Tag: Albany

One of the reasons New York spends more on Medicaid is because the health care industry uses its political power to charge more, the subject of my prior post. A second reason is it charges for services it does not actually deliver – Medicaid fraud. A third reason is that New York provides more Medicaid services for recipients than do other states. And as I wrote here, the beneficiaries of most of those additional services are the elderly.

Today’s American elderly are the best off people, with the easiest lives, in history – unless one counts slave-owners. Tomorrow’s elderly, those born after 1955 or so, will not be as fortunate. Entering the labor force after social security taxes were raised, on the wrong end of multi-tier labor contracts, without defined benefit pensions and perhaps, when they reach their 50s, losing health insurance as well, and with limited savings, today’s young and middle-aged will reach old age as social security funds begin to run dry and the debts run up by their predecessors must be paid. We will have to work until no longer able, and will then face poverty. The poverty rate of the elderly, much lower than that of children in recent decades, is likely to explode – unless the seniors use their political clout to tax their own children into poverty, or to wipe out public education, or otherwise do unto their offspring what was done to them.

One of the reasons New York spends more on Medicaid is because the health care industry uses its political power to charge more, the subject of my prior post. A second reason is it charges for services it does not actually deliver – Medicaid fraud. A third reason is that New York provides more Medicaid services for recipients than do other states. And as I wrote here, the beneficiaries of most of those additional services are the elderly.

Today’s American elderly are the best off people, with the easiest lives, in history – unless one counts slave-owners. Tomorrow’s elderly, those born after 1955 or so, will not be as fortunate. Entering the labor force after social security taxes were raised, on the wrong end of multi-tier labor contracts, without defined benefit pensions and perhaps, when they reach their 50s, losing health insurance as well, and with limited savings, today’s young and middle-aged will reach old age as social security funds begin to run dry and the debts run up by their predecessors must be paid. We will have to work until no longer able, and will then face poverty. The poverty rate of the elderly, much lower than that of children in recent decades, is likely to explode – unless the seniors use their political clout to tax their own children into poverty, or to wipe out public education, or otherwise do unto their offspring what was done to them.

One of the reasons New York spends more on Medicaid is because the health care industry uses its political power to charge more, the subject of my prior post. A second reason is it charges for services it does not actually deliver – Medicaid fraud. A third reason is that New York provides more Medicaid services for recipients than do other states. And as I wrote here, the beneficiaries of most of those additional services are the elderly.

Today’s American elderly are the best off people, with the easiest lives, in history – unless one counts slave-owners. Tomorrow’s elderly, those born after 1955 or so, will not be as fortunate. Entering the labor force after social security taxes were raised, on the wrong end of multi-tier labor contracts, without defined benefit pensions and perhaps, when they reach their 50s, losing health insurance as well, and with limited savings, today’s young and middle-aged will reach old age as social security funds begin to run dry and the debts run up by their predecessors must be paid. We will have to work until no longer able, and will then face poverty. The poverty rate of the elderly, much lower than that of children in recent decades, is likely to explode – unless the seniors use their political clout to tax their own children into poverty, or to wipe out public education, or otherwise do unto their offspring what was done to them.

What I would do about Medicaid is not what I would do about health care.  In my view, because those in need of expensive care, and those who do not want to pay for them, are free to move across state borders, health care is a national problem with a national solution (see here).

Any state that attempts to provide universal care for its residents will end up providing universal care for all Americans – until its economy collapses and it provides nothing to anyone.  With regard to Medicaid, my goal is to avoid having the health care industry – with its political power and indifference to the consequences of its increasing demands – from destroying other public services and the economy of the state.  Medicaid, for me, is a fiscal issue, not a health care issue, and my goal is to continue to get necessary health care without paying twice as much as everyone else.  That is different from the current fiscal goal – to pay as much as possible in for as little as possible in exchange for political support.  The current situation is a product of incentives – the state government gets to hand out money to its supporters, but other governments are forced to pay much of the cost and impose much of the sacrifice.  My proposal is to change the incentives.

What I would do about Medicaid is not what I would do about health care.  In my view, because those in need of expensive care, and those who do not want to pay for them, are free to move across state borders, health care is a national problem with a national solution (see here).

Any state that attempts to provide universal care for its residents will end up providing universal care for all Americans – until its economy collapses and it provides nothing to anyone.  With regard to Medicaid, my goal is to avoid having the health care industry – with its political power and indifference to the consequences of its increasing demands – from destroying other public services and the economy of the state.  Medicaid, for me, is a fiscal issue, not a health care issue, and my goal is to continue to get necessary health care without paying twice as much as everyone else.  That is different from the current fiscal goal – to pay as much as possible in for as little as possible in exchange for political support.  The current situation is a product of incentives – the state government gets to hand out money to its supporters, but other governments are forced to pay much of the cost and impose much of the sacrifice.  My proposal is to change the incentives.

What I would do about Medicaid is not what I would do about health care.  In my view, because those in need of expensive care, and those who do not want to pay for them, are free to move across state borders, health care is a national problem with a national solution (see here).

Any state that attempts to provide universal care for its residents will end up providing universal care for all Americans – until its economy collapses and it provides nothing to anyone.  With regard to Medicaid, my goal is to avoid having the health care industry – with its political power and indifference to the consequences of its increasing demands – from destroying other public services and the economy of the state.  Medicaid, for me, is a fiscal issue, not a health care issue, and my goal is to continue to get necessary health care without paying twice as much as everyone else.  That is different from the current fiscal goal – to pay as much as possible in for as little as possible in exchange for political support.  The current situation is a product of incentives – the state government gets to hand out money to its supporters, but other governments are forced to pay much of the cost and impose much of the sacrifice.  My proposal is to change the incentives.

Since I’ve been asked to write for this blog, I’ve delivered a litany of (primarily) fiscal complaint, a series of objections to the ongoing and expanding advantages grabbed by powerful interests in Albany (and elsewhere) at the expense of the private sector working poor, the young, the future, and New York City’s children.  But I try not to make complaints unless I have what I believe are at least partial solutions.  So for state government, and for the month of October, I’m going to provide some.

They won’t make many people on the inside happy.

Since I’ve been asked to write for this blog, I’ve delivered a litany of (primarily) fiscal complaint, a series of objections to the ongoing and expanding advantages grabbed by powerful interests in Albany (and elsewhere) at the expense of the private sector working poor, the young, the future, and New York City’s children.  But I try not to make complaints unless I have what I believe are at least partial solutions.  So for state government, and for the month of October, I’m going to provide some.

They won’t make many people on the inside happy.

Since I’ve been asked to write for this blog, I’ve delivered a litany of (primarily) fiscal complaint, a series of objections to the ongoing and expanding advantages grabbed by powerful interests in Albany (and elsewhere) at the expense of the private sector working poor, the young, the future, and New York City’s children.  But I try not to make complaints unless I have what I believe are at least partial solutions.  So for state government, and for the month of October, I’m going to provide some.

They won’t make many people on the inside happy.

I once heard Tom Seaver, providing color commentary on a baseball game, describe some advice a pitching coach had once given him. “What’s the best pitch in baseball?” the coach asked. “The fastball,” he said. “What’s the second best pitch in baseball?” he asked again. “The fastball,” he once again answered his own question. His point, Seaver said, was not to forget the fastball. Major league pitchers know they need a good second pitch to succeed, so often they focus on their off-speed pitch, whether a curve, slider or change-up, to the exclusion or near exclusion of the fastball. And that’s a mistake, because it’s the fastball that makes the whole thing work.