Monday, October 7, 2013

An Open Letter To Tom Coburn on Medicaid Expansion Money For Oklahoma

Dear Mr. Coburn, 10-7-2013

I recently read your editorial in the Tulsa World in support of our state leaders’ decision to turn down Medicaid expansion money.

I believe your reasoning is flawed in many respects.  You voice concerns in your piece about our state’s financial situation if we do expand Medicaid.   But let’s be clear - the federal government’s proposal is to send our state millions and millions of dollars.   These dollars would have provided medical care to the poorest among us.  But let’s also not forget, we are talking economics here after all, that these hypothetical dollars would not disappear into the ether after they are spent.   When medical personnel receive payment for their work, they in turn spend that money in their local communities.

What I am saying is that because we have turned down Medicaid expansion funds, local businesses in Oklahoma are missing out on millions of dollars in business.  This is money that would surely drive unemployment down and enrich our citizens.  It would almost certainly provide enough income for some citizens to lift themselves right off of the Medicaid roles.  Jobs and rising incomes are the answer for the large number of poor in Oklahoma.  And this decision to turn down money for healthcare, and therefore for local businesses, is going directly against that possibility.  

Small business owners, look around your store.  There would be more people in it if our state had accepted Medicaid money.    Governor Fallin’s decision has directly led to less use for your cash register.  And you are paying your federal taxes while other states (not ours) receive the economic benefit of federal dollars in return.

I can hear criticisms now:   “We don’t want money that was put here by federal spending.”     But you, Mr. Coburn, know that ALL money is put into the economy through federal spending.   That is where financial resources originate.  Dollar bills are not dropped from helicopters.  They do not spontaneously generate in our wallets.   They are introduced through federal spending.   Then we use those dollars locally to facilitate business.  (Banks also introduce dollars, but those dollars are owed back to them.  Federal spending introduces dollars owned free and clear.)

I have addressed the federal debt with you in previous letters.  However, I must point out that suggesting, as you did in your editorial, that a check from the US government could “bounce” is a falsehood.  You know this is not true, but you are stoking ignorance and paranoia in order to promote your political goals.

The United States government has run a continuous debt since 1837.  It always will, for its debt is simply the creation of money into the non-government sector.  The United States cannot, in principle, bounce a check, because all checks anywhere originate with federal spending.   You might as well suggest that the NBA might run out of points for its next game.    

In fact, the only way the US ever could come close to bouncing a check is if conservatives in Congress willfully choose to do it on purpose - which is exactly what they are threatening to do.   You and your colleagues are pronouncing fearful prophecies and then trying to self-fulfill them.  

But even if the federal government was not proposing a huge stimulus to care for our poor, our state would not go broke if we did it on our own.   Rather, we would need to spread our resources out in a different manner in order to provide more health care.  We could boost our overall productivity by hiring the unemployed, and if we need to divert some resources away from luxury cars, vacations, video games, etc. to provide basic humanity to the poor, then so be it.    

But the resources are there.   

Let’s talk about the working poor.  A childless person bagging groceries for $8 an hour cannot afford healthcare.  She is also not eligible for Medicaid, since she has no children and is under 65.  Governor Fallin’s decision to turn down the Medicaid expansion has made sure that this person still cannot qualify for Medicaid.

Do we need people to bag our groceries?   To cook and serve our meals at restaurants?  To pour our coffee?  To work our cash registers?   To care for our children?   

Then let’s not blame them for their station in life while simultaneously depending on them.  We need them.  Let’s get them health care.

I think that if you don’t want them to have health care - you will say you do, but without offering a legitimate possibility, this is a lie - then you should probably pour your own coffee.

We live in a world where people are more interested in the world obeying their particular political philosophy than they are in feeding and healing the poor.   But if the private sector were able to provide adequate care for the poor, then it would already be done.   Until churches routinely pay for heart surgeries, we need the public sector to be involved, as a public good.

I often imagine Jesus being asked - should we feed the hungry and heal the sick publicly or privately?       I imagine his answer to be   -    YES!

Perhaps the biggest weakness in your arguments against accepting Medicaid expansion money is what you propose to do instead.   Which is basically nothing.

What I read in your letter is essentially this - please stay away from the doctor, working poor.  

You make the line too long.

Mr. Coburn, I appreciate your intellect and your energy.   And I am sure that you are a wonderfully capable physician.   But on the issue of the Medicaid expansion in Oklahoma, you are guilty of both economic and moral malpractice.

Sincerely, your constituent, 

Steven Stark, Oklahoma City