Governor Mary Fallin’s decision to reject the implementation of Exchangocare and Medicaid expansion has resulted in an earth-shaking development:  one of the members of the state board of health has noisily resigned, shooting his cap guns in the air on his way out.  What?  You didn’t notice?  

Dr. Glenn Davis, DDS, said,” It’s like federal funds are suddenly dirty.”  Continuing, “I will not serve as a ‘rubber stamp’ for the status quo in this political environment.”  There’s more. “Federal taxes paid by Oklahomans will now help pay for the health care of citizens in other states.” “It doesn’t make any sense to me.”  

Dr. Davis doesn’t get it.  He probably never will, in spite of my attempts to help him and others understand in this blog.

Stephen Gold, prominent Philadelphia attorney, is another matter altogether.  He understands completely.  The Oklahoman, our local newspaper, published his “point of view” on Dec. 5th, a piece containing his arguments for embracing Medicaid expansion here in Oklahoma.  

“If the state agrees to expand its programs, then by 2019 Oklahoma will get more than $13.4 billion in federal funds in return for spending $789 million in state dollars.  A ratio of 13,400 to 789 is a terrific rate of return on state funds and a great federal financial stimulus.”

Now let’s translate this insanity.

The Oklahoma government takes $789 million dollars from taxpayers in Oklahoma and gives it to the Oklahoma Health Care Authority, administrator of Medicaid.

In response, the federal government takes $13.4 billion dollars from Oklahoma taxpayers, then gives it to the Oklahoma Health Care Authority.  I can see why the leftist lawyer, Gold, thinks this is good deal for the Oklahoma Health Care Authority.  Looks to me like one theft after another of the taxpayers, though.  Unlike Dr. Davis, this leftist lawyer knows full well how this really looks on a balance sheet.  

What it is, is a transfer of wealth from taxpayers to tax takers.  You don’t have to read much in the news without encountering the corporate healthcare giants (hospitals primarily) drooling over the prospect of getting their hands on this dough.  Getting more money in the pockets of corporate healthcare was the entire purpose of Obamacare!  That’s why you and I are mandated to buy “insurance” for ourselves and Medicaid for those who can’t afford “insurance.” Undoubtedly, those in corporate healthcare see our bank accounts as a mere stopover of money due them.  

Giant hospitals need more money, don’t they?  Gold actually mentions the “poor hospitals” in his piece, lamenting the disappearance of the DSH (disproportionate share hospital payments, the uncompensated care rebate scam I’ve written about) payments first, then the loss of Medicaid money in general, second.  More money in their hands will allow them to more aggressively prey on the rural hospitals and physician practices,  and maintain or increase their support of sports franchises and their own ad and building campaigns.

Dr. Tom Coburn has cautioned in his writings about state addiction to federal funds, an addiction the roots of which lie in a refusal to acknowledge that the source of “federal funds” is your own or someone else’s wallet.  The “get all you can while you can” attitude and “if we don’t grab this dough, someone else will,” is what we have come to after all, isn’t it?    

Governor Fallin’s rejection of this federal crack cocaine is essentially an admission that must be made by all addicts:  we have a problem.  Hurray for her courage and that of all the other governors that have taken this stance, one which amounts to the refusal of yet another drink for our alcoholic government.

G. Keith Smith, M.D.