Jonathan Swift’s classic 18th century essay “A Modest Proposal” satirized heartless attitudes toward the poor by suggesting they sell their children to the rich as food.
We’re not nearly that pitiless yet, but 21st century America is doing its best to become one big, broad, baggy-pantaloons farce — the sort of country where satire veers dangerously close to conventional Tea Party wisdom.
I’m a bit late to the party on this one, but it would be a shame not to note it. According to a group of Harvard researchers — who, granted, probably scoot around their tony Cambridge neighborhoods without giving so much as a thought to strapping large, goo-festooned animal carcasses to their Bentleys (so what do they know about our state, really?) — Wisconsin’s decision to refuse an expansion of Medicaid under the Affordable Care Act is going to have real-world consequences.
Imagine!
According to the study, the states that have refused Medicaid expansion will see a host of baleful outcomes. In Wisconsin alone, the authors predict, we will see up to 671 excess deaths.
The study also predicts that while states that opted in to Medicaid expansion will see a precipitous drop in their number of uninsured residents, states that opted out can expect only modest declines.
For example, neighboring Minnesota — whose successful progressive policies have made Walker’s presidential aspirations look like a big-studio Oscar campaign for Tara Reid — will likely see its uninsured population drop from 443,002 to around 232,000. By contrast, Wisconsin’s uninsured population will tick down from 549,798 to around 442,000.
Nationally, the numbers look even more grim. According to the study’s authors:
We estimate the number of deaths attributable to the lack of Medicaid expansion in opt-out states at between 7,115 and 17,104. Medicaid expansion in opt-out states would have resulted in 712,037 fewer persons screening positive for depression and 240,700 fewer individuals suffering catastrophic medical expenditures. Medicaid expansion in these states would have resulted in 422,553 more diabetics receiving medication for their illness, 195,492 more mammograms among women age 50-64 years and 443,677 more pap smears among women age 21-64. Expansion would have resulted in an additional 658,888 women in need of mammograms gaining insurance, as well as 3.1 million women who should receive regular pap smears.
Those are the real human costs of Walker’s politically motivated decision to tell the feds to take our residents’ tax money and shove it. (As I’ve noted before, the financial repercussions are bad enough on their own.)
But it’s not just death and dismemberment the uninsured will face. As anyone without insurance knows, fear is a constant companion, as bankruptcy and medical uncertainty are always lurking in the shadows.
The authors continue:
Based on recent data from the Oregon Health Insurance Experiment, we predict that many low-income women will forego recommended breast and cervical cancer screening; diabetics will forego medications, and all low-income adults will face a greater likelihood of depression, catastrophic medical expenses, and death.
It’s worth noting that while Wisconsin and other opt-out states may look buffoonish to Minnesota and other opt-in states for turning down their own tax dollars and leaving their residents in the lurch, our country as a whole looks like a vulgar burlesque show to the rest of the developed world, which is famous for its “socialistic” universal health care coverage.
It’s really not that complicated. Pre-Obamacare, we spent more per capita and as a percentage of GDP on health care — by a long shot — than any other developed country in the world, and for the most part, we got worse results.
(Continued)
Obamacare — which was largely based on Republican market-based solutions — merely seeks to soften the crushing blow of our collective stupidity. While most progressives would have preferred a single-payer option, Obamacare is an improvement on the status quo, which left Americans far too vulnerable to bankruptcy and bad fortune.
This should be the mantra that’s recited over and over again in the health care debate:
We pay more and get worse results.
We pay more and get worse results.
We pay more and get worse results.
That these facts are mostly ignored is baffling.
Over and over again, conservatives have accused Obamacare of being a job killer. Last week, they resurrected this meme based on a clumsy (or maybe dishonest) interpretation of a recent Congressional Budget Office report.
But turning down Medicaid funds under Obamacare is a killer. Full stop. Maybe our governor can put off running for president long enough to notice.
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