Saturday, November 09, 2013

Die Now, Die Later, Or Just Go Away

Speaking at the Port of New Orleans on Thursday, President Obama implored Governor Bobby Jindal, who has rejected Medicaid expansion, to accept free money:

We want to work with everybody, mayor, governor, insurance companies -- whoever it is that wants to wants to work with us here in Louisiana to make sure even if you don't support the overall plan, let's at least go ahead and make sure that the folks who don't have health insurance, let's make sure we do that. It's the right thing to do.

But the Louisiana governor would have none of it, responding (according to The Huffington Post, punctuation included)

We will not allow President Obama to bully Louisiana into accepting an expansion of Obamacare. “We have rejected Obamacare’s Medicaid expansion in Louisiana because it would cost Louisiana taxpayers up to $1.7 billion over the next ten years and move nearly 250,000 Louisianians from private coverage to Medicaid. “The disastrous rollout of Obamacare is a case in point that we don’t need top-down, one-size-fits-all federal mandates, and instead should continue to focus on health care solutions that make sense for Louisiana. “Obamacare needs to be repealed. The dysfunction of the website and the President’s broken promises on being able to keep your health plan are just the tip of the iceberg in regards to the problems with this law.

The big 'bully' says "take our money- or else I'll give a speech," and Bobby Jindal quakes. Obviously, "Obamacare" is anything but a "one-size-fits-all-mandate," given that states can set up their own (private insurance) marketplace, allow their citizens to participate in the federal (private insurance) marketplace, or collaborate with the federal government in establishing a (private insurance) marketplace. And then the individual may choose from among a range of (private) insurance companies, as planned by the Socialist president.   Of course, an expansion of Medicaid would move Louisianans from costly private coverage to Medicaid, for which Louisiana taxpayers would have to pay a whopping 10% of the cost beginning in 2016 to insure its poorest citizens. That's after paying 0% until 2010.

Bobby Jindal wants to repeal Obamacare and continue the system in which residents of his state in 2009 paid $6,795 per capita for health care, lower than in most states but approximately twice as great as that of the 34 nations in the Organization for Economic Cooperation and Development as of 2010.

Bloomberg recently released a study of health care systems world-wide on, as The Huffington Post, explains

three criteria: life expectancy (weighted 60%), relative per capita cost of health care (30%); and absolute per capita cost of health care (10%). Countries were scored on each criterion and the scores were weighted and summed to obtain their efficiency scores. Relative cost is health cost per capita as a percentage of GDP per capita. Absolute cost is total health expenditure, which covers preventive and curative health services, family planning, nutrition activities and emergency aid. Included were countries with populations of at least five million, GDP per capita of at least $5,000 and life expectancy of at least 70 years.

The map below illustrates how the U.S.A. fared on one of the measures of cost:

Cost per capita in this nation are exceeded only by those in Switzerland, which ranked first in the world in health care efficiency, which put it 45 places ahead of the U.S.A. of the 48 nations studied by Bloomberg:

In its 2010 update of the study (entitled "Mirror, Mirror") of the health care systems of Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the U.S.A., the Commonwealth Fund found that our nation ranked last overall... as it did in 2007, 2006, and 2004. But Bobby Jindal knows what all those analysts don't, that prior to the Affordable Care Act, the U.S.A. had an efficient, humane health care system with access to all and malice toward none.

In September, 2009 then- (and again) U.S. Representative Alan Grayson of Florida presented on the floor of the House a visual display slamming the G.O.P. approach to health care.   He explained "if you get sick, America, the Republican health care plan is this: die quickly."

Two Tennessee Republicans were horrified.   Jimmy Duncan exclaimed "That is about the most mean-spirited partisan statement that I've ever heard made on this floor and I, for one, don't appreciate it." Professional liar Marsha Blackburn whined "it's fully appropriate that the gentleman return to the floor and apologize."

Grayson declined to apologize and, truthfully, not all Republicans want every sick American to die.  But if you're poor, or elderly and out of funds, and are sick, Governor Bobby Jindal and those Repub governors who are declining to expand Medicaid have a request: Take your time, or hurry. But just die.

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