“The problem,” says Texas Senator John Cornyn,” is that Medicaid is a fundamentally broken program that is failing our neediest citizens.” This is the “Conservative Lament,” and it describes the State of Texas perfectly, Senator Cornyn. This is the state that leads the nation in percentage of citizens without health insurance and percentage of students dropping out of high school. The state has hovered in the bottom ten percent in these categories for a decade and finally bottomed out.
Broken programs is what we’ve got, Senator, and our best alternative is to get the most out of broken programs until they improve. But for the citizens of Texas, it’s better to reject any help for its neediest, than accept help that could be inefficiently delivered. The “Conservative Lament,” verse two.
Michigan, ruled by a Republican governor and Republican legislating bodies, expanded Medicaid with the opportunity provided by the Affordable Care Act. Not everything we do in Michigan makes me proud, but this does. My mother spent four years of her life on Medicaid, although she came off it in her final year, because she received a modest inheritance from her deceased sister. We didn’t complain or dodge our responsibilities, when her bank balance exceeded $2,000. We paid her nursing home expenses until she died a year ago.
Mom was under the misapprehension that her Medicaid was a Veteran’s benefit from her World War II service. “I served my country, and now they serve me,” she liked to say. It was beyond her imagination to think that her country would care for her medical needs, merely because she couldn’t. Apparently it is beyond the public imagination in Texas as well.
The protest that we should not care for the poor and uneducated, because our system is broken is a sham to shirk responsibility. You don’t want to help the needy, because it might cost you and yours something to do it, Senator Cornyn. How the righteous right gets away with this dodge in Texas or in the other twenty-odd states that rejected Medicaid expansion is beyond me. The thought that one or two families might scam the Medicaid system keeps some people up at night. In the daytime, they vote against helping the other 98% who need medical care.
The United States is home to many such “broken” programs: the Internal Revenue system, the Securities and Exchange Commission, the Electoral College, the college admissions system, all are flawed shamefully. But we work with them until a better system displaces them. And each of these systems undergoes constant scrutiny and criticism. We understand that the “perfect” should not be the enemy of the “good.”
No U.S. Senator could possibly miss that point. Even you, Senator Cornyn. God help you and your constituents if the Securities and Exchange Commission ever gets its act together. Then you’ll see some real welfare reform. Then we’ll hear the “Conservative Lament” in a new key.