This is an archived article that was published on sltrib.com in 2011, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
The poor we will always have with us. And in times of deep economic trouble, such as the recent Bush Recession, they are even more with us than usual.
Yet Utah's senior U.S. senator has this notion that, when times are tough, one thing that government ought to do is cut back on the humanitarian safety net it provides. This idea, which Sen. Orrin Hatch has formally proposed as an amendment to the Affordable Care Act, has the whole notion of what government is for exactly backward.
Government is different than business. In slow times, when people are short on cash and more careful about where they spend it, businesses often have to shrink. They do this primarily in response to a basic market signal: They have fewer customers. And those who remain may find they don't need to buy as much as they did before.
In slow times, when people are short on cash and don't have enough to spend on the necessities of life, from food to health care, government often has to grow. It does this merely in response to a basic market signal: It has more customers. And they may tend to be in much greater need than they ever imagined they would be.
The stimulus package that helped the American economy pull out of the nosedive that was the last recession did so by pulling at many different levers. One of those was a boost in federal funding for the federal-state Medicaid program, the one that provides medical care for the poor.
Hatch's bill, which carries on the pretense that the stimulus package was a waste of money, would allow states to cut back on the benefits their Medicaid programs offer as a way to trim their budgets. This is something the Affordable Care Act specifically prohibits, as it provides a migration of more people into those programs.
Hatch is totally correct when he notes that Medicaid is a huge burden on the states, and stands to get bigger, Affordable Care Act or not, as medical costs continue their upward spiral.
The key, though, is not to cut more of the least of these out of the programs, but to get tough with health care providers, drug companies and others and push them to provide medical services, no matter who pays for them, in more intelligent, less costly, ways.
Utah's Legislature has already approved a program that would seek to cut Medicaid costs, but through more intelligent purchases of health care services, not just by less humane rules for who will be covered.
That scientific method, not Hatch's blunderbuss approach, should be the focus of health care from now on.