I wish I could say the American health care system has been fixed. But it hasn't been fixed. There are still far too many people without health care in this country, and thanks to the decisions of Republican-controlled states to refuse to participate in the new Medicaid coverage and procedures, millions of people will continue to be without even the most basic health insurance.The two charts above, from the Washington Post, show the situation still hasn't improved as much as is needed -- even though Obamacare did make some improvements. As the top chart shows, the United States still spends far more per capita than other nations do on health care (and those other nations cover all of their citizens, while the U.S. does not). And the bottom chart is even worse. It shows that American citizens must spend far more of their own money for health care than citizens in other nations do (and that includes many who have health insurance).
The bottom line is that the United States government and American citizens spend far more money than the governments and citizens of other countries spend, and we get less for our spending (including the fact that millions have no health insurance, and tens of thousands die each year because of that).
There is a solution for this. We need to take the for-profit insurance companies out of the health care business, and put doctors (instead of insurance analysts) back in charge of patient health care decisions. The best way to do this would be to go to a government-run, single-payer health care system (sort of like Medicare for all Americans, which would be similar to the Canadian system). This will have to happen someday, but considering the current political atmosphere, it could take many years.
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Texas is one of the states that has refused to go along with the Medicaid expansion included in Obamacare. Governor Perry, in a move dictated by his desire to please the teabaggers who run the Texas Republican Party, said Texas would not expand Medicaid to cover the millions of poor Texans who have no health insurance. That means at least 1.5 million Texans will continue to have no health insurance at all (and personally, I believe that is a lowball number). It also means Texas will not benefit from the economic benefits of that new Medicaid money being spent in the state -- about $90 billion.
And Texas badly needs the money being offered for Medicaid expansion. In the last legislative session, the state put off budgeting any money for the current Medicaid system (about $5 billion). That bill has now come due, and it must be paid before the budget can be done for the next two years (2014-2015) by the current legislature.
The money being offered for Medicaid expansion through Obamacare (which Perry turned down) would have been quite a bit more than was needed for that expansion. The extra money could have been put in a fund to help defray the Medicaid costs when the state would need to start paying 10% of the bill (in 10 years). But that would have made sense, and Perry values ideology over common sense.
Now the Republican legislature is eyeing that federal money for Medicaid expansion. They want the money badly, but don't want to embarrass Governor Perry and the state Republican Party, or anger the teabagger base of the party. They are talking about a "compromise" -- which would get the money and save face for the Republicans. One thing they are suggesting is that the government allow Texas to set up its own system.
That is GOP code talk for allowing Texas to take the money and then set up a system that does not meet the federal standards for Medicaid. The U.S. government should turn this kind of "compromise" down flatly. Texas should either meet all of the government standards for Medicaid, or receive none of the money. Allowing Texas to get that money and then set up a sub par system would defeat the purpose of the Medicaid expansion -- to make sure poor citizens get decent health care in this state and country. And if Texas gets away with this, you can be sure other GOP states will soon follow.
