Texas : It is a far wiser strategy for proponents of Medicaid Expansion to let the pressure from local hospitals and providers grow and wait to see what happens. Let Governor Rick Perry spend some time in the pressure cooker

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Paul Burka in his excellent articles about "The High cost of Ideology" tells us how to manage the conflict between what is reasonable and intelligent for Texas and the Great power and pride of Governor Rick Perry.

My Comment : The big winners of Medicaid Expansion in Texas would be South Texas and Hispanics that are largely uninsured. This is a big political factor for the Future, Perry's stubbornness and Obstinacy may favor the Democratic Party with these voters in future elections.

Texas Monthly
The Politics of Medicaid Expansion
by Paul Burka
March 13, 2013 6:28 pm


The Politics of Medicaid Expansion


Some excerpts :

 Is it better to turn down federal funds and to dump the cost of health care for the uninsured on hospital emergency rooms and ultimately on local-property taxpayers? Make no mistake about it: The health care costs of the uninsured in Texas are a hidden tax on property. Property taxpayers have to make up the difference in the health care costs of the uninsured, or see local taxes go up. I grant you that there is a cost to accepting federal funds. The cost is in the loss of control over health care policy in this state. But, let's face it, health care policy in this state stinks. We have great hospitals, great research, and lousy government. I'd rather put the money  in the hands of the people who deliver the services than in the hands of the politicians. I suspect this is what Straus thinks too. Forget the ideology. Show me the money.

I fear that Texas is going to let a great opportunity slip through its fingers. State officials, including Straus, appear to insist on a "Texas-centric solution" before they will touch filthy lucre. Unless Straus's powers of persuasion are superhuman, it isn't going to work. Medicaid is an entitlement program. If state officials insist upon co-pays, deductibles, and other devices that are incompatible with the concept of an entitlement program, the state is going to pick up its marbles and say no, as it has done in the past. Unless things change, the best we can hope for is to squeeze out some dollars that can be used to obtain insurance for the uninsured. Very few things would be more helpful for business—and taxpayers—in this state.

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