Mero Moment: Rethinking health care for the poor

Composite image. Utah State Capitol, Photo by alexyurchenko/iStock/Getty Images Plus, Franklin portrait on banknote, Photo by iv-serg/iStock/Getty Images Plus. IV Bag Economic Stimulus, Photo by Nerthuz/iStock/Getty Images Plus; St. George News

OPINION — Commenting on the Senate health care bill currently being debated, conservative pundit Marc Thiessen writes, “Here is the summary of the bill that Democrats will take to the American people in 2018: Republicans voted to cut $701 billion in taxes for corporations and the wealthy, and pay for it with $772 billion taken from Medicaid for the poor — all while pushing 22 million Americans off health care. And Senate Republicans are writing the script for them. Have they lost their minds?”

He concludes, “Paying for a massive tax cut for the wealthy with cuts to health care for the most vulnerable Americans is morally reprehensible.”

And it is. And, yes, congressional Republicans have lost their minds. And, in so far as any of them claim to be conservatives, they also have lost their moral and philosophical bearings.

Now stay with me for a few minutes because I will ask you to remove yourself from politics and place yourself in the position of having to care for the poor without creating or adding to welfare dependency. And what I am asking you to do is not easy.

The entire Senate health care bill debate has so many layers of politics involved now that it is almost impossible to discern good policy from bad.

For instance, both sides have a penchant for basing their arguments on evidence-based data. The political problem with this exercise is that partisans do not look at studies to actually learn from them. They look at studies to use as weapons against opponents. So, we get a study like the Oregon Medicaid Experiment and both sides claim it proves conclusively that their side is correct. But, in truth, if you read the results of the study, you would see that both sides have a point and, more importantly, the conclusions serve neither side’s interests.

So, as you listen to all of the arguments over the Senate health care bill, please keep in mind that almost all that you hear is political prattle aimed at one-upmanship with the only goal being a legislative win at any cost.

In other words, these elected officials do not care about the poor; they care only about partisan politics – and that behavior really is morally reprehensible.

The question I pose to you is this: Do you really care about the poor?

Be careful if you answer yes. Because now you will have to actually know the poor, not just think about them. After all, how can you help someone you only think you know? If you try, you are bound to get it all wrong. You will only get it right if you actually know them. And, as the old saying goes, to know them is to love them.

With you in charge of providing health care for the poor, and after you got to actually know them and love them, my guess is you would look at the life and circumstances of the poor one by one. You would create processes that afford them dignity and solutions designed to uniquely meet their needs. You would balance their individualism with the common good of society, regardless of whether or not assistance is provided publicly or privately. After all, your goal is to care for them, heal them and uplift them – that is, if you seek to really know them and love them.

No doubt you would quickly conclude that the best medical care you can provide is the service closest to them – from their own families, communities, associations and, if governmental, from state and local sources. You will want to be as close to the poor as possible, even intimate in your understanding of their needs and wants.

So, now you step back as a policy maker and review your options. You will soon conclude that private assistance, one-on-one, is the best delivery system for medical care. You want to be both effective in treatment and efficient with time and money. You would approach medical providers and ask them if they would give some of their time to assist the poor and even build a professional relationship with them. But if, for whatever sad reason, those medical providers do not step up, you have to move beyond them – or, rather, you have to pay them to provide services they would otherwise donate.

Here comes your first big realization: If the private sector will not or cannot cover the care, you are left with two choices – either public assistance or no assistance at all.

As you peel back the layers on this task, you’ll soon discover that caring for the poor becomes a multi-oriented approach – some private, some public, some not at all. The only approach that will remain constant is that to effectively and efficiently care for the poor you will have to know them and love them. And that is necessarily personal and local in application.

In other words, if D.C. politicians really want to help the poor with health care, they would place all authority and resources in the hands of state and local providers, both public and private. End of Senate health care debate. Period.

Paul Mero is an opinion columnist for St. George News. The opinions stated in this article are his own and may not be representative of St. George News.

Email: paul.mero@nextgenfreedomfund.org

Twitter: @STGnews

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28 Comments

  • comments July 2, 2017 at 7:14 pm

    “if D.C. politicians really want to help the poor with health care, they would place all authority and resources in the hands of state and local providers, both public and private”

    Uhm, I think that’s called medicaid. It’s money given to the states and they fully manage it–A lot of it, maybe even most, is at their discretion. I wouldn’t trust a state like Utah to just take the cash and have full discretion. And how many times in this article does he say “the poor”… it seems slightly derogatory. I’d say “low income Americans”, but oh well. Also agree with a lot here. Modern day republicans are not conservative in the least; they are most all neo-con garbage. They’ve had over 8 years to craft a healthcare plan that will replace obamacare and be good for middle class, but they just can’t resist screwing over the American people at any opportunity.

    • comments July 2, 2017 at 7:19 pm

      I shouldn’t say that MOST of the medicaid dollars are at utah’s discretion; maybe a fraction. And I’m glad for that because the political class in this state has refused to expand medicaid under obamacare to lower income how many times now? This is a state that doesn’t look after the vulnerable, who could use access to healthcare. This is the mormon state that puts wealthy first.

  • commonsense July 2, 2017 at 9:27 pm

    if the Republicans were like the Democrats, Obamacare would be repealed and replaced along partisan lines. Instead, the party in power is struggling to do the right thing for America. Ther is no easy fix but over taxing business is an economy killer.

    I would like to see a creative approach. America can’t afford comprehensive high level care for everyone. Government programs are never efficient and always cost more. One thing is certain, Obamacare is failing and no one wants another failed program.

    • comments July 2, 2017 at 10:28 pm

      They’re struggling to do the right thing? The republican plan was so bad they couldn’t even get enough republicans on board because if they had reserve about screwing over the American people that badly. It was a horrible bill endorsed by a horrible president. Are u gonna answer my question of whether you are LDS? and are you a man or woman. I only ask bc your……… i’m not even gonna say … 😉

      • comments July 2, 2017 at 10:29 pm

        *because even they had reserve about screwing over the American people that badly.

        even, not if. ouch 😉

  • commonsense July 2, 2017 at 10:23 pm

    Utah does a superb job of taking care of the needy. The social fabric here promotes charity and churches sponsor programs that cover many who find themselves in need. Utahans are known for their high charitable donations.

    State governments are In the best positioned to dispense medical care to the poor since delivery systems vary from urban to rural areas.

    Meducaid was designed as a stop gap but now 75 million consider it as their primary insurance.
    This just can’t continue when America has such a large debt. Getting people back to work will solve a lot of the problems of the recent past. A vibrant economy with a high GDP will be magic.

    • comments July 2, 2017 at 10:41 pm

      you regurgitate right wing propaganda that you’ve been force fed your whole life almost word for word. amazing. I’d also be extremely curious to know your age, commonsense, if you’d be so kind? That’s 3 questions in total for you, buddy. 😉

      • Utahguns July 3, 2017 at 6:26 am

        So far, Commonsense has more rational, non-emotional opinions and suggestions here.
        The other ‘comments’ are fueled by the typical radicalized left-wing, “burn-the-neighborhood down”, socialistic brain washed attacks. Somebody here seems to only receive CNN news.
        It’s refreshing to read ‘commonsense’ approaches to solving issues instead of emotional, hate-based (wheres my playdough?) diatribes.

        • comments July 3, 2017 at 1:00 pm

          the problem is he doesn’t deal in facts, just purely right-wing mythology

  • 42214 July 3, 2017 at 12:09 am

    There are 7 entries here and comments made 5 of them. Is this a filibuster or do you just talk too much?

  • .... July 3, 2017 at 5:42 am

    This is a joke. ..period ! the only people with with decent medical care are the politicians

    • Real Life July 3, 2017 at 1:18 pm

      Does the institution know you are here?

  • ladybugavenger July 3, 2017 at 10:02 am

    As a person in the real world, observing and living the low wages and no healthcare. I am also college educated. But have a disabled husband that occupies me and keeps me from working countless hours, low wages suck and Obama care would cost me half a paycheck a month and I don’t qualify for Medicaid. Quite a predicament. I’m hanging on and not seeking medical treatment which I really need to see a doctor before I can’t walk and work but I can’t afford it. Predicament, isn’t it? I work for a Fortune 500 company, which means nothing to employees who’s hours are being cut to 10-20 hours a week. Are mine being cut? So far I’m hanging on but cuts are coming in weeks. Fortune 500 company $$$$ you…know what I’m saying. People working there starving and hanging on, working 2 or 3 jobs to pay rent so they can be a Fortune 500 company? (I think they are 32 on the list) disgusting, isn’t it?

    • ladybugavenger July 3, 2017 at 10:10 am

      Or 40th on the list…..anyhoo they are a Fortune 500 company. I bet the Walmart employees working 2 jobs or working full time and on welfare to support their families feel the same way. Like who cares about the list, pass it on to the employees and pay them a living wage!

      These retailers should only be on the list of “companies that have the highest welfare participants.”

      • ladybugavenger July 3, 2017 at 11:24 am

        Unfortunately, when wages go up so does rent and food. There has to be a way to higher wages and lower rent, but people are greedy and that causes everything to go up.

        I’m not for woman’s rights or nothing like that. I’d prefer the man making high wages that can afford to pay house payments and food and take care of the family. I despise that woman that made women work- now we all suffer and can’t pay rent and buy food unless many people working and living under the same roof or on welfare. oh yes! You can go in credit card debt and many loans with high interest to pay for these things but seriously the struggle is real. I lived without credit cards for 15 years I just now realize how people could afford the things I couldn’t….duh ladybug ? they were charging it and going in debt.
        Is that the American dream? A lifetime of debt.

        • ladybugavenger July 3, 2017 at 11:36 am

          Here I am taking care of my disabled husband- who actually makes more than me on disability than I do working full times hours., he also has Medicare (He did have a really good paying gov’t job until one day all hell broke loose) now I’m Working my butt off, taking care of him, and still taking care of laundry, vacuuming, yard work (mowing, edging, pulling weeds, dusting, mopping, cleaning garage….luckily, kids are grown or I’d be raising them too. so screw that gloria lady who wanted women to work. Now we have to work full time jobs and raise the kids and clean the house….step up men! And help raise these kids (have you noticed mormon men call it babysitting?) but men have turned into lazy pigs (more than not) my husband does not fall in that category, he was a hard working, overachieving, take care of your family with no days off kinda man- who is now disabled and struggles that he’s not the man he once was…… give me some frick’n health insurance that I can afford!

          • ladybugavenger July 3, 2017 at 12:04 pm

            A $5,000 deductible is not affordable, nor is a $2,500 deductible. People making $12 an hour don’t have $5,000 or $2500 deductible. Pretty soon, everyone’s going to be homeless or combining families in one house, like Mexicans do….which is smart!

            So Bob, you’re against socislism but how do you solve my problem?

            How do I get affordable (like $40 a month) health insurance?

          • ladybugavenger July 3, 2017 at 12:19 pm

            My solution is making the least amount of money- going to part time (10-20 hours) and using welfare as my insurance and food. Isn’t that socialism? It’s the only way this system in place can give me health insurance and possibly food stamps. Crazy world we live in.

          • ladybugavenger July 3, 2017 at 12:34 pm

            The welfare system is set up to be used and for all low and middle income to be on welfare (thanks Obama) businesses know this and use it to profit themselves.

            how do you turn that around? You get tough with business, you lower their taxes- you put them in check by sanctioning them for cutting hours and you sanction them for having employees on welfare. You make them pay a living wage. What’s a living wage? You should make 3 times more than the average rent cost in your area. You lower housing cost and prohibit rent increases by lowering taxes on the people providing housing. You lower food cost and you get rid of a Fortune 500 list (nobody cares) You get back to caring more about people than you do about yourself. You bring morals back.

            But……..that ain’t gonna happen in my lifetime. God Bless y’all. If it weren’t for my mom buying a house in 1974 for $40,000 then we sell it in 2016 for $550,000 and I got half, I wouldn’t even have a home….thank you mom! I worked hard for 5 years to get my credit excellent on a $10 an hour job and my husbands disability and here I am in Oklahoma (where buying a house is half the price as utah) all thanks to my mom. Now, I’ll survive til I die….One day at a time. Who knows? Maybe I’ll be disabled in 5 years and get $500 a month to live on. we will see…..

          • comments July 3, 2017 at 1:06 pm

            I think you just set the record for most replies to yourself in a string of comments 😉 I probly had the record before, lol. I’m actually for a socialist-based healthcare model. Obamacare is just barely dipping a toe into socialism and was negotiated with the trillion dollar insurance lobby, so it really didn’t turn out so well. A republican plan will be far worse tho. No easy answers, LB.

          • ladybugavenger July 3, 2017 at 2:11 pm

            Haha Bob….I win lol

  • Hugh Jass July 3, 2017 at 3:37 pm

    If the Senate and Congress were required to participate in any “health-care reform” act they come up with, you can bet your rosy red [bottom] they’d come up with something better than what they’ve been trying to shove down our throats! Until it’s applied to all American’s, it won’t be fair or decent.
    But that’s not my biggest issue with the health care bill… Since when is “insurance” the same as health care?!?? Cut out the insurance companies and go to the providers. My bet is that if it weren’t for the insurance companies, health care cost would plummet.
    I’m in much the same situation as ladybug avenger. I, too, am caring for a disabled husband. He hasn’t been employed since Sept of 2000. For six of the years since he had to leave his job, I was a full-time State employee, with insurance and benefits. But, he disdains the medical profession. He sees them all as blindly following what big pharma has taught them to believe without using their brains to figure out what’s really going on. And he believes that the initials ‘FDA’ stand for ‘Fraud Distribution Agency’! Needless to say, my insurance was worthless when it came to his health. He won’t go to a doctor. And I believe there are several million other Americans like him.
    So can anyone tell me why I/we can be forced to buy insurance we will never use? Now I’m sure you’re saying, “Well, what if he gets ________?” (insert your favorite catastrophic or fatal disease here). In his case, he would cheer! There are things worse than death and he is suffering through them with a quality of life of less than zero. He doesn’t need insurance and he certainly doesn’t need to be anyone’s guinea pig.
    Let’s call this what it is: an unfunded mandate and a cash cow for health insurance companies.

    • ladybugavenger July 3, 2017 at 4:33 pm

      Amen!

      • comments July 3, 2017 at 6:46 pm

        LOL, you just “amen’d” a diatribe from someone named Hugh Jass. Refuses to go to doctors? Sounds like a complete lunatic or nutter.

      • ladybugavenger July 4, 2017 at 9:09 am

        I amen’d ‘cash cow for health insurance companies’ as for her husband not wanting to see a doctor…..my husband didn’t want to see them either until his heart attack and a quadruple bypass….now he has regular check ups and is a model patient 🙂 as for back surgery- he refuses-scared he will be paralyzed. And my husband has that kind of luck, so I don’t blame him.

        As far as paying for health insurance you’ll never use, that’s how I feel about my car insurance but here I am paying high prices for insurance because the uninsured drivers get into accidents…. give me health insurance with a low deductible and I’ll use it. You give me health insurance with a $5,000 deductible I may not be able to go unless something major happens.

  • commonsense July 3, 2017 at 7:51 pm

    The heart wrenching need for care has to be balanced against budgetary constraints. It just does in any system. In Europe care is rationed. It can take months to schedule surgery. The answer is not easy but highly taxing business is counter productive. Obamacare punished businesses and job production suffered.

    The answer to just about everything is a strong economy. What if ladybug had a good high paying job. Problem solved. She could buy any kind of care she desires. Almost 800 K jobs have been created since January. The markets are thriving. People are working again. Jobs are staying here. Maybe half the recipients won’t need Medicaid. Tax revenues will expand. Debt will level off.

    Ladybug’s employer sourced out and hired part timers because Obamacare punished corporations by mandatimg expensive health insurance for full time employees. Without mandates ladybug couid work more hours for higher wages without her company being punished.

    Make insurance companies compete across state lines in an open market. This would create much better choices for consumers. Make medical providers be more transparent so patients can shop for the best deals. Hold drug companies accountable for overpriced drugs.

    • ladybugavenger July 4, 2017 at 9:14 am

      there is hope for ladybug

    • comments July 4, 2017 at 2:47 pm

      Well commonsense, I know your love for the R-party runs deep within you. I hope this new republican president doesn’t bring the economy to collapse like the last one did. And I’ll say it again, we are still coasting along on obama-era economic policies. You are very very simple– dangerous black and white thinking to the nth degree.

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