Medicaid Debate

Medicaid has been thoroughly debated in Utah for nearly three years now and its conclusion seems a bit anti-climatic. As I share these thoughts, the House Republican Caucus will have voted whether to accept the latest compromise to extend eligibility to more Utahns. I would be shocked if the House Republican Caucus voted anything other than no.

Of course, I’ve followed this debate along the way. Actually, my interest in finding sound solutions to helping our neighbors in need pre-dates, by many years, the current debate – and, frankly, I’m saddened by the lack of true concern to find lasting solutions in this most charitable of states. Peel away the layers of ignorance, partisanship and self-righteous blathering, and Utah still has people in need of medical care who cannot afford it and, in doing nothing, we still have an inefficient and counterproductive delivery system to help only some of them.

The best way to care for the medical needs of Utah’s poor and indigent is through private, charitable means. Charity care provides all of the right incentives for recipients and providers. It bolsters a culture of self-reliance and charitable giving. It restores community and individual dignity. It treats our neighbors as children of God rather than objectifying them as welfare recipients. For long over a decade, I have encouraged a comprehensive, collaborative and universal system of charity care for Utah. However, this idea has been opposed on every front by special interest groups and their politicians.

Every health care special interest – from doctors to hospitals – dislike the idea of charity care because they all lose money. That is, they’re not really charitable. When citizens give charitably, directly to the people in need and directly to those caring for the people in need, the health care industry loses money. In the case of Medicaid, those special interests lose state and federal dollars. More so, those special interests lose political power – government provided health care is systemic, a tightly controlled and regulated industry that welcomes its own and fights tooth and nail to keep out providers who innovate or act independently.

Meanwhile, Utah’s poor and indigent who need medical care remain. They struggle in their own way to become part of this crony system. Mostly, they lobby government to let them in. When the private sector fails to provide services as basic as medical care, it is no surprise that government is called upon to step in. It is not an immoral request. It is a natural response to human need and suffering.

And yet, for all their trouble – for all of the effort to call upon government to give them access to medical care – many Utahns still come up short. The private sector refuses to help and government shuts them out. In many cases, our neighbors needing medical care are left unattended and hopeless. In desperation, they’re driven to rely on emergency rooms – the most expensive corner of health care – only to incur crushing personal debts. Is Utah the kind of society that would let people incur bankruptcy simply to pay for needed medical care?

There is plenty of room in the health care industry for legitimate profit making. But there is no room for profit making on the backs of the poor and needy. That is immoral and unbecoming of a people who pride themselves on Christian love and service.

Like most government programs, Medicaid is a flawed system. But it’s what we have. It’s not only what we have, it’s what the vast majority of politicians, Republican and Democrat alike, have championed for over 50 years.

Throughout the current debate over Medicaid, I have argued to extend eligibility. We should do it recover lost taxes, for sure. We should do it to argue for state waiver reforms. But, more importantly, we should do it because Utah politicians lack the vision and innovation to try something different. The Utah Legislature cannot just keep saying no to providing medical care for people who need it but cannot afford it. Again, that is immoral.

Health care is not a right but providing medical care to our neighbors in need is a moral obligation. Utah has the lowest health care prices in the nation. Unfortunately, that prize doesn’t help people who can’t afford even the lowest price to obtain medical care.

The answer lies in understanding that health care is not a right. Medicaid is not a right. So, if Medicaid is the system our politicians choose to care for the poor and needy, then extending eligibility is a no-brainer. But if the House Republican Caucus refuses to do so, it’s incumbent upon them to offer a different solution.

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