Expansion of Medicaid is a bad idea.

But decades have passed without any effective political effort by those who oppose it to liberate medicine from government. The cost of medical care has been escalating relentlessly since the adoption of Medicare, but faux market Republicans are no less likely to support the program or the cartelization of physicians through licensure than are Democrats. The denunciation of Obamacare by Republicans (including, with painful irony, by Romney as presidential candidate) has ritualistically included the declaration that it will harm Medicare, which, if anything, is more statist and socialist than Obamacare itself. It is easy and economically sound to renounce Medicaid and its expansion, but it should be less easy, and is morally dubious, to leave millions of Americans at the mercy of the kludgy, centrally controlled, medical system that has been constructed and supported by Democrats and Republicans alike over the past hundred years. Any declared ally of free markets who doesnt support the abolition of prescription drug laws, medical licensure, Medicare, and the mass of regulations that ensnare medicine, is disingenuous at best. In the main, the frantic attackers of Obamacares socialism do not also engage in an equally fervid attack on any of those things. Of course physicians, the greatest profiteers from medical socialism, cherry pick the parts of the system that benefit them, and spurn the parts that threaten their incomes. (Eight of the top 10 highest paying jobs in the U.S. are physician specialties, and another is dentistry, which is an equally effective cartel.) Thus, physicians universally embrace licensure and prescription drug laws, and generally approve of Medicare, but dislike Medicaid. Even a professional group that styles itself a friend of free markets, the American Association of Physician and Surgeons (AAPS)*, mocks those who advocate an end to licensure and prescription drug laws while it denounces the socialism of Obamacare. (Socialism for me, but not for thee.) Rare is the ostensible advocate of free markets who, like Milton Friedman and Thomas Szasz, puts ending licensure and drug laws front and center, or even off-center. As it stands, there is no hint of a plan for genuine free market medicine in Washington or the states. Medical care is unaffordable for millions uncovered by what is inaptly called insurance. (Neither private nor public plans are really insurance. Imagine car insurance that would pay for oil changes and brake pad replacement.) These people are left stranded, abandoned and desperate as the debate over care is dominated by socialists, right and left, and crony capitalists who mouth free market cliches without demanding thoroughgoing free market reforms.
*AAPS also begs the government to let doctors stay out of legal trouble by working with drug enforcement agencies to catch patients who seek scheduled drugs without what the state considers a legitimate reason. Even opponents of the War on Drugs rarely criticize physicians, though they are primary enforcers and beneficiaries of prohibition.

! Nicolas Martin, 4/15/2014 ! No copyright is claimed. Please credit the author.