We should all be Nebraskans
December 26, 2009
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With the healthcare plan getting through the Senate, the somewhat good but clearly flawed plan heads for committee. Here's what we should all hope. That the whole nation gets the same deal as Nebraska.
For those not paying attention, Nebraska's sweet deal (or maybe suite deal, I don't know where they were when they cut it) basically covers all of Nebraska's increase in Medicaid expenses going forward. At the moment, Senators Lindsey Graham and Jim DeMint of South Carolina, among others, are crying foul at the deal.
Now, I'm not going to get too into the rhetoric of it all or even the politics, but for Graham and DeMint to cry about this is so over the top it's funny. I have read the Congressional record from time to time. Those two guys are the last ones, well at least in well populated Congressional company, to complain about getting deals for their state. To try to rile people up with bogus Constitutional issues- I asked a Constitutional law professor I know and he laughed- is so blatant I can only marvel at how warped politics (not just them, because I think fully 3/4 of pols are warped) is an act of grandstanding that is funny to those not glomming onto their dysfunctional proclamations (I was going to say retarded but I didn't think that I should drag the challenged down to the level of politicians).
In any case, here's why we should all be Nebraskans. In the not too distant future, 2010 most likely, there are going to be a lot of states teetering even nearer to insolvency. Unlike California, most of those states are going to have massive problems refinancing their debts. Instead of the Federal gov'ment helping them then, the Feds ought to simply cover the cost of Medicaid nationally. Completely take that cost off the books of the states, as the program was originally intended.
Now, we can debate whether this healthcare plan should be done or not (I'll take the yes side, see my previous blog), or we can solve a couple huge problems. The first problem we can solve is getting low income people health insurance that keeps them out of the ER (the uninsured using ERs is BY FAR the largest aggregate cost inflator in the health system), that is by further opening up Medicaid based on a sliding scale program (like what is in the healthcare plan). Next, we can alleviate the need for small employers to provide healthcare until they have moved a little further up the "S" curve (like the current healthcare plan does with its opening up of Medicaid and banning underwriting discrimination which is antithesis to risk pooling anyway), which will make them much more competitive and able to hire. [Fool's Brian Orelli touches on the risk pooling a bit yesterday and how it will lower costs.] Finally, we can help all the states with their budgets, without discrimination against states minding their business well (all 4 or 5 of them) by putting Medicaid on the Federal dime where it belongs.
Here's to Nebraska and a great idea.
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