The Medicaid program was enacted in 1965 to provide a medical safety net for low-income families and for destitute elderly who had exhausted their personal resources. It has morphed into an entitlement to preserve middle-class standards of living. The reasons are understandable. You’d have to have heart of stone not to feel compassion for the millions of middle-class American families who have caretaker responsibilities thrust upon them. But the end result is an ever-expanding program that will accelerate the nation’s slide to Boomergeddon.
The latest case in point is an op-ed penned by Kathy May, director of the Virginia Consumer Voices for Healthcare, in the Times-Dispatch (no link).
As May readily concedes, she and her husband both work, and their family’s income is one-third higher than the median family income for Fairfax County, one of the wealthiest counties in the country. Both are well educated and work hard. They live comfortably and have build a “decent nest egg” for retirement.
Where would they be without Medicaid, May asks. Her 76-year-old mother, who has dementia and requires daily nursing care costing $80,000 a year, will deplete her savings in half a year. May and her husband could not afford to pay her bills.
She also has a son, Sam, born with Fragile X Syndrome, resulting in a variety of disorders requiring more support, care and intervention than for most children. To stay flexible, May worked part-time jobs at home and passed up opportunities for advancement. Not including lost wages, the family has spent $100,000 over the child’s lifetime on special care.
After waiting for many years, she writes, her son recently qualified for a Medicaid waiver, which allows him to access resources paid for by the federal government. Now Sam lives semi-independently in a group home. “Sam’s new found independence has given my husband and me a bit more freedom,” May writes. “I am able to work full-time and focus on my job and saving for retirement. My husband and I will be able to spend a weekend away alone to celebrate our wedding anniversary!”
Anyone with an ounce of empathy would share May’s relief at having such huge financial burdens lifted from her shoulders. Frankly, you would have to be a beast not to. We are a kinder, gentler, more civilized society for having a program like Medicaid that cares not only for those whom we think of as poor but the elderly who have drained their life savings and the disabled who never had savings to begin with.
We are also a society heading for a fiscal meltdown. At some point, we will have to make some excruciatingly difficult choices. Obamacare is expanding the rolls of Medicaid beyond poor households to include the “near poor,” adding millions of new recipients. Meanwhile, the Baby Boomer generation is marching into retirement. In another 10 to 20 years, Medicaid expenses will explode as large numbers of Boomers wind up in nursing homes. The United States will be unable to maintain Medicaid at its current level of generosity while also maintaining other entitlement poverty programs, corporate welfare, globe-straddling military commitments and an activist government.
Something has to give. We can make tough decisions now, when small changes can make a difference over a long period of time, or we can wait until the system collapses and the choices become much crueler. I see no sign that the American people are willing to make those choices now, or even that they recognize the need to make them. As May concludes her op-ed after not a single word about America’s parlous fiscal condition, “Medicaid touches the lives of so many American families — a fact which many politicians too often forget.”
Ooh, those heartless politicians! Shame on them for looking 15 years down the road! Perhaps the question that May should ask is, how many lives will Medicaid touch when state and federal finances collapse? And who will pay for Sam’s care when it does?