Dr. Oz Speaking with Dr. Blase of the Paragon Health Institute on ACA Fraud. A few key points.

In my last post (normspier828307.substac… ), I indicated that in the full discussion on fraud Between Dr. Oz and Dr. Blase, (this talk: youtube.com/live/yKOoQN…), there were a few points where I caught a framing or omission of key details by Dr. Blase which could mislead a person not fully familiar with the ins and outs of the issue.

So, I figured I should point them out, now that I have some time.

Case 1: Here youtube.com/live/yKOoQN… Blase indicates Medicaid and ACA spending “soared” under Biden.

It did rise substantially (“soared” is of course manipulative wording), but Blase omits that the spending increase was substantially due to the ACA expanded subsidies, which increased ACA enrollment from 12 million people to 24 million people (from here: kff.org/affordable-care… ) , and, as well, brought the percentage of uninsured people under 65 in the country down by more than 1% (from here: kff.org/uninsured/key-f… .)

Case 2: youtube.com/live/yKOoQN… Blase says “Medicaid was designed as a safety-net welfare program and in California and New York, 4 in 10 residents of those states are on the Medicaid program”.

You probably don’t need me to point out the terminology “welfare program” as a propagandistic wording to cause anger in a certain subset of people. More materially, Medicaid may have been designed that as a safety net program, but back in 1965, but with the ACA, in was expanded and intentionally given the role to health insure people with incomes below 138% of the Federal Poverty Level, and even without an asset test.

Thus, what it was designed for originally is not relevant. It has, since the ACA, been used differently, and now about 20 million people get their health coverage through expanded Medicaid, and they don’t have to be dirt poor in both income and assets, as in the original Medicaid as conceived in 1965.

(I’ve seen this little rhetorical trick before, BTW!)

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It’s not that Dr. Blase and Dr. Oz don’t have some points. The issue of the federal government paying, and the states possibly net benefitting from Medicaid (say when the benefit to the state economy from the federal Medicaid share is taken by the state to exceed the state Medicaid share).

But they’re not proposing to solve that issue, by say a federally-financed federally-run single payer. Their proposals will just take away coverage entirely from some people, and make it worse for others.

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(I figured I really needed to point these things out. The people who might need it most are those in the audience viewing the two of them speaking. The setup of the talk is basically the same as that of an informercial, except for the omitted periodic panning to the audience clapping and nodding their heads.

The speakers indicate they are inserting many details for people who don’t know about the system, so I presume the audience is perfect material to absorb the whole presentation with complete credulity.)

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Relatedly, I caught this Paragon post while researching the above, and this is a case of clear propaganda as well. Really, it’s a trick:

paragoninstitute.org/pa…

So, it says:

“The first change is that the Affordable Care Act (ACA) significantly expanded Medicaid by granting eligibility to able-bodied, working-age adults and favoring them over traditional Medicaid enrollees (children, pregnant women, seniors, and the disabled) through significantly higher federal reimbursement rates for state spending on them. Paragon has produced paragoninstitute.org/me… that would end the ACA’s federal discrimination against traditional Medicaid enrollees and move nearly half of Medicaid expansion enrollees into the exchanges with a large premium tax credit. This is a long overdue policy reform that Congress should consider.”

What this is about is that ACA expanded Medicaid has a 90% reimbursement rate to states from the federal government, whereas old-fashioned traditional Medicaid, which still exists, and covers some people (indeed, many children, pregnant women, seniors, and the disabled) is reimbursed 50%-70% by the federal government.

The reason the higher reimbursement was done for expanded Medicaid when the ACA was passed in 2010 was to make it financially not too difficult for states to expand Medicaid, thereby covering a good chunk of their people who would not otherwise have any affordable coverage.

And, you want to keep the higher reimbursement, not reduce it (which is what Paragon proposes). Because, you want states not to have an incentive to not expand Medicaid (as 10 Republican ones still have not), or to undo the expansion of Medicaid. (Thus, states that are really crappy to their citizens would save an especial amount of money, and, as well, sometimes wind up freeloading on other states that are not crappy to their citizens when citizens move to another state to have health coverage. This is, actually, the exact same argument for not having completely open U.S. borders with automatic U.S. citizenship for anyone as soon as they get here.)

I’ve also seen this little trick before, in a purported policy document from the Manhattan Institute, which, actually and God bless him, former Biden White House chief economist Jared Bernstein posted on his Substack once, as a useful document to get a grip on solutions to the U.S. debt problem, which is a concern of his.

I found this significant enough to do a Substack post on it: normspier828307.substac… .)

Jared indicated when he referenced the document that he did not agree with everything in it. (And, of course, I don’t expect him to have read the whole thing carefully, and pass the long document on to 20 different policy experts in 20 different areas to find all of the tricks the Republicans had buried in it, before posting it. So it’s OK, JB!)

Still, I was kind of stunned to see the trick embedded in the document on policy to try and subvert the ACA covertly.