Tag: health care reform

The Health Care “Reform” Scam

…and Corporate Ownership of the R&D end

Past Posts to the Issues:

REAL Health Care Reform

Angry Letter to My Blue Dog CongressCritter

Scam of Ages

The Great Unicorn Flu Panic of 2009

Some Herbal Wonders

Every day we’re encouraged and cajoled to call and write our representatives to encourage them to include some sort of public option in their ridiculous sham of a street theater road show deceptively called “Health Care Reform,” long since bought and paid for by the health insurance industry itself. They want us to beg – and we have begged and begged some more – but they’re not going to give us anything. Never intended to, this is just a show. What is planned isn’t any sort of reform at all of a system designed on purpose to kill off those pesky (and too numerous) Baby Boomers as well as all the excess no-longer-employable working class slaves the nation’s banks and brokers no longer need or want, along with sickly citizens of all descriptions. Sooner, not later.

There are some who want to believe the current swine flu epidemic and planned vaccination program is genocide-writ-large, but it’s not. It’s just a bug that got out and deaths from it or its vaccines won’t even be half the annual toll from regular seasonal flu. Which will kill its 30-50 thousand come January/February and nobody will think a thing of it. Instead, what we’ve got is this complete sham of a health care non-debate that is really just another corporate bailout for crooks who don’t need or deserve a single cent of our hard-earned money.

Health Care Reform: Who Will Make the Final Call?

Over one-hundred and seventy-five years ago, an obscure Louisiana senator awaited his time to speak in front of the Senate gallery.  In a few short days, what would have seemed to be a relatively limited debate about the merits of selling public lands in the western states of a still relatively small nation had been transformed into an expended discourse about whether secession from the Union had any legal basis.  The senator in question, Edward Livingston, had listened to a series of variously thrilling, erudite, and eloquent emotional addresses given by the giants of that body in those days.  Each trying to outdo the other, perhaps concerned a tad more for his legacy than specifically for the cause at hand, a highly competitive chamber in the best of times had grown even more charged and partisan.  Livingston had no intention of bettering what anyone had said before, rather his desire was to appeal to a sense of hopefully uniform conscience and fair play.    

The best speakers had already writ their words into if not immortality, at least a place in the history books for several generations.  Daniel Webster’s thundering, inspiring speech imploring for national unity did much to keep together an increasingly fragile peace, but words alone would prove insufficient to prevent Civil War.  Giving birth to generation of brilliant statesman after brilliant statesman would not reconcile the divisions based far more on passions than on more cerebral pursuits.  From this point onward, slavery and states’ rights overshadowed every issue on the agenda, and this singular focus inevitably drew debate back to a raging boil, regardless of how seemingly innocent and harmless was its basis.  

Upon this context, Livingston spoke.

The post of partisanship for partisanship’s sake–of seeing politics as blood sport, where the kill is the only object of the exercise–was, Livingston said, too high for a free society to pay.  Differences of opinion and doctrine and personality were one thing, and such distinctions formed the natural basis of what Livingston called “the necessary and…the legitimate parties existing in all governments.”

Parties were one thing; partisanship was another.  “The spirit of which I speaking,” Livingston said as he argued against zealotry, “…creates imaginary and magnifies real causes of complaint; arrogates to itself every virtue—denies every merit to its opponents; secretly entertains the worst designs…mounts the pulpit, and, in the name of a God of mercy and peace, preaches discord and vengeance; invokes the worst scourges of Heaven, war, pestilence, and famine, as preferable alternatives to party defeat; blind, vindictive, cruel, remorseless, unprincipled, and at last frantic, it communicates its madness to friends as well as to foes; respects nothing, fears nothing.”  

American Lion:  Andrew Jackson in the White House by Jon Meacham.

We have had our allotment of that madness after a long hot summer of discontent, but what has recently calmed down into something like order if not decorum constantly threatens to regenerate into something much more sinister.  Our own weariness and fatigue with this recession may be the only thing that keeps down the thermostat to a tolerable level.  Red state governors and representatives learned that the quickest way to win short-term accolades and the war whoops of the crowd is to obliquely raise the specter of nullification and even withdrawal from the Union, a battle which is long since past us, but still immortalized in the myth of the Great Lost Cause.  Indeed, as a native Southerner, even I was exposed to such a romantic, dashing ideal only present in the psyche of those who win the first half’s worth of play on sheer emotion, but ultimately lose the game in the fourth quarter against fresher legs and superior depth.  This is a very dangerous construct, one shared by Germans and utilized by Hitler for his own ends in advancing a narrative of historical oppression and imaginary enemies that gave unity to many but led to brutal slaughter of many others.  Given half a chance, the masses will always clamor for a re-match.

Livingston at a slightly later date stated,

There is too much at stake to allow pride of passion to influence your decision.  Never for a moment believe that the great body of the citizens of any State or States can deliberately intend to do wrong.  They may, under influence of temporary excitement or misguided opinions, commit mistakes; they may be misled for a time by the suggestions of self-interest; but in a community so enlightened and patriotic as the people of the United States, argument will soon make them sensible of their errors, and when convinced they will be ready to repair them.”

Ibid.



A belief in the inherent decency and rational sense of the American people often reads like empty rhetoric in this day, especially when so much ink gets spilled about how clueless and uninformed are the average citizen.  However, in this instance, modern day Senators and Representatives would be wise to heed the wishes of those whose trust they are the supposed stewards.  Poll after poll has shown a slow, but nonetheless undeniable upward tick in support of Public Option and other reforms.  Legislators, much like we ourselves, seem to be caught in that eternal quandary, pondering whether the commoners can act in their own best interest, or whether it is the unenviable burden of the elites to superimpose their own will in its place.  The paramount lesson to be learned here is that Americans are frequently slow to warm to and inherently suspicious of expansive change, no matter whether or not self-interest is keenly involved.        

Speaking specifically to the months-long debate with ourselves and our government, whichever health care bill is passed may likely include a provision whereby states can opt-out of a means to establish parity among health care providers, and no matter how what blend of incentives or threats of consequences, many GOP-dominated states simply will not follow suit.  The often unsatisfying compromise between centralized power and regional control known as Federalism will often materialize in these situations.  Both perspectives, either for or against are under-girded by a strong sense of distrust of distant bodies and corresponding fear of corruption.  Certain, usually conservative states are fearful of Washington’s seemingly limitless expansive control into their own affairs and even more fearful of Capitol Hill’s perceived incompetence and wasteful behavior.  The destructive power of yahoo moralizing, especially when wedded to a fear of the bumbling, slothful behavior of nameless Federal Government bureaucrats remains a force, particularly in solidly red states.  Those who would keep our union together have no choice but to navigate this rocky course and in so doing cobble together one unsatisfying compromise measure after another.          

Even so, I do believe that much good will stem from reform, whenever it shall arrive on President Obama’s desk, and though the deletion of certain particulars is not exactly to my liking, I will have to grit my teeth and live with the cards I am dealt.  It is foolish to wish for failure in the hopes that dismal outcomes will produce eventual success based on public outcry and this goes for Olympic games, the success of the first African-American President, or health care reform.  Instead I wish for resounding positive results and with it the recognition that there will be an inevitable need to tweak or slightly modify the existing framework with the passage of time.  Perhaps a true public option will arrive with time, once states that refuse to participate recognize the great benefit other states derive from its existence.  We ought to have learned by now that all or nothing thinking isn’t just unfair, it goes against logic itself.  The American people, after years of being talked to like children are being faced with a very adult decision, and unaccustomed to such treatment, do not quite know how to respond.  My hope, as it is always, is that all Americans are invited to the table and in so doing dealt a hand, so as best able to recognize that the political process is frequently a high stakes game of chance and strategy.      

Livingston concluded,

“There are legitimate and effectual means to correct any palpable infraction of our Constitution,” he said, “Let the cry of Constitutional oppression be justly raised within these walls, and it will be heard abroad–it will be examined; the people are intelligent, the people are just, and in time these characteristics must have an effect on their Representatives.”

Ibid.  

May it be so.

Quote Of The Day:

“This is a moment of truth for the Democratic Party. Will we stand for the people or the insurance companies?

We compromised on [a] single payer [health care system] by backing a public option, and now we are being asked to compromise the public option with negotiated rates. In conference, we will likely be asked to compromise negotiated rates with a trigger.

In each and every step of the health care debate, the insurance companies have won. If they get hundreds of billions of dollars in new taxpayer subsidies, they get to raise their premiums, and increase their co-pays and deductibles, while the public is forced to pay for private insurance, then the insurance companies win big.

If this is the best we can do, then it is time to ask ourselves whether the two-party system is truly capable of representing the American people or whether the system has been so compromised by special interests that we can’t even protect the health of our own people.”

                — U.S. Congressman Dennis Kucinich, D-OH

The Parallel Universes of Politics and Popular Sentiment

Politics is one part ballet, two parts theatrical performance, with the same players taking different roles as the latest situation requires.  It is a shifting sort of organic arrangement, whereby that who is one’s ally in the morning can be one’s enemy the next.  The most successful politicians know this instinctively and recognize that this degree of constant posturing and shape-shifting should be attributed to the profession itself, not to the practitioner.  We, however, do not live in such a world of allegiances that shift like tectonic plates.  We do not easily recognize that political pronouncements have a shelf life of roughly three hours time, upon which they are superseded by the latest changing of the wind, or, for that matter, changing of the guard.        

Still, we try to apply the code of conduct and rules of the game that exist in our world of resolute, lasting convictions to that of the politician. This is what leads us to great frustration.  This morning some are criticizing President Obama for not coming down more punitively on Joe Lieberman when he had the chance.  A week ago, Republicans were lashing out at Olympia Snowe for her duplicitous perfidy.  A week before that, Progressives were purple with rage at Senator Max Baucus.  A week from now, a new target will arise, align himself or herself with something we either support or oppose, and the game will begin again.  The process reminds one of nothing less than an endless round of musical chairs.  Those congressional leaders involved in an active tug of war will always reposition themselves on safer ground as need be, while the ones who stand firm are often likely to find themselves without a seat.

In this eternal game of chess,

O O O O that Shakespeherian Rag –

It’s so elegant

So intelligent                                                        

“What shall I do now? What shall I do?”

I shall rush out as I am, and walk the street

“With my hair down, so.  What shall we do to-morrow?

“What shall we ever do?”

– T.S. Eliot

Observe the ballet, though the steps may be a bit quicker, the pace may be sterner, and the tempo deliberately accelerated.  As regards politics, in which there is always something tangible to gain or to lose, I only believe in the last statement made by whomever utters it.  This would be considered exceptionally pessimistic in the real world, but makes complete sense within the realm of political discourse.  Lament it if you will, but even a charismatic figure elected to shake up Washington and a largely underwhelming speaker could not betwixt the two of them figure out how to drain the swamp.  It takes more than legislation to undo a complex, frequently befuddling system of strange allegiances and stranger bed fellows.  The skillful politician is a master of both slight of hand and cerebral dexterity.  He or she rarely gets caught in a lie or a half-truth, while the less skilled end up without a chair when the music ends.  The results when tabulated might be half chance, like everyone’s else’s, but they are always composed of calculated risk, with the hope of ultimate profit and gain.              

We may have a rough idea of the relative platform our Senator or Congressperson stands upon, but beyond that, one needs an actuarial table to correctly calculate where he or she might go from one moment to the next.  Risk assessment doesn’t just stop with insurance and rare is the incumbent who can count on an easy re-election campaign, year in and year out.  If we were all more or less the same in allegiance and conviction, then politicians could be reliably counted on to talk out of only one side of their mouth.  Until then, we are stuck with the system we have, which satisfies few and enrages many.    

To better explain my case, I sought to divine what was the historically highest possible Congressional approval rating ever recorded.  While I certainly was inundated with sources which told me what the lowest approval rating for the both chambers had been at many points in time, attaining its compliment, however, provided elusive.  In the data I did find, Congress never polled above 45%, which means that if it as a collective body ran for office, it would never win and probably never even trigger a runoff.  This fact also underscores what a convenient target the legislative branch is for many of us, but also proves that its overall popularity is pointedly meaningless unless it drops to single, or near single digit lows.  By contrast, even the least popular Presidents in modern memory still managed to poll slightly above 20% in their lowest periods and some scored nearly 80% in their times of highest popular favor.  As Americans, we favor personalities over collective bodies, perhaps because we can relate more to a individual rather than a frequently flummoxing deliberative entity whose ways are misunderstood even by the highly educated.    

Returning to the matter of effective analysis, the most skillful strategies for determining future courses of action might be found within the brains of those who think three and four moves ahead while recognizing that events are always subject to change.  This is not to imply that some method to the madness exists, either.  Best intentions are often preempted by breaking news and any schedule ought to be penciled in, rather than chiseled into granite.  Those public servants who are caught flat-footed or utterly unawares are always the easiest targets for ire and criticism.  They also tend to not survive.  That who we have in our cross-hairs today will often be our firmest unforeseen ally with time.  As for the present moment, which is all we are ever granted in politics, the once and future Health Care Reform proponent assumes a temporary position in our affections and our current antagonist draws boos and jeers.  The Public Option is dead, long live the Public Option.  This is, of course, until the funeral is called off and the coronation resumes, once more.

The Amazing About-Face of Orrin Hatch — Mr Entitlements

Back in August, barely 2 months ago, Senator Hatch (R-UT), displayed a graciousness and a spirit of bipartisanship, rarely seen among the Party of NO.

Senator Orrin Hatch on Ted Kennedy’s Life

The Situation Room — Aug 26, 2009

BLITZER: […] the issue that was the most important to him, health care for the American people, you were — you’re a member of the Finance Committee. […] And since this was so important to your good friend, Senator Kennedy, I’ll ask you directly, Senator Hatch — are you willing to get back into those negotiations with the Democrats right now in memory — in honor of Senator Kennedy?

You know how important health care reform was for your friend.

ORRIN HATCH: …

No We Can’t: Obama sabotages Harry Reid’s PO efforts

President Obama and his staff (Rahm Emanuel) are actively undermining Senator Harry Reid’s efforts to get a Public Option through the Senate, with the opt-out provision, and instead favor the Insurance Company blessed “triggercharade that has been championed by Republican Senator Olympia Snow.

A sitting U. S. President has enormous power to influence wavering Senators on close bills, and keep unity within the Party on important goals. But Obama is not only sitting by passively and refusing to get behind Harry Reid’s effort, he is actually now scoffing at it, and projecting that Reid’s effort can’t work (i.e. sabotaging the momentum) while refusing to lend any proactive help to make it succeed.


NBC News reported that Obama administration officials called Reid’s decision to go ahead with an opt-out public option “dangerous.”

The administration basically told Reid, “You’re the vote counter. But don’t come crying to us when you need that last vote,” Chuck Todd said on MSNBC.

Obama privately discouraged Senate Democrats from pursuing the opt-out plan. “Everybody knows we’re close enough that these guys could be rolled. They just don’t want to do it” a senior Democratic source told the Huffington Post, saying that Obama is worried about the political fate of Blue Dogs and conservative Senate Democrats. “These last couple folks, they could get them if Obama leaned on them.”

Link:

Common Sense Health Care; Individualism or the Commonweal

CmmnSns

copyright © 2009 Betsy L. Angert.  BeThink.org

Democrats dance in the streets and declare success.  An ABC News-Washington Post poll released on October 18, 2009, found that only twenty percent of the population defines themselves Republican.  Progressive assert this result will work in the their favor if the public option is to pass.  However, the now ecstatic portion of the electorate discounts the “disconnect” discussed in the aforementioned study and also addressed in a Pew Research Center report published only a week earlier.  The overjoyed overlooked the Independents (42%), the leaner’s, Left and Right (39%), and the less than inspirational number who proclaim themselves proud Democrats (33%).   For these individuals, the topic of health care reform is a complex issue.  Trust in Congress is near nil.  People are engaged in the subject, albeit a bit overwhelmed.  Sixty-six percent (66%) say they do not understand the proposed policies.  Personal matters move most people, more so than Party politics does.  Possibly, that is the problem, or the predicament that precludes authentic medical insurance reform in America.

Daring to Dance to No One’s Funeral

Taking the time to contemplate the vast amount of right-wing smears that have been either facilitated, advanced, or concocted by conservatives over the past several months is an overwhelming task.  Within each of these petty, partisan, often nonsensical parries and thrusts I am reminded again of the excesses of the Pharisees.  Wishing to have everything on their own terms and in accordance with every selfish demand, modern day Pharisees are found not merely in the opposition party, but regrettably sometimes among our own ranks, particularly in the form of people who fail to neither understand nor respect the vast amount of indignation felt when crucial reform legislation is watered down or vaguely outlined due to nothing more than political expediency and self-preservation.  If this sort of thing was limited to politicians, it might be more easily challenged, but one sees it everywhere.  Most recently, those well-connected business types who long ago lost their souls in selling the whole world are also guilty as charged.

       

What Are We Gonna Do?

What are we gonna do when  we don’t get true health care reform/out of Iraq and Afghanistan/torture investigations/financial reform/job creation/restored civil liberties/audit of the Fed/repeal of the Patriot Act?   I voted for Obama, admittedly getting a bit caught up in the whole spectacle.  But the reasons I disliked Bush and his cohorts, are the same reasons I am exasperated with Obama and his cohorts.   We aren’t getting any change.  Spare change maybe, but not change “you can believe in”.  As it’s going, Obama will go down in history as the most dishonest President we’ve ever had.  Much like Bush trying to make colonizing through occupation and torture legal, Obama has transformed the “chicken in every pot” political promising propaganda to a whole new level.  

I’ve thought since shortly after the election we wouldn’t get torture investigations.  We won’t “leave” Iraq by 2011.  We won’t get out of Afghanistan and in fact will escalate there and in Pakistan.  We won’t get single payer, which turned out to be a major understatement.  We won’t get financial reform as evidenced by the casinos open for business bonuses and financial gains made by the banks and Wall Street.   We won’t “recover” from this financial catastrophe because there is no plan for creating the millions of jobs that have been lost.  

Why have I been thinking that?  I’m like a jack of all trades, master of none.  I’m not an expert in geopolitics, realpolitik, or the machinations of the political system in the halls of Congress and the Senate.   But I’ve read stuff man.  Lots of stuff.  Stuff written by the experts.  Isn’t that how one learns?  Certainly contrarian views from the MSM and the Obamabots, but stuff that I believe speaks the truth.  Stuff from Antiwar.com, Counterpunch, Common Dreams, Real News Network, Truthdig, Salon, Asia Times, and on and on.  

Progressives complain about the MSM and the lack of true reporting.  Well, there is true reporting going on and it is coming from people who have spent the better parts of lives studying, analyzing and living the issues.  These are people that take honest looks at the serious issues regardless of what political party or administration is in charge.  They are consistent and look at the facts, not the promises from the speechmaker.    

Health care reform, not an insurance company bailout

Yesterday, the U.S. Senate Finance Committee passed the Baucus health care bill.  

What a disappointment. No public health insurance plan. No universal coverage. No real price controls. Billions of taxpayer dollars for insurance companies.

Tell your members of Congress to support the best and simplest reform plan: Medicare for all.

After you take action, please help build the momentum for real health reform by telling 5 friends.

The U.S. health system has left 46 million Americans uninsured. [1]  45,000 people die every year due to lack of insurance. [2]  Insurance companies deny coverage to thousands more when they actually get sick. And insurance is simply too expensive for millions of people and businesses.

The Baucus bill solves none of those problems.  

By contrast, Medicare is so efficient that it could insure all Americans for the same amount of money that we now give to private corporations. [3]

Under such a single-payer system, you still get to choose your doctor… except without a profiteering insurance corporation standing between you and your health care.

Will you ask Congress to support real reform — in terms they can understand?

Yes! I’ll tell my members of Congress that I won’t support them unless they support Medicare for all.

Notes:

(1)  “Income, poverty and health insurance coverage in the United States: 2008.”  Census Bureau, September 10, 2009.

(2)  “Harvard study finds nearly 45,000 excess deaths annually linked to lack of health coverage.” Physicians for a National Health Program, September 18, 2009.

(3)  “Single payer system cost?” Physicians for a National Health Program.  

Olbermann’s call to Action: a Photo Essay

Hopefully you saw Keith Olbermann’s Special Comment on the sorry state of the Health Insurance System in American.  And hopefully, you were moved to action, like I was.  There’s still time to pony up, if it slipped your mind.  Let’s give Keith some ammo when he resumes the fight next week.

DONATE HERE: National Association of Free Clinics

as linked on Countdown’s home page

Time is a task-master, that waits for no one,

We can only heed its call, as it marches, inexorably forward …

Hopefully we will find compassion, as we turn its pages.

If you missed the Special Comment, read on for some of the highlights …

Medicaid is No Public Option

The news broke late yesterday afternoon that the Senate Finance Committee sought to broker a compromise measure regarding the Public Option.  Giving each individual state a choice of whether or not to provide a public option appeals to fiscal conservatives and red state legislators whose most coherent reservation regarding health care reform is a concern over cost.  Still, these kind of messy federal/state mandates reinforce substantial inequality.  A Medicaid-style measure like this would mean that those who lived in most well-funded blue states would have superior health care coverage, while those who lived in most, if not all red states would have their health care costs still largely dictated by private carriers, many of which hold near-monopolies in individual states.  If the aim of reform is to level the playing field for every American, this falls well short of the stated objective.  

Today’s Politico contains a brief, but noteworthy column written by Ben Smith, which underscores the controversy regarding Medicaid reform.  


The Medicaid expansion would, in a stroke, add 11 million people to the program’s ranks by raising the income cap, and one key negotiating point at the moment is the share of that cost the federal government will pick up.

The income cap, however, is only one facet to increasing eligibility.  Many states, particularly red states, do not extend coverage to single adults at all, no matter how dire their need.  Coverage is often provided only to adults with children and sometimes Medicaid coverage is granted to children only, leaving their parents with nothing.  As a result of this, many adults are forced to file for SSI disability to obtain Medicaid coverage, since doing on is the only means by which they might attain any health care coverage at all.  However, this removes individuals from the workforce, reduces tax dollars paid into the tax system as condition of employment, and places a drain upon the never-ample General Fund out of which all Medicaid expenses are paid.  Removing these strict qualifying factors might costs more in the short term, but the long term consequences are much more detrimental.  Someone pays the cost when a person goes bankrupt from enormous medical bills or visits the Emergency Room without insurance, having no means to pay at all.  Still, to simplify this unnecessarily as another annoying example of the red state/blue state divide would not be a fair telling of the truth.    

Republican governors haven’t been the only ones raising doubts.

Tennessee Democratic Gov. Phil Bredesen has been an outspoken foe of the plan, and a senior Republican aide notes that two more left-leaning Democrats are also raising complaints.  According to the Columbus Dispatch, Ohio Gov. Ted Strickland “warned on a recent visit to Washington that the ‘the states with our financial challenges right now, are not in a position to accept additional Medicaid responsibilities.’

“Strickland said that he wants a health care package that is inclusive and provides for all citizens’, but he adds that if Medicaid is expanded, he hopes to see the Federal Government assume the greater portion of the costs, if not the total costs.'”

And New Hampshire Gov. John Lynch last week refused to sign a letter than other Democratic governors sent to congressional leaders urging passage of a health care bill this year, because it failed to “address concerns regarding potential cost shifting to the states,” according to a spokesman for the governor quoted by the media.

States do have to adhere to balanced budgets and in times of economic famine like these cannot resort to deficit spending.  However, budget priorities are often disproportionately skewed away from social services and relegated to other matters, which are just as wasteful, if not more so than any pork barrel project pushed by a House or Senate member.  Before Republicans and Democrats criticize Washington for its excesses or its financial demands, they would be wise to start first in their own backyards.  Citing specific instances of pork barrel projects is a rhetoric device which borders on cliche, so I will spare you another retelling of it.  Needless to say, room could be made even in a much reduced year of tax revenue.  The obscene amount of tax breaks and concessions made to foreign automakers in order to entice them to build auto manufacturing plants is a good place to start.  Those states who have never made an attempt to reform their image as little more than an endless supply of cheap labor have shortchanged themselves in ways they seem incapable of comprehending.      

A more streamlined approach would, in my opinion, be best.  Each state sets its own criteria regarding Medicaid in accordance to how the program was set up in the 1960’s and I have no doubt that similarly messy compromises would likely typify the efforts the states willing to institute a public option.  Most red states would opt out altogether, of course.  I will note that a complete reliance on the superior wisdom and judgment of the Federal Government might be naive, but I have rarely seen any state government be more efficient.  What I have seen is a multitude of red states whose efficiency and collective wisdom resembles a Banana Republic combined with a slap-stick comedy routine.  That they are the ones who are so quick to  shoot barbs at Washington, DC, strikes me as biting the hand that feeds you.  Many of these states would have nothing if it hadn’t been for the generosity of Capitol Hill and many of their universities would find themselves without needed funding if they couldn’t achieve Federal Government grants.  So it is here that I’m afraid I can’t muster much sympathy for those Governors who rarely pay more than ten percent of the cost of Medicaid anyway.  The real lesson to be learned here is that long-term gain is much more important than the facade of short-term cost reduction.  

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