JH- While it is true that there was significant growth in HHS spending during the past decade, your critique conveniently omits some critical points. First, most of that growth was not a function of lawmaker largesse to people in need, but of the explosive growth in health care costs generally. As a matter of fact, Medicaid has actually done a better job of containing costs than private health care plans. Second, while state politicians did indeed adopt modest expansions of Medicaid in the 1990’s, these changes did not make for anything akin to a “Cadillac” program. For instance, it was only in the last year –after a successful lawsuit by the Justice Center and others (which the state fought all the way to the U.S. Supreme Court)– that North Carolina has even provided a reasonable reimbursement rate for dentists treating poor kids. Prior to that, parents of poor kids were often forced to drive four hours to find a dentist that would see them for Medicaid’s then-paltry fee.
Now, as for the question of poverty in general and that tired old aspersion about “wealth redistribution,” take a look at our Policy Brief from earlier this year about John Edwards’ “Two Americas” campaign. The real wealth redistribution in this country over the past 30 years involves the shift from those in the middle and at the bottom to those at the top. While no one at the Justice Center is arguing for a revival of the kind of crude and disastrous economic leveling that marked Eastern European socialism during the 20th century, I sure hope you’re not arguing that we should pursue the kind of anarchic, every person for himself, capitalism that marks modern Russia. The trick, it seems, is to craft the right balance. Sure, it’s not an adequate solution for us to simply label a huge percentage of the population as “needy.” Neither, however, is it good enough for us to say that we’ll simply make sure that nobody starves or dies in the street and leave it at that.
