... The initial reaction to the court’s ruling split along party lines. More than half a dozen Republican governors — including those of Texas and Florida, which have the nation’s largest populations of poor uninsured residents — said they would not expand their programs because Medicaid already eats up an unsustainable share of their budgets. A slightly bigger number of Democratic governors said they would move swiftly to expand coverage in their states, with the federal government pledging to pick up all the costs at first and 90 percent of them after 2020.
But as they gathered here this weekend at a meeting of the National Governors Association, most governors in both parties said that faced with a choice they did not expect to have, they needed to study how to proceed with this significant change in federal-state relations. Not all Democrats were leaping at the chance to expand their programs, and not all Republicans were ruling it out. ...NYT
The same is, of course, happening among individuals now that "Obamacare" is an ongoing program of reform and expanded healthcare. It's gradually being accepted. No longer just another opportunity for new bumper stickers and divisive rhetoric, it's an accepted part of the healthcare landscape.
Our rural hospital here in Texas has been enjoying a year of national awards and kudos after winning top billing in pretty much all relevant categories of healthcare . In this very Republican area, the reaction to the news that our now-famous medical care facility will also lose -- under the new system -- about $2 million a year in government support has been met with county-wide sigh and the conviction that "we'll find the money to make it up." Nobody's grousing.
... Richard P. Nathan, a senior fellow at the Nelson A. Rockefeller Institute of Government who has written about American federalism, called the health care law “the biggest change in state-federal relations since the enactment of Medicaid and Medicare in the Great Society.”
Mr. Nathan pointed out that there was initial resistance in many states to the original Medicaid program, but that all states eventually signed up, with Arizona becoming the last to do so in 1982. He said the same thing could happen this time. “I think it’s not unreasonable to believe that even these posturing, recalcitrant states will, in the final analysis, come in,” he said. ...NYT
The New York Times has also been covering the horrendous story of a child in Queens who died a few days after getting a cut on his leg in a school gym. It's a case of medical neglect, the kind one finds in a nation -- like ours -- that has a low score in healthcare when measured against many other developed countries.
... Rory was so roaring with life, it was impossible to believe how quickly life drained out of him. ...On Wednesday, March 28, he fell while playing in the school gym and scraped his elbow, opening a cut. ...
... The following Sunday, Rory died of septic shock from a strep infection, his parents curled around his body in the hospital bed.
Rory might have been saved by a swift dose of antibiotics but instead perished in a perfect storm of false assumptions, overlooked data and overburdened doctors.
Despite the cut, severe leg pain, blotchy skin and other clues pointing to sepsis, Rory’s pediatrician surmised that the vomiting, 102-degree fever, 140 pulse and 36 breaths a minute spelled a stomach bug and sent him to the NYU Langone Medical Center emergency room. Doctors there discharged Rory with an antinausea drug, even though his vital signs were alarming. The lab tests that were ordered came back three hours later showing abnormal production of white blood cells, a sign that infection could be raging, but that red flag was ignored.
“Nobody said anything that night,” his mother told Dwyer. “None of you followed up the next day on that kid, and he’s at home, dying on the couch?” ...Maureen Dowd, NYT
And it's not as though the screaming hypocrisy of the Republicans has gone away, not as long as they choose to stay at the intellectual and emotional age of about 6: I don' wanna but I wanna!...
... Vermont's Peter Shumlin said some of his Republican colleagues aren't being honest by calling for the repeal of the health law on the one hand, while declining to say whether they'll accept the federal Medicaid funding that flows from it on the other.
"Have a spine. The American people are sick and tired of spineless politicians. [Either] say, 'I believe the Affordable Care Act is the wrong thing, so I will not take the loot,' or say, 'I believe the Affordable Care Act will help my state cover uninsured Americans, grow jobs, economic opportunities, and I'm taking the loot,' " Shumlin said. "But to say, 'I'm gonna criticize the plan, but I won't tell you whether I'm taking the loot or not until after the election,' that's what breeds cynicism among the American people."
O'Malley of Maryland thinks most of those Republican governors will eventually come around and take the money for economic — if not political — reasons.
"Once the posturing of the election is past, I think that a lot of these governors are going to have a hard time going home to their doctors, nurses, hospitals and explaining to them why they are passing up an opportunity to transform these dollars into better economic uses for job creation in their states," he said. ...NPR