Securing the Safety Net

As the sheer audacity and real costs of ObamaCare become more apparent every day, we can't say we weren't warned.

Back in 1961, Ronald Reagan explained the allure and dangers of "free" medical care:

One of the traditional methods of imposing statism or socialism on a people has been by way of medicine. It is very easy to disguise a medical program as a humanitarian project. Most people are a little reluctant to oppose anything that suggests medical care for people who possibly can't afford it.

Sadly, I have had first-hand knowledge of the impact of "free" medicine. My family is from England, and over the years I have watched grandparents, aunts, uncles, cousins and friends wait years for what we Americans consider routine health services.

My dear aunt, whose cataracts were so severe that she could hardly see, finally got surgery eight years after being diagnosed. An uncle exhibiting classic heart attack symptoms was told by a local doctor to take an aspirin and go to bed. He died before morning.

In America, hip and knee replacements have become a rite of passage for those of us over 60, but not in the UK, where you can wait years for such treatment -- if you qualify at all. The UK's National Health Service (NHS) and other "free medicine" countries typically treat patients with pills, potions and waiting lists. 

Lack of funding has caused many UK hospitals to shut down and others are an utter disgrace -- often so filthy that family members have to pitch in to keep their loved ones clean. And here's another dirty little secret about the NHS: if you have the money, you get to jump the queue, while the old-age pensioners and working class patiently wait their turn. Patients must be patient, after all.

Americans won't willingly accept what passes for health care in the socialized world, but that's exactly what Obama has planned for us, largely by expanding the already failing Medicaid program.

Medicaid was created in 1965 to finance medical care for welfare recipients. Today, it is collapsing under the weight of providing about 40% of all federal transfer payments to the states. State and federal spending for Medicaid surpassed $400 billion in 2010. Under ObamaCare, another 17 to 25 million people will be added to the rolls at an additional cost of nearly $120 billion.

States are forced to maneuver through a maze of rules, regulations and mandates to satisfy Medicaid bureaucrats. A recent study exposed that Medicaid patients have higher mortality rates than even the uninsured. Not a record to be proud of by any means.

America is a humane nation, and that demands we maintain a true medical safety net for those with nowhere else to turn. But, expanding that safety net to cover ever increasing numbers of people will further weaken the system and marginalize the truly needy.

Since the 1960s, we have spent trillions of dollars to fight poverty, and far too much of that money has been spent in the wrong ways on the wrong people. Ronald Reagan understood that financial resources -- whether federal, state or one's own -- are, by definition, limited. And, he believed that it was not only a fiscal but a moral imperative that government aid be targeted to those most in need.

The answer to providing quality medical care to our needy is to follow the example of the successful 1996 Welfare Reform and block grant funds for Medicaid and the Children's Health Insurance Program (CHIP) to the states. This will permit each state to design its own rules to cover the needs of its own population, and provide incentives to discourage rampant abuses. The "State Health Flexibility Act" (HR 4160) introduced on Wednesday by Rep. Todd Rokita (R-IN),  Rep. Tim Huelskamp (R-KS), Rep. Paul  Broun, M.D. (R-GA), and Rep.  Jim Jordan (R-OH) will do just that.

This legislation will provide the states with funding locked in at 2012 levels but with the flexibility to: determine who needs help and at what level; cut red tape and wasteful bureaucracy; identify misuse and fraud and impose penalties for those who abuse the system; and, be accountable to America's taxpayers by saving $1.8 trillion over the next decade - money that just about everyone in Washington is willing to admit we do not have and will not have. 

Of course, making this bill law will require sensible legislators to step up, and making it work will take courageous governors to take on the challenge.  But, it's not like we haven't done this before.

Susan A. Carleson, widow of Robert B. Carleson, Ronald Reagan's chief welfare advisor and the architect of modern welfare reform, is founder and president of the Carleson Center for Public Policy, an exclusively Reaganite think-tank devoted to continuing the reform of American welfare policy. www.theccpp.org.

As the sheer audacity and real costs of ObamaCare become more apparent every day, we can't say we weren't warned.

Back in 1961, Ronald Reagan explained the allure and dangers of "free" medical care:

One of the traditional methods of imposing statism or socialism on a people has been by way of medicine. It is very easy to disguise a medical program as a humanitarian project. Most people are a little reluctant to oppose anything that suggests medical care for people who possibly can't afford it.

Sadly, I have had first-hand knowledge of the impact of "free" medicine. My family is from England, and over the years I have watched grandparents, aunts, uncles, cousins and friends wait years for what we Americans consider routine health services.

My dear aunt, whose cataracts were so severe that she could hardly see, finally got surgery eight years after being diagnosed. An uncle exhibiting classic heart attack symptoms was told by a local doctor to take an aspirin and go to bed. He died before morning.

In America, hip and knee replacements have become a rite of passage for those of us over 60, but not in the UK, where you can wait years for such treatment -- if you qualify at all. The UK's National Health Service (NHS) and other "free medicine" countries typically treat patients with pills, potions and waiting lists. 

Lack of funding has caused many UK hospitals to shut down and others are an utter disgrace -- often so filthy that family members have to pitch in to keep their loved ones clean. And here's another dirty little secret about the NHS: if you have the money, you get to jump the queue, while the old-age pensioners and working class patiently wait their turn. Patients must be patient, after all.

Americans won't willingly accept what passes for health care in the socialized world, but that's exactly what Obama has planned for us, largely by expanding the already failing Medicaid program.

Medicaid was created in 1965 to finance medical care for welfare recipients. Today, it is collapsing under the weight of providing about 40% of all federal transfer payments to the states. State and federal spending for Medicaid surpassed $400 billion in 2010. Under ObamaCare, another 17 to 25 million people will be added to the rolls at an additional cost of nearly $120 billion.

States are forced to maneuver through a maze of rules, regulations and mandates to satisfy Medicaid bureaucrats. A recent study exposed that Medicaid patients have higher mortality rates than even the uninsured. Not a record to be proud of by any means.

America is a humane nation, and that demands we maintain a true medical safety net for those with nowhere else to turn. But, expanding that safety net to cover ever increasing numbers of people will further weaken the system and marginalize the truly needy.

Since the 1960s, we have spent trillions of dollars to fight poverty, and far too much of that money has been spent in the wrong ways on the wrong people. Ronald Reagan understood that financial resources -- whether federal, state or one's own -- are, by definition, limited. And, he believed that it was not only a fiscal but a moral imperative that government aid be targeted to those most in need.

The answer to providing quality medical care to our needy is to follow the example of the successful 1996 Welfare Reform and block grant funds for Medicaid and the Children's Health Insurance Program (CHIP) to the states. This will permit each state to design its own rules to cover the needs of its own population, and provide incentives to discourage rampant abuses. The "State Health Flexibility Act" (HR 4160) introduced on Wednesday by Rep. Todd Rokita (R-IN),  Rep. Tim Huelskamp (R-KS), Rep. Paul  Broun, M.D. (R-GA), and Rep.  Jim Jordan (R-OH) will do just that.

This legislation will provide the states with funding locked in at 2012 levels but with the flexibility to: determine who needs help and at what level; cut red tape and wasteful bureaucracy; identify misuse and fraud and impose penalties for those who abuse the system; and, be accountable to America's taxpayers by saving $1.8 trillion over the next decade - money that just about everyone in Washington is willing to admit we do not have and will not have. 

Of course, making this bill law will require sensible legislators to step up, and making it work will take courageous governors to take on the challenge.  But, it's not like we haven't done this before.

Susan A. Carleson, widow of Robert B. Carleson, Ronald Reagan's chief welfare advisor and the architect of modern welfare reform, is founder and president of the Carleson Center for Public Policy, an exclusively Reaganite think-tank devoted to continuing the reform of American welfare policy. www.theccpp.org.

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