FacebookTwitterGoogle+RedditEmail

Hunger Games Politics

by CHRISTOPHER BRAUCHLI

If a free society cannot help the many who are poor, it cannot save the few who are rich.

— John F. Kennedy, Inaugural Address

Not all of the states’ reactions to the recent health care decision by the U.S. Supreme Court are an embarrassment.  Only a select few.  Some States, like Oregon, welcomed it.

In 2008  Oregon embarked on a program to provide health care to some of its residents who live in poverty.  It did not have enough money to cover all its impoverished residents so it set up a lottery system and folks who entered it got a chance to win health insurance coverage. Unlike lotteries at charity events, this lottery didn’t cost a thing to enter.  The only requirement to participate in the lottery was that the entrant be poor and not have health insurance.  The lottery was an instant success.

In 2008, 89,284 people entered the lottery and the lucky winners received that which those who live in other wealthy, industrialized nations get without entering a lottery-health insurance.   Once the lottery had taken place its effects on those won was studied to determine the costs and benefits of the coverage.  The study disclosed that 25 per cent of the winners were less likely to be burdened by unpaid medical bills and 40% per cent less likely to find that paying medical bills forced them to skip paying other significant obligations. Those who won were more likely to have a family doctor they visited regularly and enjoyed better overall health than those who did not have insurance.

Notwithstanding the success of the lottery many residents remained uninsured and Oregon is happy to abandon the lottery in favor of having all its residents obtain insurance. Bruce Goldberg, the Oregon Health Authority director, is not worried about the additional cost to the state.  He said the Supreme Court decision is “very good news for the 600,000 Oregonians who do not have health care coverage. . . . Under the Affordable Care Act, the health care lottery for low-income Oregonians goes away and everyone wins.  That is good for them, good for their families, and good for Oregon.  They will have better health care and more financial security. . . .” If governors of some of the other states cared about the health of their citizens they would study the results of the lottery and might even decide to permit their Medicaid rolls to expand. They haven’t and they don’t.

A spokesman for South Carolina’s Gov. Nikki R. Haley, said:  “We’re not going to shove more South Carolinians [600,000 poor people without insurance] into a broken system that further ties our hands when we know the best way to find South Carolina solutions . . . is through the flexibility that block grants provide.”  Since there are no block grants available, if South Carolina fails to take advantage of the ability to expand eligibility, 600,000 poor South Carolinians will remain uninsured.

Governor David Heineman of Nebraska explains his opposition to  expanding Medicaid eligibility explaining that if it is expanded it will affect state aid to education even though the federal government will pay all the cost of the increased costs of expanding Medicaid until 2017 and by  gradually decreasing amounts  until 2020 when states will have to assume 10% of the cost with the federal government paying the remaining 90%.  Another Governor who is unambiguous in his response is Florida’s governor, Rick Scott.

Governor Scott has said that: “Florida will opt out of spending approximately $1.89 billion more taxpayer dollars required to implement a massive entitlement expansion of the Medicaid program.”  Explaining his decision the governor said:  “Floridians are interested in jobs and economic growth, a quality education for their children and keeping the cost of living low.  Neither of these provisions (Medicaid expansion and insurance exchanges) will achieve those goals, and since Florida is legally allowed to opt out, that’s the right decision for our citizens.” Twenty percent of Florida’s residents lack health insurance.  Mr. Scott is not among them.  The state provides health insurance for him. If Florida took advantage of the expansion 1 million residents would get coverage.

Health insurance seems like a luxury only to those who have it, people like Governors Haley,  Heineman and Scott.  Since they  refuse to take advantage of Medicaid expansion the law permits and largely funds, to help their impoverished citizens, perhaps they would consider starting a lottery.  Oregon did cover it in an impartial manner as many people as limited funds would permit.  The recalcitrant governors could do it to give the impression that they were doing something positive for their poor citizens even though they were doing far less than the law permits.  Watching to see who won the lottery and, therefore, obtained health insurance, could be a source of amusement for observers who already have insurance and would give the uninsured but hopeful poor a distraction to take their minds of the other hardships poverty forces them to endure. Kind of like Hunger Games.

Christopher Brauchli is an attorney living in Boulder, Colorado. He can be emailed at brauchli.56@post.harvard.edu

 

May 03, 2016
Gary Leupp
Hillary Clinton’s Foreign Policy Resumé: What the Record Shows
Michèle Brand – Arun Gupta
What is the “Nuit Debout”?
Chuck Churchill
The Failures of Capitalism, Donald Trump and Right Wing Terror
Dave Marsh
Bernie and the Greens
John Wight
Zionism Should be on Trial, Not Ken Livingstone
Rev. John Dear
A Dweller in Peace: the Life and Times of Daniel Berrigan
Patrick Cockburn
Saudi Arabia’s Great Leap Forward: What Would Mao Think?
Doug Johnson Hatlem
Electoral Votes Matter: Hillary Clinton or Bernie Sanders vs Donald Trump
Chris Gilbert
Venezuela Today: This Must Be Progress
Pepe Escobar
The Calm Before the Coming Global Storm
Ruth Fowler
Intersecting with the Identity Police (Or Why I Stopped Writing Op-Eds)
Victor Lasa
The Battle Rages on in Spain: the Country Prepares for Repeat Elections in June
Jack Rasmus
Is the US Economy Heading for Recession?
Dean Baker
Time for an Accountable Federal Reserve
Ted Rall
Working for US Gov Means Never Saying Sorry
Dave Welsh
Hunger Strikers at Mission Police Station: “Stop the execution of our people”
John Eskow
The Death of Prince and the Death of Lonnie Mack
May 02, 2016
Michael Hudson – Gordon Long
Wall Street Has Taken Over the Economy and is Draining It
Paul Street
The Bernie Fade Begins
Ron Jacobs
On the Frontlines of Peace: the Life of Daniel Berrigan
Louis Yako
Dubai Transit
Bill Quigley
Teacher, Union Leader, Labor Lawyer: Profile of Chris Williams Social Justice Advocate
Patrick Cockburn
Into the Green Zone: Iraq’s Disintegrating Political System
Lawrence Ware
Trump is the Presidential Candidate the Republicans Deserve
Ron Forthofer
Just Say No to Corporate Rule
Ralph Nader
The Long-Distance Rebound of Bernie Sanders
Ken Butigan
Remembering Daniel Berrigan, with Gratitude
Nicolas J S Davies
Escalating U.S. Air Strikes Kill Hundreds of Civilians in Mosul, Iraq
Binoy Kampmark
Class, Football, and Blame: the Hillsborough Disaster Inquest
George Wuerthner
The Economic Value of Yellowstone National Park
Rivera Sun
Celebrating Mother Jones
Nyla Ali Khan
Kashmir and Postcolonialism
Mairead Maguire
Drop the Just War Theory
Weekend Edition
April 29, 2016
Friday - Sunday
Andrew Levine
What is the Democratic Party Good For? Absolutely Nothing
Roberto J. González – David Price
Anthropologists Marshalling History: the American Anthropological Association’s Vote on the Academic Boycott of Israeli Institutions
Robert Jacobs
Hanford, Not Fukushima, is the Big Radiological Threat to the West Coast
Ismael Hossein-Zadeh
US Presidential Election: Beyond Lesser Evilism
Dave Lindorff
The Push to Make Sanders the Green Party’s Candidate
Peter Linebaugh
Marymount, Haymarket, Marikana: a Brief Note Towards ‘Completing’ May Day
Ian Fairlie
Chernobyl’s Ongoing Toll: 40,000 More Cancer Deaths?
Pete Dolack
Verizon Sticks it to its Workers Because $45 Billion isn’t Enough
Moshe Adler
May Day: a Trade Agreement to Unite Third World and American Workers
Margaret Kimberley
Dishonoring Harriet Tubman
Deepak Tripathi
The United States, Britain and the European Union
Eva Golinger
My Country, My Love: a Conversation with Gerardo and Adriana of the Cuban Five
FacebookTwitterGoogle+RedditEmail