Medicaid is the ultimate justification for much of the anti-government run health care sentiment. As an underfinanced, shame-based means tested entitlement it provides many of the horror stories that fuel people’s abhorrence of government agencies — capricious state eligibility requirements, unreliable bureaucracies determining benefit limits, substandard care offered in anonymous, dirty clinics overrun with overbooked patients, treated by disdainful providers who are only there to fulfill mandated obligations for service in return for privileges at a facility. Then there is the absence of available specialty care, so patients on Medicaid can obtain a diagnosis occasionally, but nothing more, and are basically left to die in the gutter. Of course there are many exceptions, but that is the all too common presentation of the Medicaid experience.

Expanding that Medicaid experience to a wider swath of the poor and near-poor will serve to further mute and diminish any public favor for government provided health care, and further bury the chances of single payer ever being enacted. No one wants to demand a place in the second-class citizen cohort, and no one wants to parade in the streets to remain one of the publicly degraded who do not deserve care. That is the public definition of “government run health care” — shared misery.

All the health care reform efforts now being proposed by Democrats in the Senate are merely aimed to reduce the proportion of uninsured back down to the “acceptable” numbers where public outcry will revert to its earlier acquiescence. No politician wants to be responsible for reining in the monster that the industry fueled astroturf groups have created to demand profitable services. They want to leave it to the private health insurance industry to take the bad rap, and they are happy to do so, especially with an individual mandate to procure their health care rationing services.

Jay Kallio, PNHP NY Metro