Bargaining with Ourselves on Healthcare

Health Care
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     New Orleans      These are the tough choices.  Hobson’s choices.  Devil or the deep blue sea choices.  Sacrificing one to save the many, or risking that all die.  To read the daily papers is to find the Democrats in their thin majorities now having to bargain with themselves, libs to mods to worse, on who gets to ride in the healthcare lifeboat to keep the Titanic $3.5 trillion infrastructure and budget reconciliation bill afloat.

I found this dilemma particularly poignant living in the South.  So-called moderates reportedly arguing that the best use of the money in the bill would be to extend coverage to Medicaid to the dozen-odd states where recalcitrant Republican governors and legislators have blocked Affordable Care Act expansion.  Most of those states are now in the South and the West.  These are places that I call home, and where I was raised.  I can see and feel this pain almost on the daily.

On the other hand, liberals led by Senator Bernie Sanders, are arguing that it is more important to extend the package of benefits available in Medicare and the elderly throughout the country.  This would be done by adding coverage for dental and vision, which are not covered currently.  Being old as dirt now, I can tell my comrades and any young pups out there listening, that stuff doesn’t last.  Teeth are bones.  It turns out they wear down and out.  You either walk around with your tongue constantly cleaning out the spaces or saddle up to pay thousands upon thousands.  Eyes, much the same.  Medicare and insurance pay part of cataract surgery, not all by a longshot.  I confronted both of these twin terrors in the 2020 pandemic year, saying to myself, essentially, what the hell, I’m not traveling, better do some repair work.  Laser surgery for cataracts was a life changer.  For the first time in thirty years, I was able to put the glasses down.  Doctor claims it’s a lifetime thing, but even if he’s lying, I can tell you I feel like a character in one of those Grade B movies where I can stand up and yell, “I can see!”  It wonderful to read easily, to see the fine print, and pick out the stars in the night.

Choices have to be made, so eeny meeny miny mo, which way do we go?

            My first kneejerk reaction had been, “Go with the home folks!” and extend Medicaid for lower income families, but the more I think about it, the more I’m edging towards the Sanders’ position.  Unfortunately, I’m still not comfortable with either choice.

            Red state after red state, including Missouri, Oklahoma, and others have voted whenever they get the chance to expand Medicaid.  In my head, I think it’s just a matter of time before the people in every state rise up and demand expansion.  Tactically, adding benefits, on the other hand, like vision and dental, could be permanent, and once there, history indicates that no politician is stupid enough to take a benefit away, once given.  My misgiving though is being confronted for some untold number of years with the death count and callousness of so many red state Republican politicians who are willing to endure a needless body count for an ideological position.  We see that with masks and vaccines now. 

            I’m going to stick with vision and dental, but I have to honestly admit that I’m not a hard yes, but a soft maybe.  I don’t like bargaining with myself.  I want them both, and would prefer we look at skinning this cat another way.