That’s the message of several posts (like this one by TPM’s Josh Marshall) I’ve seen pop up recently on lefty blogs. Medicaid, you see, “pays the bill for 66% of all nursing home residents.” And, Josh informs his readers, “these aren’t the indigent – most\many of them are the result of middle-income people who have already run through their own money paying for their nursing home costs, and then become eligible for Medicaid. If Medicaid doesn’t pick that up anymore, who’s left? The children of the residents?”
So Josh cares about Medicaid and thinks his readers should too. But he assumes they won’t care, at least not enough, unless they believe that Medicaid cuts will affect them personally. As long as it’s just poor people suffering and dying because they can’t access medical care, that’s apparently no biggie, but raising the specter of middle class folks burning through their savings to pay for their once-middle-income parents’ nursing home care–now, THAT will get their attention. This isn’t just a case of people caring more about things that hit closer to home. Intentional or not, these posts have the unmistakable ring of “Medicaid isn’t just for those undeserving poor people; GOOD PEOPLE LIKE US could be affected!”
There are several interesting assumptions here. The first, of course, is that the readers of these liberal and progressive blogs are predominantly middle class. It never seems to occur to Josh and the others who have written similar posts that their readership could include a large percentage of poor and working class people. Assuming that they know the demographics of their readers better than I do, this would explain a lot about the focus and allegiances of the major lefty blogs. I mean, who could forget AMERICAblog’s John Aravosis complaining about not getting a stimulus check when he’s barely scraping by on $75,000/year (as a single dude with no kids, no less)? As a person who is REALLY barely scraping by, I feel a profound disconnect from much of the lefty blogosphere, particularly from the major high-traffic blogs. Reading their posts and comments, it’s abundantly clear that most of these people inhabit a world that’s very different from the one I experience every day. It’s also clear that they’re not really talking to people like me, though they sometimes talk about us.
Even more troubling than the exclusion of poor and working class people is the assumption that the supposedly progressive readership of these blogs won’t care about programs like Medicaid if those programs benefit only poor people. What type of progressives are these? Having no children, I don’t qualify for Medicaid (or Medi-Cal as it’s called in California), but that doesn’t stop me from recognizing the program’s lifesaving importance. Inadequate as it is to meet the health care needs of poor and working class people, it’s much better than nothing. I wish I was eligible for Medicaid. My friend who died earlier this year might still be alive if she had been eligible. She ignored early, non-emergency symptoms of what turned out to be cancer, hoping it was nothing serious, because she didn’t have the money to pay for a doctor. By the time her cancer was diagnosed, it had already metastasized.
Some of the “Protect Medicaid” posts also mention the poor and disabled children covered by the program. That’s because poor children, unlike their parents, are usually not held responsible for their dire economic circumstances (at least until they turn 18, at which point they must magically lift themselves out of poverty or they’ll be viewed as losers just like their parents). Able-bodied adults, on the other hand, should be able to fend for themselves. That’s the well-worn theme any time any aid to poor adults is discussed, but it’s never more infuriating than when we are talking about a life-and-death matter like health care.
What exactly are people supposed to do when they’re sick or injured and their minimum wage job doesn’t offer health insurance (or they’re unemployed/underemployed/self-employed and barely making ends meet)? This is not just about preventable deaths from major conditions that would have been treatable if medical attention had been sought sooner, though that’s certainly a critical concern. There’s also the untold suffering caused by relatively minor conditions. For instance, Josh talks about Medi-Cal cutting dental benefits like it’s no big deal. Have you ever fractured a tooth, exposing the nerve, while biting down on something hard? Imagine suffering excruciating pain and not being able to afford treatment. It shouldn’t be necessary to spell this stuff out for progressives.
There’s something very wrong with a progressive movement that needs to be told that Medicaid cuts could impact their bank balance, so they might give a damn about protecting the program. Because apparently the suffering and deaths of people deprived of the opportunity to earn a living wage aren’t enough to make them care. That’s the kind of thinking we usually expect from Republicans.