Economist Aaron Carroll compares the current Republican doomsaying about the Medicaid expansion with reactions to Medicaid’s debut in the 1960s and finds that not much has changed. Back then, conservatives were convinced that Medicaid would bankrupt the nation and health care providers would abandon the program in droves. Sound familiar?
He concludes:
It’s easy to scream that the sky is falling. Remember when Ronald Reagan told us that Medicare was the death of freedom? At some point, though, you have to look around and realize that things just ain’t that bad. We’ve heard these arguments before. They didn’t come to pass. States have all embraced Medicaid. The feds never broke the bargain. Docs made a fortune in the 80′s. There are more medical school applicants than ever before. At some point, we have to stop giving these arguments so much weight.
Obamacare will not be perfect. Neither will the Medicaid expansion. We’ll need to fix them. But neither will bring about the end of the republic, just as no health care reform in any other country resulted in the end of democracy itself.
All of these quotations were from 40-50 years ago. Not only is Medicaid thriving, but just last year, the Supreme Court decided it was so “apple pie” that threatening to take the program away was coercive. I think it’s more likely that’s how we’ll think about the ACA 40-50 years from now, than that any of the doomsday scenarios will come to pass.
Since I started working on this stuff a few years ago and discussed it with friends and acquaintances, I’ve been made acutely aware of just how brief our collective memory is. We recycle the same arguments and the same fears about health care reform every couple decades. Those arguments will probably continue long after the ACA is implemented, but at least more people will have better access to health care.
