid expansion, which is what Obamacare is rapidly becoming, it never would have happened.
Playing the fear card, Beshear warned that a repeal of Obamacare will imperil people’s health. Because the subsidized, commercial insurance side of Obamacare is already collapsing, what he is really discussing is rolling back Medicaid. Is there anything other than anecdotal evidence that his Medicaid expansion has improved Kentuckians’ health or decreased emergency room use? And at what cost? When there is a shortage of primary care doctors, sick people go to the emergency room, especially if it is free. Two separate studies of the 2008 Oregon Medicaid expansion published in the New England Journal of Medicine undermine the dogma that Medicaid expansions make people healthier and less likely to use emergency rooms.
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Ohio Republican Gov. John Kasich believes that expanding Medicaid is the “Christian thing to do.” Beshear echoes those words. Would Jesus consider the piling of debt on the backs of children, or the taxing of able-bodied adults who work to benefit able-bodied adults who don’t, to be charity? When you tax Neighbor A to benefit Neighbor B, the latter become useful politically. Neighbor A is the person quietly suffering under the higher taxes, higher premiums, higher deductibles, and higher co-pays of Obamacare.
Like using meth, the Medicaid expansion is a short-term money buzz that will cause chronic, long-term damage. Beshear evidently considers himself a patriot and a man of compassion, but his moral preening does not negate the truth. Creating more debt in Washington, and more dependency in poor states like Kentucky, will ultimately harm those states and the republic when the bills come due. Is that patriotism and compassion?
Perhaps if the focus of the Obama/Beshear years had been on lowering the costs of medical care and growing the economy, fewer people would have needed Medicaid. Nothing about Obamacare addresses the primary problem in health care — the lack of price transparency and market forces needed to drive down costs. Beshear’s claim that his opponents have no ideas to accomplish those goals is utterly false.
Thanks to decades of one-party rule in Kentucky, our public employee pension system has unfunded liabilities that exceed $30 billion — three times the state’s annual budget. Beginning this year, Kentuckians will start paying a portion of Beshear’s Medicaid expansion. The projected costs are unclear, but a 2015 study by Deloitte Consulting states that outlays by 2019 could be one quarter of a billion dollars. Going forward, the Beshear Medicaid expansion may become the most irresponsible financial decision made by a governor in the history of the state.
By expanding Medicaid, Beshear usurped the rightful prerogative of the legislature and put the people of Kentucky on the hook for crushing, ongoing costs for years to come. Like our pension system, the Medicaid expansion was ultimately just another vote-buying scheme, paid for by our children. Stealing from children is hardly worth bragging about.
Cameron S. Schaeffer is a physician in Lexington.