Welfare Is Not ‘Insurance’


“We’re growing the health care safety net to help more people.”

That’s Human Services Department spokesman Kyler Nerison, boasting about how Medicaid expansion has pushed the share of New Mexico’s population without “health insurance” down to 10.2 percent.

Wait a second. Getting on a welfare program does mean one has “insurance.” And it’s not at all clear that, broadly speaking, Medicaid expansion means more “help” for New Mexicans. Access and quality problems are severe, and honest researchers have found verifiable positive outcomes from Medicaid enrollment tough to document.

So what’s going on here? New Mexico’s taxpayers are bearing the relentless burden of liberals’ obsession about “the uninsured.” For decades, the fact that some Americans lack health insurance garnered votes and power for Bernie Sanders-style populists. But for those willing to undertake the task, unpacking the data on the uninsured was revealing. Some were already eligible for Medicaid and/or other government programs. Some were illegal aliens. Some were young, healthy, and not at serious risk of an illness or injury. Furthermore, the duration of most uninsured periods was rather short. And charity and cash discounts helped the uninsured access care more than was commonly understood. No better evidence for this phenomenon existed than Oregon’s pre-Obamacare expansion of Medicaid. As Avik Roy noted, when a “lottery” was held to sign up new beneficiaries, “40 percent of those who ‘won’ … didn’t bother to sign up.”

Lack of insurance was a problem — not a crisis. And the solution was broad agenda of market-oriented reforms that would have dramatically lowered the cost of premiums, and this permitted more individuals and employers to purchase coverage.

Instead, we got Obamacare. Medicaid expansion, massive new mandates, and subsidized insurance through “exchanges.” It isn’t working. Then again, it couldn’t. A few months ago, the National Center for Policy Analysis’s John R. Graham wrote what is perhaps the best summary of the “Patient Protection and Affordable Care Act”: “Obamacare is a welfare program camouflaged as a reformed health insurance marketplace.”

The Human Services Department predicts that by 2020, 43 percent of New Mexicans will be on Medicaid. But that’s just one part of the larger atrocity of taxpayer-provided healthcare. The U.S. Department of Health and Human Services reports that 53.9 percent of residents here currently have “public health plan coverage.” That is the largest portion among the states, and far higher than our neighbors Utah (23.6 percent), Texas (28.3), Colorado (30.2 percent), Oklahoma (36.5 percent), and Arizona (41.0 percent).

Single payer, here we come!

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2 Replies to “Welfare Is Not ‘Insurance’”

  1. Everything you say is correct. But aren’t we failing to acknowledge the 800 pound gorilla in the room? That is, the primary reason that America has a health care coverage crisis is because health care costs are so astronomical that millions of Americans can’t afford them.

    In the excellent book by Stephen Brill, “America’s Bitter Pill,” the author acknowledges that Obamacare has greatly expanded medical coverage in the country. Unfortunately, the coverage has been expanded with no control of medical costs and with the use of massive tax subsidies.

    I’m not going to say that all of the U.S. healthcare system engages in price gouging, but a significant portion does. Healthcare costs used to be the leading cause of consumer bankruptcies prior to Obamacare. I think they are now #2. Just one example. There is a drug that is quite effective in curing hepatitis C. The drug costs one thousand dollars PER PILL in the U.S., and you have to take the pill for 84 consecutive days. I saw an article in the Albuquerque Journal that the cost of the 84 pills AND the medical treatment that goes with it in Egypt is less than $1000. That’s price gouging.

    The extraordinary cost of medical care in the U.S. has invited political intervention.

    1. Thanks for your comment, Charles.

      I have plenty of issues with Steve Forbes, but he nailed it, back in 2008: “The problem with health care … is the disconnect between providers and consumers — that is, our third-party payment system. If that arrangement existed in any other economic activity, you’d find the same inefficiencies and rampaging cost increases that affect health care. The current system hurts productivity; it is geared toward a cost-plus way of doing things and is hostile to new ways of doing things.”

      I think you have it backwards — it’s political intervention that has caused the extraordinary cost of medical care.

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