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Rant du jour:  My response on a Linked-In Discussion to someone who wrote that Medicaid Expansion is a "Free Lunch" that should be turned down because it "will" cost the state money in the future; that this country has some of the best health care in the world and that we don't know the "unintended consequences" of Obamacare:

1. Bad timing on the House 38-39th vote to repeal Obamacare. Looks like an "intended consequence" has occurred:

"State insurance regulators say they have approved rates for 2014 that are at least 50 percent lower on average than those currently available in New York. Beginning in October, individuals in New York City who now pay $1,000 a month or more for coverage will be able to shop for health insurance for as little as $308 monthly. With federal subsidies, the cost will be even lower."

2. This country has been thinking about providing universal or near-universal health "care" for a long time. In fact, one of the thinkers was the Heritage Foundation, which thought up the insurance method of Obamacare. It's not my first choice, but it's better than nothing.

This country has some of the best cars, yachts, houses, and a lot of things in the world too. I measure health care by both the quality and the percentage of people covered. I think it's a failure of this country that it ranks 37th in health care as measured by care of all its citizens -- infant mortality, etc.

Let me ask differently -- Are you OK with 45,000 per year dying because they have no health care (if you doubt that figure, are you OK with half that)? Are you OK with hundreds of thousands driven into poverty or bankruptcy because they have to use the ER or have to have a procedure they can't afford? Is taking away this suffering and anxiety a "free lunch?'

Merely labeling something as a "free lunch" doesn't mean anything. According to the right, only poor people and liberals are the ones who want a free lunch. Free lunch does not include:

Carried Interest tax breaks
Farm subsidies
FDIC insurance for deposits
Ability for some like Romney to value IRA assets low and therefore get 25-50% returns
Road repairs that enable you to get to work
Air traffic control funds to enable flying, e.g., to Asia

If you really are interested in "Free Lunch" read David Cay Johnston's book by that name and discover in what direction the money for free lunches really goes.

3. As for the Medicaid expansion: I asked what's your choice: If you balance (1) the possibility that in 10 years, your state may have to cover a small portion of the costs of expanded Medicaid versus (2) the immediate reality that the expansion will actually save your state hundreds of millions or more and help you balance the budget today."

Your answer is (1) -- choosing a future by-no-means-certain possibility versus a definite present gain. (at the expense of millions continuing not to have health care).

Fortunately, the governor and legislature of your state don't agree. Next year many in WI, TX and 18 other states will be wondering why their states made the opposite decision.


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