These are indeed dangerous times. In the name of “cost-effectiveness,” we cut back health benefits to the poor, who are more likely to be sick than the nonpoor. We miss our chance to heal. In the setting, we’re told, of “scarce resources,” we imperil the health care safety net. In the name of expedience, we miss our chance to be humane and compassionate.’
Medicaid is again - still - the subject of reform discussions in Washington and in state capitals. The program has been subject to varying, sometimes conflicting pressures since its inception. Its primary purpose has been serving the health care needs of the poor and disabled. It was structured, however, to appeal to (or at least to not alienate) private health care providers. In addition, its mix of state and federal funding and control was intended to draw in the states as partners.