I always learn something valuable when around fellow AAPS (Association of American Physicians and Surgeons) members.  Dr. Jane (of Arc) Orient’s analogy for states considering Medicaid expansion:  ”…embracing Medicaid expansion is like taking delivery of a baby elephant with a 2 year supply of hay.”  

I love this.  I am going to expound on it, however.  The honest truth is that if you take delivery of the elephant and the 2 year supply of hay, you not only are responsible for feeding this gigantic animal after the hay has run out, but you actually bought the hay that showed up with the elephant!


When you read some fool editorial by a supporter of the expansion of this failed government program, watch for them to say something like, “..’it won’t cost anything the first two years…it’s paid for with federal dollars,” or some such variation.  Dr. Orient’s analogy helps break this down, making it easier to see the source of all tax dollars, federal and state, very simply the looting of the wages of all who play the host to the tick.

G. Keith Smith, M.D.