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Medicaid plan a bargain next to military’s outlay


Hospitals in Republican Senate President Keith Faber’s western Ohio district employ about 5,500 people. And in 2011, the latest year available, those hospitals gave patients about $50 million worth of uncompensated care, more than half of it in Allen County (Lima).

That’s just one of the facts that figures, or should, in the Statehouse debate over whether the state should expand Medicaid to cover 275,000 more Ohioans, including an estimated 26,000 veterans.

That $50 million in uncompensated care in Faber’s Senate district equals $137,000 a day. There, or elsewhere, to cover uncompensated care costs, hospitals must (a) charge your health plan more or (b) cut hospital costs, which means layoffs.

Expanding Medicaid would help pay for uncompensated care. That’s one reason why among those calling for expansion are GOP Gov. John R. Kasich, the Ohio Chamber of Commerce and the Ohio State Medical Association.

For the first three years, Washington would cover 100 percent of Ohio’s Medicaid expansion costs. The federal share would gradually taper to 90 percent. (Kasich wants a fail-safe clause in any expansion law so that if Washington double-crossed Ohio on costs, Ohio would cancel expansion.) In 2015, about $1.9 billion would sluice from Washington to Columbus if Ohio expanded Medicaid.

General Assembly members who oppose expansion (Republicans scared they’d actually have to campaign in 2014 primaries) claim they have no problem helping the (“worthy”) poor or the (“truly”) sick, but — hey — there’s a federal deficit, you know.

But fiscal conservatism or rugged individualism hasn’t kept most General Assembly members (88 of 99 House members, 28 of 33 senators) from enrolling — at your expense — in a state-subsidized health-care plan. For every $1 of that plan’s costs, the taxpayer ponies up 85 cents.

Still, assume federal budgeting (not, say, nose-thumbing in Barack Obama’s direction) really is what’s behind the legislature’s stalling on Medicaid expansion. Divide the $1.9 billion Ohio would get in 2015 for expansion by the U.S. population (316,044,561 people Thursday night, the Census reckoned). Cost per U.S. resident of Ohio Medicaid expansion: $6 — or 1.6 cents a day.

Sure, $6 is $6. But look at some other costs Americans already bear, thanks to decisions by Congress, George W. Bush or Obama. Take the U.S.S. Gerald R. Ford, the Navy’s newest aircraft carrier, now under construction.

Bloomberg News reported last month that the Ford’s “maximum total cost” is now $12.9 billion — a national cost of about $41 per person. (The Pentagon aims to build three such carriers, though, so that’s arguably $123 per person.)

The Ford’s $12.9 billion price tag doesn’t count planes, however. The Navy says the Ford will carry “approximately 60-plus” aircraft. Perhaps they’ll be the Navy’s version of the Lockheed Martin F-35. The F-35 is said to be America’s most advanced warplane ever. And it’s pricey.

The Navy version, the F-35C, will likely cost $270 million per plane in 2014, according to Winslow Wheeler, in Time magazine’s Battleland blog. That means a complement of 60 F-35Cs for the Gerald R. Ford, at $270 million each, could cost $16.2 billion — about $51 per U.S. resident. (That doesn’t count 120 more planes for the other two Ford-class carriers.)

The Navy’s men and women deserve the best America can provide. That’s called taking care of our own. Nursing the sick is also taking care of our own. If the Medicaid expansion debate is really about costs, not politics, and if the United States can spend $41 per resident to build one ship and $51 per U.S. resident for that ship’s planes, it can spend $6 per resident to help 275,000 Ohioans.

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