You've had your eye on a new car and have made logical arguments for why you need it and how it would benefit your life. Problem is, you can't afford it. A relative, let's say your uncle, recognizes how this car would really benefit you so he offers to pay 90 percent of the cost if you buy it. Would you? Most of us would be driving that car off the lot before he changed his mind..
That is precisely the proposition facing North Carolina. Uncle Sam, the personification for our federal government, is offering to let us add health insurance benefits to some 500,000 (about 5 percent) of our citizens through Medicaid expansion. And the government will pay 90 percent of the cost.
I've never understood why our legislative leaders are so opposed to this proposition that 39 other states have accepted. I have tried but the only three arguments they have offered don't wash. The first is that there are better ways than Medicaid to provide health insurance for people. OK, what are they and why haven't you proposed and enacted them? Crickets. By the way, Medicaid has been proven to be a cost-effective program.
The second is they don't want to further expand the welfare state and increase costs to us taxpayers. Fact: uninsured people are going to get healthcare somewhere, somehow. More times than not they show up in the emergency departments - the most expensive healthcare available - and often their health has deteriorated before going to the ED, meaning it will take more time and cost more money to treat them. Indigent care amounts to many millions of dollars for our hospitals and clinics each year since federal law requires that anyone who goes to a hospital must be treated, regardless of whether they can pay or not. The costs incurred must be paid by someone.
Where does the money come from? The answer is simple: you and I pay through higher insurance premiums and increased hospital charges. Call it taxes or call it increased costs, but you are paying. Do we choose door number 1, your uncle pays, or door number 2, your personal costs are increased? That's a no-brainer. And by the way, North Carolina hospitals and others are willing to fund the additional 10 percent in state costs from Medicaid expansion because they know it will end up saving them big bucks. Your federal tax dollars are going to the other states who have expanded Medicaid.
Having discredited their first two arguments, the third is equally bogus. Opponents say we have no guarantee that the federal government will continue this 90-10 match indefinitely. Really? Imagine what would happen if the government suddenly decided to end Medicare, veterans benefits or Social Security. The January 6th insurrection would look like a Sunday School picnic compared to the outrage and revolt that would ensue. 39 other states recognize that once you extend a benefit to someone you cannot revoke it. They aren't worried.
The opposition to Medicaid expansion is another mean-spirited lack of concern for a large segment of our population. This "I've got my health insurance, you need to figure out yours" attitude flies in the face of a state where we have historically shown compassion and help for those less fortunate. Our official State Toast proclaims North Carolina to be a place, "where the weak grow strong and the strong grow great." But how can the weak grow strong without some help, especially healthcare help?
I'm convinced the real reason for the opposition is that Barack Obama included the expansion option to states as part of Obamacare.
It's time our state stopped stalling and did the right thing. Expand Medicaid in North Carolina.
Tom Campbell is a Hall of Fame North Carolina Broadcaster and columnist who has covered North Carolina public policy issues since 1965. He recently retired from writing, producing and moderating the statewide half-hour TV program NC SPIN that aired 22 1/2 years. Contact him at firstname.lastname@example.org.