The following op-ed was published this weekend in the St. George Spectrum.
Runaway healthcare costs are the gift that the federal government wants to keep on giving. The gift this year for consideration? Medicaid expansion, which is on your ballot in the form of Prop 3.
Government intervention into the healthcare industry in the past century has failed us. Skyrocketing prices, misalignments in coverage, and unaffordable insurance rates are the result of a long line of missteps and bad incentives.
Prop 3 represents a continuation of the status quo and a compounding of the problem. Until we focus on introducing true price transparency and have a major increase in the supply of healthcare, Utahns will struggle to afford the care and coverage they need.
The healthcare debate has largely focused around how many people have health insurance. But simply increasing the number of people who have health insurance can undermine the goal of increasing access.
The best way to improve access is to create a dramatic fall in prices. Adding or forcing more people into the current system will only perpetuate the problem by increasing the demand on a limited supply of health care services that comes from individuals using subsidized and bloated insurance policies. This leads to tremendous strain on the ability for programs like Medicare and Medicaid to deliver a certain quality of care in a timely manner.
Medicaid was designed to help the most needy and vulnerable among us to obtain health care. But in states that have already expanded Medicaid, priority is instead being given to working age, able-bodied, single adults with no children. The needy are often put on a waiting list — and in Utah, there are already 2,900 disabled people waiting.
Instead of improving Medicaid, Prop 3 expands a mediocre program that currently struggles to carry out its mission to provide healthcare to those most in need. If anything, Prop 3 puts the disabled and those unable to provide for themselves in a much more precarious position by making them wait for services behind able-bodied Utahns. Proponents have used the stories and experiences of a few to push for a broad expansion rather than focusing on targeted populations that are truly in need.
For example, proponents may claim that these projections include some 22,000 children, but fail to communicate that these children already qualify for Medicaid. And realistically, a broad expansion of Medicaid will actually make it harder for the program to serve these children.
The reason is rather simple. Services and resources for low-income children, the elderly, and the disabled become more scarce since the state is financially incentivized by the federal government to focus on enrolling 150,000 new people, many of which are able to provide for themselves, in order to obtain more funding.
In the end, expanding Medicaid is simply an expansion of Obamacare that will give the federal government more control over our health care decisions, taking power away from patients and their doctors.
If Utah expands Medicaid under Obamacare, as proposed by Prop 3, the state will be unable to protect taxpayers when enrollment in the program exceeds estimates — which has happened in every state that has expanded Medicaid. And Utah taxpayers will be forced to foot the large bill, beyond the current tax increase that Prop 3 proposes.
Medicaid expansion in Utah will have a devastating impact on our state budget, ballooning to the point where other essential services like education, roads, and public safety could face severe cuts. And Prop 3’s $90 million sales tax increase would be added on top of the many other tax increases we’ve seen in Utah during the last four years.
Prop 3 adds more fuel to the fire to a system that can’t seem to raise rates and prices fast enough. Whatever short term gains are made will be wiped out by a perpetuation of failed government policies and the justification of crony capitalism within healthcare.
Common sense solutions are needed that will lead toward a healthcare market that can work for everyone, rather than pricing out the poor. Ideas to reduce barriers to concierge and telemedicine, direct-pay models, medical cost-sharing, and charity care should all be explored in addition to introducing true price transparency and increasing the supply of care.
Medicaid expansion — and Prop 3 on your ballot this year — is a faulty band-aid applied to a system that needs a serious intervention. The wrong incentives have created this mess and it’s time we paid attention to those incentives to fix our healthcare system.
