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Would you also take federal money to expand medicaid coverage to the poor citizens of your state? If so you might not be qualified to be a republican governor.

Would you also take federal money to expand medicaid coverage to the poor citizens of your state? If so you might not be qualified to be a republican governor. Wouldn't it be much better to hire your friends as IT consultants, make broken systems as confusing as possible, and continuously change the rules, and then starve the half-assed system of funding in an attempt to keep people from signing up for coverage at all? What makes this plan doubly republican-friendly is that all players are your donors and most victims are minorities.

fragmede 3y ago
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cscurmudgeon 3y ago
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- deathanatos 3y ago
  … this is just whataboutism. I can disagree with Republican cronyism and the endless "let some private contractor do it poorly" when the Federal government could just do it directly, and poorly, but with less indirection. … I can also disagree with blue state's NIMBYism, "I got mine and screw you" attitudes towards housing, and work to promote things like better zoning laws, fairer tax legislation, better public transit, etc. at the same time. (Note: the parent edited the above comment to add the CNN article. At the time I replied, it was only the NYT link.)
  - cscurmudgeon 3y ago
    It is not whataboutism. It is pointing out outcomes in the other approaches may not be as good sounding as they are. You know how NIMBYism is done in California? It is usually along the lines of "We can't let developers profit!!" and "They are going to build luxury homes and not affordable homes!!".
    - liveoneggs 3y ago
      So you think rejecting federal money to expand medicaid is good?
      - cscurmudgeon 3y ago
        Where did I say that? I was responding to the ill-informed rant about state-govt websites and corruption while hilariously ignoring the article stems from corruption and issues in the original healthcare.gov website. (https://en.wikipedia.org/wiki/HealthCare.gov#Concerns_about_the_website https://en.wikipedia.org/wiki/HealthCare.gov#Concerns_about_...) Do you think not addressing root cause for high medical costs is good? https://harvardmagazine.com/2020/05/feature-forum-costliest-health-care https://harvardmagazine.com/2020/05/feature-forum-costliest-...
        liveoneggs 3y ago
        if you weren't addressing my point (medicaid expansion) then why are you responding with random articles? I, in fact, think things like negotiating drug prices is good, sadly it was outlawed by republican policy: Medicaid Part D (One of the most expensive policies ever) -- the Biden "Inflation Reduction Act" addresses this Bush-era money-grab for drug companies.
        deleted 3y ago
        [deleted]
        Aloha 3y ago
        I will still give Bush immense credit for passing Part D, even if it blew a hole in the federal budget - there is no way politically it would be possible today, and it was almost not possible then.
      - mattmcknight 3y ago
        It will be interesting to see what happens as that funding is starting to be phased out. https://www.kff.org/medicaid/issue-brief/fiscal-implications-for-medicaid-of-enhanced-federal-funding-and-continuous-enrollment https://www.kff.org/medicaid/issue-brief/fiscal-implications... Meanwhile, finding lower cost ways of providing health care still seems elusive in the face of provider and pharma legal efforts.
  - oldgradstudent 3y ago
    > … this is just whataboutism. "Whataboutism" is just pointing out you're applying a double standard. A rhetorical tool used since time immemorial.
AnthonyMouse 3y ago
> Would you also take federal money to expand medicaid coverage to the poor citizens of your state? The federal money is an extortion scheme. The way federal programs nominally work is that people with money pay taxes to fund the programs. The people with money disproportionately live in certain states, which is the justification for making it a federal program -- then you can have a uniform national program even if some states don't have the tax base to provide it themselves. But then the representatives from the states with money make it so the federal government doesn't fund the entire program. This benefits them first because they can shift some of the tax burden from the rich taxpayers in their state to the poorer taxpayers in some other state where any of the program's beneficiaries are. It tries to force every state to fund part of the program from their own tax base even if the people in that state didn't want it, because the alternative is to pay the federal taxes anyway but not get any of the federal money. Then it benefits rich people again because the rich states, of course, implement the programs and get the federal money, but any state that refuses the scheme that disadvantages them is still paying federal taxes and gets nothing. So now you're getting a transfer of wealth from poorer states to richer states -- a penalty the representatives from the richer states intended when they constructed the program that way. But the poorer states may not have the money to fund the state's portion of the program, and in any event refusing it is the only way the state government has to protest the federal program being constructed in that way. It puts pressure on that state's federal representatives to reform or remove the program. So don't blame the poorer states for not implementing the program, blame the richer states for passing it without funding it.
- snowwrestler 3y ago
  States pay for the health care of their poor residents either way. Residents who do not have private or public health coverage still get health care. They go to the ER when they need help and they receive care in the most transactional and expensive way possible. The cost for this care is paid by all the other residents who do have private care (via higher prices) and in their taxes. The goal of Medicaid is not to pay for more care, it is to better organize the care that is being provided, and in doing so, improve outcomes and lower the overall cost. One reason Medicaid expansion has seen steady adoption, even in “red” states, is that earlier implementations have shown that this happens and the program is a net improvement.

fragmede 3y ago

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cscurmudgeon 3y ago

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deathanatos 3y ago
… this is just whataboutism. I can disagree with Republican cronyism and the endless "let some private contractor do it poorly" when the Federal government could just do it directly, and poorly, but with less indirection. … I can also disagree with blue state's NIMBYism, "I got mine and screw you" attitudes towards housing, and work to promote things like better zoning laws, fairer tax legislation, better public transit, etc. at the same time. (Note: the parent edited the above comment to add the CNN article. At the time I replied, it was only the NYT link.)
- cscurmudgeon 3y ago
  It is not whataboutism. It is pointing out outcomes in the other approaches may not be as good sounding as they are. You know how NIMBYism is done in California? It is usually along the lines of "We can't let developers profit!!" and "They are going to build luxury homes and not affordable homes!!".
  - liveoneggs 3y ago
    So you think rejecting federal money to expand medicaid is good?
    - cscurmudgeon 3y ago
      Where did I say that? I was responding to the ill-informed rant about state-govt websites and corruption while hilariously ignoring the article stems from corruption and issues in the original healthcare.gov website. (https://en.wikipedia.org/wiki/HealthCare.gov#Concerns_about_the_website https://en.wikipedia.org/wiki/HealthCare.gov#Concerns_about_...) Do you think not addressing root cause for high medical costs is good? https://harvardmagazine.com/2020/05/feature-forum-costliest-health-care https://harvardmagazine.com/2020/05/feature-forum-costliest-...
      - liveoneggs 3y ago
        if you weren't addressing my point (medicaid expansion) then why are you responding with random articles? I, in fact, think things like negotiating drug prices is good, sadly it was outlawed by republican policy: Medicaid Part D (One of the most expensive policies ever) -- the Biden "Inflation Reduction Act" addresses this Bush-era money-grab for drug companies.
        deleted 3y ago
        [deleted]
        Aloha 3y ago
        I will still give Bush immense credit for passing Part D, even if it blew a hole in the federal budget - there is no way politically it would be possible today, and it was almost not possible then.
    - mattmcknight 3y ago
      It will be interesting to see what happens as that funding is starting to be phased out. https://www.kff.org/medicaid/issue-brief/fiscal-implications-for-medicaid-of-enhanced-federal-funding-and-continuous-enrollment https://www.kff.org/medicaid/issue-brief/fiscal-implications... Meanwhile, finding lower cost ways of providing health care still seems elusive in the face of provider and pharma legal efforts.
- oldgradstudent 3y ago
  > … this is just whataboutism. "Whataboutism" is just pointing out you're applying a double standard. A rhetorical tool used since time immemorial.

AnthonyMouse 3y ago

> Would you also take federal money to expand medicaid coverage to the poor citizens of your state? The federal money is an extortion scheme. The way federal programs nominally work is that people with money pay taxes to fund the programs. The people with money disproportionately live in certain states, which is the justification for making it a federal program -- then you can have a uniform national program even if some states don't have the tax base to provide it themselves. But then the representatives from the states with money make it so the federal government doesn't fund the entire program. This benefits them first because they can shift some of the tax burden from the rich taxpayers in their state to the poorer taxpayers in some other state where any of the program's beneficiaries are. It tries to force every state to fund part of the program from their own tax base even if the people in that state didn't want it, because the alternative is to pay the federal taxes anyway but not get any of the federal money. Then it benefits rich people again because the rich states, of course, implement the programs and get the federal money, but any state that refuses the scheme that disadvantages them is still paying federal taxes and gets nothing. So now you're getting a transfer of wealth from poorer states to richer states -- a penalty the representatives from the richer states intended when they constructed the program that way. But the poorer states may not have the money to fund the state's portion of the program, and in any event refusing it is the only way the state government has to protest the federal program being constructed in that way. It puts pressure on that state's federal representatives to reform or remove the program. So don't blame the poorer states for not implementing the program, blame the richer states for passing it without funding it.

snowwrestler 3y ago
States pay for the health care of their poor residents either way. Residents who do not have private or public health coverage still get health care. They go to the ER when they need help and they receive care in the most transactional and expensive way possible. The cost for this care is paid by all the other residents who do have private care (via higher prices) and in their taxes. The goal of Medicaid is not to pay for more care, it is to better organize the care that is being provided, and in doing so, improve outcomes and lower the overall cost. One reason Medicaid expansion has seen steady adoption, even in “red” states, is that earlier implementations have shown that this happens and the program is a net improvement.