Condolences, Senator Carrico

This web site recognizes valid arguments on both sides of this issue, and the position of this web site is that the State Senate is right. We need to abolish Obamacare (in every State, actually); we need to move away from all handouts based on the unsustainable ideal of "from each according to his ability, to each according to his need," which rewards "needing" at the expense of productivity and thus drags everyone down. We need to develop plans for promoting more financial responsibility and self-sufficiency, decentralizing and downsizing all government programs, and--without relying on handouts of untrustworthy medical care!--shift more older people away from plans based on "I'll 'retire' and the government will take care of me after a certain predetermined date" to "I'll work as long as I'm able and plan the rest of my life based on what I've personally earned, saved, and arranged for myself."

Medical care providers can be expected to kick and scream if told that they ought to be--as lawyers, lawyers, "trained sharks," are--public-spirited enough to extend a certain amount of decent-quality free service to those in real financial need, pro bono publico. But they ought. If a lowly massage therapist whose maximum hourly fee was $50, for (after some experience) a maximum of two hours in one day, can offer free service to the poor on Saturdays, you know doctors can do that too. I did; I took the risk of limiting myself to providing only my best quality service in order to protect myself from being sued, and I was never sued. I'm willing to go to Richmond or Washington and call other health care people out on this if necessary. Mandating that would be a first step toward restoring sanity to our medical care system, cutting out the huge inflation of prices that the insurance gambling racket is sucking out, and making it feasible for ordinary people to pay for most medical care out of their own private wages and/or savings account, the way it was when I was young enough to panic and rush to doctors while able to walk.

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April 11 - Special Session

The General Assembly returned to Richmond this week to begin the process of completing work on Virginia’s 2018-2020 Budget. The differences between the proposed spending plans by the House and Senate remain what they were when the regular session concluded just over a month ago. There is still more than $3 billion in revenues separating the two proposals. The House’s plan still includes Obamacare’s optional Medicaid expansion and a new tax on hospitals to pay the state’s share of the funding for that provision. And, the House’s plan still spends additional revenues intended for healthcare to increase spending in areas entirely unrelated to healthcare. Much of the news coverage related to the continuing budget impasse has, predictably, focused on the politics of the differences. A minority of House Republicans joined with every House Democrat to approve a budget that would fully implement Obamacare in Virginia, while every Republican senator (along with four Democrat senators) voted to approve a budget based on existing revenues without expanding Medicaid. Although there are many differences between the House and Senate approaches to spending your tax dollars over the next two years, the implications of those differences on the people of Virginia has not received the same level of scrutiny. Reducing the differences to “Obamacare” or “Medicaid expansion” accurately pinpoints the key to the current disagreement. But, what does Medicaid expansion really mean? When you read about Medicaid expansion, that policy is referring to an optional feature of Obamacare that would give Medicaid benefits to able-bodied adults who are currently not eligible for the program. If this policy were to be enacted, it would not increase benefits for any of the 1.3 million Virginians currently covered by Medicaid. Medicaid currently reimburses hospitals, healthcare providers, and physicians who accept Medicaid patients for a portion of the expense of providing care to around 650,000 children in low income families and about 360,000 who are the caregivers or parents of those children and pregnant women. It also covers around 260,000 individuals with disabilities and 80,000 elderly patients. What Medicaid expansion would do is increase by about 30% the number of those eligible for the program. Virginia’s taxpayers would be required to pay 10% of the expense for those additional patients by 2020, as well as bear the expense of the administrative costs related to any “requirements” it placed on eligibility. And, President Trump’s proposed budget phases out funding for Medicaid expansion, meaning that 10% expense could become a lot higher very soon. That is the crux of this impasse. Virginia has to identify over $300 million to cover its portion of fully implementing Obamacare by expanding Medicaid. The House’s proposal does this with a new tax on hospitals. But, that tax will not likely cover the growth of the expense of this program, which averaged nearly 9% annually over the last decade. Under its current provisions, spending on Medicaid accounts for 23% of the state’s General Fund. In 2007, it only represented 14%. Virginia shouldn’t expand Medicaid – unless we are prepared to increase taxes or significantly reduce what we pay for public schools, higher education, public safety and other core government services.

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