RE: medicaid means testing ...

From: John Wallace <JWallace@karta.com>
Subject: RE: medicaid means testing ...
Date: Sat, 11 Jul 1998 14:53:55 -0500

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Paul Michael Brown wrote: 
>
>I respectfully disagree with Mr. Timken's attempt to distinguish
>Medicaid from welfare.  Both Medicaid and welfare are what policy
>wonks call "means-tested entitlements."  Means-testing is just a fancy
>way to say that you are not "entitled" to these payments unless you
>are "indigent" or "needy" as defined by the eligibility rules. As Mr. 
>Timken concedes, the Medicaid program pays some of the medical
>expenses for people who are indigent. And as Mr. Timken notes, the
>Medicaid program is financed by taxes collected from people who
>generally do not qualify for Medicaid payments. Other forms of what we
>call "welfare" (AFDC, food stamps, Section 8, etc.) operate on exactly
>the same principle. Taxes are collected from non-indigent folks and
>payments are made to indigent people. Granted, there are minor
>differences in the financial details (the use of trust funds, for
>one). But in the end, Medicaid is a means-tested entitlement, just
>like any other form of welfare.
> <<SNIP>> 
>First, let's debunk the "I paid into the system argument" that's so
>common in the debate over the intergenerational transfer of wealth via
>Medicare, Social Security and Medicaid. The taxes that Mr. Timken's
>mother paid during her working lifetime do not even begin to pay for
>the benefits that she will collect from Medicaid. So it's a myth that
>her Medicaid benefits represent some "return" of "what she paid in."
>(Albeit a myth many folks cling to because it reduces the "welfare"
>stigma that might otherwise attach to receiving payments from Social
>Security, Medicare and Medicaid.)
>
>The difference between the trivial amount of taxes she paid and the
>money she collects from Medicaid comes from the rest of us. This is
>where the public policy debate comes in. If Mr. Timken's mother is
>*truly* indigent, most people would not mind paying taxes to fund her
>Medicaid payments. On the other hand, most people would, I think, be
>less willing to pay taxes which are then used to pay for Mrs. 
>Timken's medical care when the net result is to increase the amount
>inherited by Mrs. Timken's heirs. Put crudely, we don't like people
>who scam the system and play us for suckers.
>
> <<SNIP>>
>
>------------- REPLY SEPARATOR --------------------------
>
>   (I missed the first round of this discussion, so I hope my $0.02 worth is
>not duplicating anything that was said previously.) 
>
>I would take issue with the statement that there is no fundamental difference
>between Medicaid/Social Security on the one hand  vs. AFDC/Food Stamps, etc.
>on the other hand. In conventional welfare (AFDC, etc.) the government takes
>wealth from the rich & the middle class, and gives it to the poor. Reasonable
>people can disagree as to whether playing Robin Hood is a legitimate function
>of government. They can also disagree as to whether receiving handouts is
>really in the longterm best interest of the poor; but at least the system is
>"honest" (i.e. the givers know that they are losing wealth & the receivers
>know that they are receiving) and the system is "stable" (i.e. barring some
>totally unforseeable catastrophe, the ratio of payers to payees is likely to
>remain reasonably constant over time.)
>
>Medicaid / Social Security on the other hand is an INHERENTLY unstable
>pyramid scheme. It can only survive in its present form as long as the pool
>of taxpayers is expanding at least as rapidly as the pool of retirees. Now,
>you & I & most of the people on this list, who are better educated & more
>financially sophisticated than the average person, have probably known for a
>long time that our Social Security payments are just another tax, like any
>other; but the average citizen is just now dimly beginning to realize this. 
>
>So I say that the "... people who scam the system and play us for suckers."
>are the politicians who have been deliberately lying to the public for all
>these years, rather than Mr. Timken & his mother who are simply trying to
>grab as much as the law allows from a rapidly shrinking pie (in the sky).
>People cling to the "I paid into the system argument" not to reduce any
>"welfare stigma" but rather because this is the Big Lie that their "leaders"
>have been telling them since day one.     
>  



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