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Not expanding Medicaid in Pa. is a no-brainer

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Contact Colin McNickle (412-320-7836 or

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Saturday, July 6, 2013, 9:00 p.m.

The purveyors of perennially expanding government are beside themselves. Who in their right mind wouldn't support expanding Medicaid in Pennsylvania?

“Ah, that's it!,” they “reason”; it's “the right,” as in conservatives. You know, “right-wingers.” And they don't have any rational, fact-based reason to oppose it. Even a supposed Republican has bitten on the madness.

“I think it's almost a knee-jerk reaction,” state Sen. Patricia Vance, who represents Cumberland and parts of York counties, told The Associated Press. She chairs the Senate Public Health and Welfare Committee. “They don't like Obama. So this is part of ObamaCare, so we hate it. That seems to be the rationale without understanding what it means.”

Ah, “what it means,” eh?

Or as the York Dispatch editorialized: “House Republicans' hatred of all things Obama is so illogical, not even the plight of Pennsylvania's children could sway them.”

Ah, yes, it's “for the children.”

Gee, aren't you surprised that nobody has claimed opposition to Medicaid expansion is “racist”? Wait a few days.

If the ignorance used as rationale for allowing Leviathan to be ever more our master could be captured and burned, we could stop importing foreign oil.

The bottom line for not expanding Medicaid in the Keystone State is that it's a poorly designed proposal fraught with peril.

In one fashion or another, proponents of Medicaid expansion cite the need to provide health insurance for hundreds of thousands of Pennsylvanians earning up to 138 percent of the poverty threshold. They also cite promises by the federal government to pay 100 percent of the expansion costs for three years, then 90 percent thereafter.

That, they argue, will save the commonwealth hundreds of millions of dollars a year. Why, it's akin to “free money,” some gush. And, by garsh, such a massive expansion of government will be a major boost to the economy.

Would that it were. What, the last massive expansion of government (i.e., “stimulus”) didn't solve all of our economic woes?

For starters, this progeny of the “War on Poverty” long has been unsustainable, medically and economically. “Medicaid has failed to reduce poverty and offers episodic and disjointed care,” writes the Commonwealth Foundation's Elizabeth Steele. In just one little to wit, she notes that, under Medicaid, children with ear infections have only a 38 percent chance of being able to secure an appointment with an ear, nose and throat doctor.

Many physicians won't see Medicaid patients and many more say they won't accept new Medicaid patients. Why? Reimbursement rates don't cover the cost of their services.

Making a big failure an even bigger failure will bring success, is that it?

What's the real skinny on Medicaid? Higher taxes. Shrinking uncompensated care reimbursements for hospitals. Perversion, if not destruction, of private health insurance markets. Fewer doctors willing to put up with more and more (and more) government control and compliance nonsense. Less care, worse care and, quite possibly, no care for the neediest among us.

Who in their right mind would support expanding Medicaid in Pennsylvania?

Colin McNickle is Trib Total Media's director of editorial pages (412-320-7836 or

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