Rich State, Low Poverty, Ranks High In Health Outcomes....Medicaid Expansion is a Trap. - Granite Grok

Rich State, Low Poverty, Ranks High In Health Outcomes….Medicaid Expansion is a Trap.

We are being sold the idea that we need to expand Medicaid in NH.  Why?How to pick pockets- A guide to Governing as a NH Democrat

New Hampshire is historically a very well off state, with the lowest poverty rate in the nation.  We rank in the top five every year for healthiest state while ranking 36th for public health funding.    (Knocks on wooden heads…) That says that public health funding (consistently)  has nothing to do with actual outcomes.

Our poverty rate is well below the national average, recently dropping from 8.8 to as low as 5.6% and currently somewhere in between because of the Democrat’s stagnating economy.  That’s 5-8% of the population in New Hampshire–and that is a determination based on measures  established by people trying to expand the program, so take that with a grain of salt if you like.

So without  going further you’d be right to ask why a well-to-do state, with low poverty, low unemployment, and high health outcomes with low public health funding, would even need to embrace the ugly entanglements of Obama-Care in exchange for a $2.4 Billion dollar bribe.

The answer is “we don’t.”

Just looking at Welfare and Medicaid, we may already be serving more people that have a legitimate need.

Keep in mind that I did not see numbers for SCHIP (Children’s Health entitlements–which I believe is part of Medicaid), and we’re not factoring in Social Security or any other means of support in this instance.  Nor are we attempting to account for other programs or services that may be available so there is still a huge resource of existing dollars and programs to care for those few who are in legitimate need that I have not considered here.

Plus, as a “rich state” we have families that provide help to each other without the need of state or federal aid so there are people who would not need the assistance who might still be technically  eligible based just on income without factoring in any other circumstances.  (Things you are better equipped to address t he state and local level without Federal interference.)

In short, if there is a problem in NH it has nothing to do with the pool of services available.  That means that expanding the pool was never the answer and might actually make things worse.

So where are we?

With a poverty ball-parked at 8% that would put roughly 110,000 people at or near poverty.   In 2010 NH had 168,000 people on Mediciad.   That’s 13% of the population, not 8 percent.  And while I’m willing to admit that the back of the envelope calculations are rough and a bit off, they are not off by a significant enough amount to justify a $2.4 Billion dollar expansion.

Which brings us to the real problem.   If we are somehow not caring for the truly vulnerable in a state like ours (and I mean the truly vulnerable not people whom bureaucrats claim need SCHIP or free lunches even though they make $50- $60,000.00 per year), it is the inefficiency of the bureaucracy, waste, or issues with fraud siphoning off taxpayers dollars that need our attention.

So here’s the big money question.  How do you, as elected officials, justify rewarding that same bureaucracy with a $2.4 billion dollar reward and a budget expansion in perpetuity, one that will inevitably result in higher taxes for New Hampshire to address a manufactured need that does not even appear to exist, when the solution to what New Hampshire really needs, if it can be argued that we need anything at all, is not more money but better management of the money we already have?

Shouldn’t we consider streamlining, auditing, and following up to make sure people on Welfare or Medicaid are not living with a spouse, partner, or family member in some mini-mansion first?  That they are not working under the table and screwing taxpayers in the process?  And while you are at it, should we be paying large pensions for twenty years to people who “retire” and then get good paying jobs on top of their pensions?

Are these not jobs people ‘In need’ might be able to fill?

Is there no scenario where legislators defend Taxpayers from getting stretched on one or both ends of the entitlement rack?

If, by the way, the argument for expanding Medicaid is to “cover people who can no longer insure themselves because Obama-Care made it too costly or made their plan illegal,”  the answer to that problem is  not to raise taxes and take a $2.4 billion dollar bribe.  The answer to that problem is to get rid of ObamaCare in New Hampshire.

We don’t need Medicaid Expansion in NH.  Anyone who tells you otherwise has some other agenda.  One that will inevitably take more money out of your pocket.

Update:  For 2013 we came in 5th.  Why?  Binge drinking and Public health funding, not exactly objective points considering the changing definition of Binge drinking.

  • High prevalence of binge drinking
  • High incidence of pertussis infections
  • Low per capita public health funding

I’m questioning the Pertussis designation on the grounds that the NH DHHS instructed care providers back in 2012 to…”Consider the diagnosis of pertussis in patients with compatible clinical signs,even if they have been vaccinated.”  So if it looks like a duck, and walks like a duck, and David Campbell has not run it down in his BMW…call it in as Pertussis.    Also, cases increased across the entire nation in 2011-2012 but decreased–including in NH–in 2013.

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