Press "Enter" to skip to content

Posts published in “Day: February 27, 2025”

Little apples

Little apples

February 27, 2025

It appears Representative Jordan Redman has given up on his Idaho Medicaid Expansion repeal bill, HB 138. It barely passed the House and was headed to stormy waters in the Senate. You have to ask, why does this effort to get people off health insurance keep coming up?

So there’s another shot out of the cannon, HB 328. It’s complicated.

Sorry about all the details here, but it is worth your consideration.

Maybe not, if the US Congress decides to make big cuts to Medicaid to fund the Trump Rich People’s Tax Cuts. Whatever is attempted on the state level will be shriveled by the federales.

I truly appreciate all this effort. As I have said so many times, the health care swamp in this country could just be our downfall.

But cuts to Medicaid?

What does one Idahoan on Medicaid Expansion cost the taxpayer?

Keep in mind, under the current split, Idaho pays 10% of the total cost. And don’t let the big numbers thrown around confuse you.

There are many folks covered in Medicaid. There’s the most expensive with severe disabilities. They cost over $20K/ year per person.

Then there’s the kids. Children are cheap. They cost less than $3K per year.

Medicaid Expansion folks cost about $7K/ year.

So, Idaho pays $700 a year of Idaho taxpayer dollars to get them health insurance.

What does Idaho pay to get its legislators health care insurance?

I’m sure Representative Redman knows these numbers. He sells health insurance. Him and his wife and six kids get covered on our tab at over $10K per year. That’s a nice juicy benefit.

But these Medicaid Expansion losers could be scamming us. Sitting on the couch and playing video games all day and we have to pay for their doctor bills. I can see why there is the concern.

So instead of dropping Medicaid Expansion as would have happened in the first bill proposed, this new bill wants to privatize the health care coverage of this small sector of Idaho.

What’s wrong with that?

By the way, privatize has become “Managed Care” in the newspeak of this age.

We have seen how “Managed Care” has affected Medicare (Old people’s guvmint health insurance). Everybody confuses these: Medicare/ Medicaid = Mediconfusion.

Private companies can take over tax funded Medicare (old folks) health insurance and run it for a profit for their stockholders. There’s 20 years of experience. It’s clear. Profit is a powerful motivator, even in this “helping” industry of healthcare. The care is worse, the cost is more , but the profits are real.

It appears Rep. Redman and his cosponsors have decided Idaho would be better served to hand over Idaho Medicaid Expansion to the private equity folks.

At the same time, they want to abandon the effort started ten years ago to hold doctors accountable for wasteful practices.

The most powerful force in this twisted, arcane, convoluted system of health care in this very health care expensive country is, unfortunately, the doctor.

We have given this demigod the power to order unnecessary tests, perform unnecessary surgeries, prescribe harmful and unnecessary medications, and thereby spend our money. If it’s private insurance, the stockholders are pissed. If it’s public insurance, we taxpayers weep. If it’s a normal, honest citizen under this hammer, they just get smashed.

This needs to change.

Idaho started down the road to change this about ten years ago. The progress has been slow.

But throw that baby out now to the venture capitalist wolves?

I am very thankful that our state legislators are trying to reform health insurance. It could be so much better.

But why is their focus on Medicaid? That’s a small apple. Medicaid controls how much it pays. Why aren’t they looking at the big apple, their own big red benefit we all pay for?

 

The correlation

The correlation

February 27, 2025

Oregon was one of the founders of the ballot issue as a means for citizens to sei8ze control of how they are governed. But how much effective use has been made of it?

The elections web site Ballotpedia put some specific numbers to that question this week, releasing a mass of statistical studies of ballot issues. One of those studies focused on Oregon, and it raises some useful questions.

It points out, for example, that since the initiative and referendum were begun in the state just past the turn of the 20th century, "Oregonians decided on 881 ballot measures, approving 411 and defeating 470 – a 46.7% approval rate. The average approval rate of the six states we've published summary content on so far is 59%."

The first full decade after the ballot issues began, the 1910s, was the high point both for the raw number of issues on the ballot - they'd has more than half a century to percolate by then - but also a high water mark for the number defeated. Few people probably knew then just how popular or unpopular a measure would be, so they may have thrown everything at the wall. Only some of it stuck.

Not only that. Legislatures can place issue on the ballot too, and at least in the early days those proposals were a lot more successful than the citizen-generated kind.

After the early 20th century, the numbers of ballot issues sank in the mid-century, but then rose again. This may may correlated with the contemporaneous rise of a genuinely competitive two-party system (Republicans were heavily dominant most of the time until the mid-century) and a growing distinctiveness between the parties after the 1970s or so. Both parties, at various times, may have felt just shut out enough to want to resort to the ballot issues - and may also have wanted to use them as organizing devices.

All of which makes the more recent falloff in numbers of ballot issues, in the new century, the most curious part of the statistics. As this new century has gone on, Democrats have become more dominant, and as the shut-out party you'd expect Republicans to take to the ballot issue quite a lot. Occasionally they have, but no more than people from the other side of the spectrum, and overall a lot less than simple politics logic would seem to indicate. Might that be out of concern that much of what they would put on the ballot would fail (as many of the Republican-backed issues in fact have failed)? If so, that could be a real indicator of the party's problems in Oregon.

The whole study, linked above, is worth a review. It constitutes a profile of much more than simply items which made the ballot.