The inverse relationship between medicaid expansion and affordable insurance for everyone else

The cost of Medicaid has risen from $27 billion in 1987 to $400 billion today. Millennials’ favorite word is “unsustainable.” Not my favorite word except when it comes to Medicaid. If anything is unsustainable it’s Medicaid. Something that can’t go on forever won’t. Yet Susan Collins says she won’t vote for any health care bill that doesn’t include continued expansion of Medicaid. Collins and her ilk need to face some cold facts about Medicaid.

Let’s Stop Pretending That Medicaid Saves Lives

Remember Deamonte Driver? He was the 12-year-old who died of a toothache in 2007. The boy lived in Maryland and was enrolled in that state’s Medicaid program, which covers dental care for children, as all Medicaid programs are required to do.

But Deamonte’s mother couldn’t find a dentist who would take Medicaid. At the time, only about 16 percent of Maryland dentists accepted Medicaid patients, and Deamonte was in dire need of basic dental care—as was his younger brother, DaShawn, who had six rotted teeth.

By the time Deamonte’s toothache got attention, bacteria from an abscessed tooth had spread to his brain. He underwent two emergency operations and six weeks of hospital care that cost more than $250,000. But it was too late, and Deamonte died. A routine, $80 tooth extraction could have saved his life.

Why hadn’t they been able to find a dentist? And what is the point of being enrolled in Medicaid if there are no doctors or dentists willing to treat you?

The answer is not just that doctors and dentists aren’t willing to work for the pittance that Medicaid pays. They have expenses they have to cover and they can’t do that if they don’t get paid. How is it that the government spends $400 Billion a year on Medicaid and yet doctors and dentists don’t get paid enough to allow them to treat Medicaid patients without going bankrupt?

It’s not payments to doctors and dentists that is making Medicaid so expensive. It’s the massive and expensive bureaucracy that Medicaid has created that is eating up all the Medicaid money and threatening to turn healthcare for the poor into Venezuela care. Obamacare should have finally taught everyone that you cannot insert a massive government bureaucracy between patients and their doctors without making health care more expensive. Obamacare should also have taught us that you cannot have a functional private market in health insurance without the wisdom of free market forces.

An alternate title for this post is “The inverse relationship between Medicaid expansion and access to health care for the poor.”

See also, Enough about Medicaid, what about the rest of us?

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