Jeffrey Parks MD FACS
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"Undeserving"

3/19/2015

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Well things are getting ugly in New Hampshire, of all places.  The state legislature just voted to end the ACA-derived Medicaid expansion (available as a federally funded option to all states) beyond the year 2017, thereby throwing tens of thousands of vulnerable poor citizens into the stressful chaos and financial uncertainty that defines being an adult in America without health insurance.  This quote from Republican state representative Dan McGuire was particularly uninformed and odious:
“Expanded Medicaid is a huge disincentive for people to work,” said Rep. Dan McGuire, R-Epsom, who voted to let the expansion sunset at the end of 2016. 

“There wasn’t a lot of debate on it. Traditional Medicaid is designed to benefit people who are deserving of charity due to conditions beyond their control. Expanded Medicaid benefits people who are undeserving of charity. These are people who don’t have any reason for not working.” 
Those are just delightful sentiments, aren't they?  It seems that, in the world of Representative McGuire, the only acceptable excuses for being on Medicaid would include "Struck down by thunderbolt from the hand of Zeus", "Limbs gnawed off by sharks", "Earthquake destroys town", "Typhoon washes away all manufacturing employers in 50 mile radius" and "Abducted by aliens".   Mass unemployment, economic stagnation during the Great Recession of 2008-2011, and off-shoring of industrial and manufacturing jobs over the past 30 years are irrelevant, inconvenient details.  

I love how Mr McGuire seems to think that "having a job" eliminates all worries about health benefits.  I think all of our Wallmart and McDonald's workers forced to accept 25 hour work weeks would have something to say about that assumption.   It's as if the working poor don't even exist in his worldview.  Anyone qualifying for Medicaid must necessarily be a lazy, unmotivated, entitled slug who would prefer to sponge off more successful, more "authentic" Americans.  It doesn't even cross this guy's mind that there are plenty of struggling Americans working several jobs--50, 60, 70 hours a week-- but don't have health insurance, either because they are part time at all those jobs or the company doesn't even offer benefits, and they are unable to purchase individual insurance because it's far too expensive.   Furthermore, this bill they passed only eliminates the Medicaid expansion, i.e. those who incomes fall within 138% of the poverty line.  It has nothing to do with basic Medicaid itself.  This expansion only applies to those people who are already working but earn too much to qualify for regular Medicaid.  This has nothing to do with freeloaders choosing to stay at home and play X-Box stoned all day.  The whole thing is just about as disgusting and cynical and deceptive as you can imagine.  

The richest, most powerful country in human history.  That's not hyperbole.  And yet the provision of affordable health care for its citizenry remains an unsettled political powder keg.   It remains a dark stain on our collective moral standing....

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    Jeffrey C. Parks MD, FACS

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