Monday, October 15, 2012

Medicaid, Or One Reason I'm Voting For Obama Instead Of Punting

I've been steeling myself for a half hour to write this post, and I'm still not sure I can make it through without bursting into tears of rage. But I owe it to you, your parents, your children and our nation to tell this story. My family's story.

My mother and father did everything Americans of their generation ("the greatest," so says tradition) were supposed to do. Both busted their buns (Dad more than Mom, whose family had enough resources to fund her education) to make it through college. Remember those radio and early TV ads that said "To get a good job... get a good education!"? They believed them. Youth of modest (Dad) and middle-class (Mom) means, they had what it takes to make their bid for the American dream. Both graduated and went to work in the oil business, planning to marry soon.

America's entry into W.W. II intervened. Dad, again doing what he was supposed to do for his country, enlisted in the Navy, displayed real skill and judgment, became a fire control officer on a landing ship and took fire on several of the beaches of Europe. He and his crew (he always credited them; Dad never bragged on himself) gave as good as they got. Most of them survived the war with, in Dad's case, minimal shrapnel wounds. In a way, my existence is a miracle. But Dad did his duty, the war ended, Mom and Dad married, and here I am. Do stories have endings any happier than that?

But that's not the end. Decades later, Mom, in her mid-sixties, began showing signs of what proved to be Alzheimer's disease. The dread disease progressed quickly, and she was soon to a point at which Dad, himself in declining health, could no longer take care of her at home. Our hearts filled with a sorrow I cannot describe in words, we committed Mom to a nursing home in Houston. Some time after that, we transferred her to an Alzheimer's specialty home.

Long story short...

DAD WENT ALMOST BROKE PAYING MOM'S NURSING HOME BILLS, awaiting the level at which the stingy-assed State of Texas would qualify him for Medicaid.

The week Dad qualified for Medicaid WAS THE WEEK MOM DIED.

I am willing to bet nothing like that ever happens to Governor-until-Preznit GeeDubya Bush. Or Governor-for-Life Goodhair Perry... or King Myth Rmoney. None of them have any such worries for their personal descent into old age.

Enough of my family's personal tragedy. Let me point you to David Dayen's FDL article, The Dividing Line Between the Presidential Candidates on Social Insurance Really Falls on Medicaid, for a few words about the real difference between Obama's ACA and King Myth's medical care "reform" as best we can discern it. Dayen's conclusion caught my eye:

You might suggest that the Obama campaign doesn’t have much of a record on this issue for differentiation. You would be wrong. The Affordable Care Act includes an expansion of Medicaid that would allow 16 million more low-income individuals into the system. That would unquestionably help defray the nursing home costs of more low-income seniors.

This chart above, via Kevin Drum, shows the difference pretty clearly. The level of spending on the health care safety net program for the poor veers almost entirely between Obama and Romney. And this ad shows that the Obama campaign has finally decided to make a fight on that point.


The point is that, even if Obama wanted to keep Medicaid spending constant, this would represent a huge difference with Romney. But he actually has signed legislation expanding it. If Medicaid doesn’t come up in the context of the safety net in tomorrow’s town hall-style debate, then somebody isn’t doing their job.

I have a hunch... how many times have I begun with that statement, only to have the rug pulled out from under me... that Obama is ready for this one. We'll know soon.


  1. What Women Voters Want

    1. Enfant, of course I can't speak from personal experience, but among a wide variety of technical professional women I've known over the years, the absolute dividing line between the Republican and Democratic positions is... not abortion... but contraception. A typical woman programmer or software engineer in America has virtually no chance of pursuing a career comparable to a man's if she does not have unfettered access to contraception, and I mean unfettered... no government interference, no church interference, no interference from her husband (if any), none, period. Abortion is essential in its own role, but contraception is the sine qua non of a woman technical professional's career.

      For what it's worth, my very first contract job after I quit working for The Boss was a political database for the entity now known as Planned Parenthood Gulf Coast. It was a labor of love as surely as a source of income. PPGC has grown mightily since those days, and doubtless replaced the software I developed several times, but I still feel a real sense of accomplishment about that contract.

  2. Hugs to you, Steve. I've dealt with both scenarios: nursing home v home. Neither is easy and there is guilt on all sides.

    And you are so right, being able to control one's reproductive process is life changing, which is what the anti-women-birth control-abortion people dislike. Things were simpler when women died in back alleys and hung their heads in collective shame over being pregnant and unwed. Bring back the pretend tv style 50s!

    1. ellroon, I am glad to see you are angry about it... it would be downright inhumane NOT to be angry about it. Yes, I recall your mentioning similar experiences with the elder care dilemma, and it's tough no matter which way you approach it. I'll never forget my father's attempt at home care for my mother: one day, Dad phoned me, almost in tears, and said, "Steve, you can have one parent in an institution, or the other parent in an institution." Of course he was referring to his role as caregiver, and the extreme nature of home care for a person with senile dementia. Past a certain stage of the disease, as you know too well, home care becomes impossible unless you are wealthy, have a huge resident medical staff, have a gigantic home to house them, and a budget to pay them.

      The other thing the Rmoneys of the world seem to be clueless about is this: home care for extremely ill parents (probably kids too) is a life-altering experience from which one never really recovers. My hair turned gray. My confidence in the rightness of the world, our nation, our health care system and every other damned thing I used to believe in, was shattered. People in our situations need affordable, reliable, assured quality health care. They do not need sermons from conservative jerks like Rmoney. Thank you for your kind sympathies; all these decades after the fact, they are still greatly appreciated.

      (BTW, please read my post from early Wednesday morning.)



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