Dr. John M. Livingston | Medical Policy Adviser

I was again thinking about the two arguments of the Medicaid expansion group.  One was the so-called “moral argument” that without Medicaid expansion, we wouldn’t be taking care of those in need.

In my 41-year career, I have never seen in this country a patient in need not attended too.  In fact, because there is no enrollment period or preexisting underwriting mechanism required to qualify patients for Medicaid,  patients can actually be signed up after a medical need when identified--a pregnancy, a traumatic accident or cancer, or a mental health intervention.

The proposed Medicaid expansion does not help those truly in need who through no fault of their own and maybe because of a chronic disease process cannot take care of themselves. Instead, it takes money that would have gone to them and redistributes it to able-bodied, childless adults. If we care about the poor, why would we take resources from those who need help and give it to those who are less needy?

Second, we know that in reality buying insurance for healthy young adults is only subsidizing multibillion-dollar hospital systems and large insurance carriers. The poor and needy aren’t the beneficiaries of Medicaid expansion. The medical industrial complex is.

Additionally, taking money from often struggling families and companies to feed the medical industrial complex means those families and companies wind up with less money saved for retirement, college, and healthcare in the long term.  By not saving and investing today, the obligations are passed onto the next generation. What could be more immoral than that?

As I mentioned in a previous post, increasing overall taxes to a family of 4 from 23 percent of income 65 years ago to 38 percent today has limited GDP growth to 2 percent per year during that time and the aforementioned family's income has remained stagnant $52,000 per year then until $56,000 per year. They struggle to make ends meet, but they’re forced to subsidize Big Medicine.

So please tell me how it is "moral" to tax the revenue of a family making $60,000 a year and who have also seen their insurance premiums co-pays and deductibles double in the past 8 years, and transfer it to subsidize insurance carriers and large hospitals.

The answer is, there’s nothing moral about it at all.