Medicaid versus the Kindness of Strangers

In the wake of Ted Kennedy's death, healthcare reform is getting another look. That look may or may not mean a renewed sense of progress come September, when Congress resumes what is sure to be a contentious debate. But it's clear that the kind of government role Kennedy believed in, on healthcare and other issues, will not be forgotten soon.

Acting on that vision, and getting meaningful reform for the consitencies Kennedy advocated for most, will not be easy, and in some ways got much harder with Kennedy's deterioration and death.

Ted Kennedy advocated for governmental programs because he knew that good hearted and well meaning efforts to provide charity to the poor - as the Catholic Church does  - could not deal, alone, with vast social problems. Welfare programs, Food stamps, and, yes, Medicaid, were meant to provide a certainty that charity could not, to broaden opportunity for support, and access to services for all. And that definition of liberal government - that we are obligated, as a nation, to help others in need - continues to speak to millions of progressives, liberals, and Democrats. I know it is the reason for the politics I speak for, and believe in, deeply.

One example of why we need Medicaid expansion came to me on the morning after Kennedy's death - an NPR report on healthcare for the homeless, especially homeless, single adults (often men) who continue to have limited access to health services, are generally unable to qualify for Medcaid, and rely... well, on the kindness of strangers. The report details the work of clinics and health providers who reach out to the homeless, and try, as best they can, to provide basic care.

This isn't hard: it would help, tremendously, if we could provide more certain care for the homeless. That's what it means to expand and fund Medicaid properly. When we rely on a patchwork of well meaning, often underfunded, largely volunteer, efforts... some things can be done. But not enough, not broadly enough, not consistently enough. Basic access to a clinic, a doctor, or another health professional, without fear of harassment or expense... is something we can do. It's something we ought to do. Ted Kennedy understood things like that, and fought for them, and it's what made his work so impressive and admirable. Without him, without the fight... we are left, once again, to rely on the kindness of strangers. And that, really, is no solution at all.

Photo "enoshima is my home" by kalandrakas, used under a Creative Commons license from flickr.