The State of Texas recently negotiated a deal with the federal government that will fund more than $4 billion dollars in Medicaid health insurance for poor Texas families. However, this deal is only for 15 months, and Texas will lose these funds. Texas officials state they are required to commit to spending billions of dollars more in order to keep getting federal funding. They say they cannot afford to keep this type of spending without cutting costs elsewhere, or without raising taxes.
This approach by Texas officials is short-sighted and will end up costing Texas taxpayers more. Thus, it will not create the highest amount of good for society. In fact, if you take human lives into account in addition to money, the position of Texas officials will create a negative for overall happiness.
We live in a nation in which all lives are considered equal. As a result, all people will be given basic medical care if they show up in an emergency room. This is the law of the land. The hospitals then send a bill to local governments, which then have to raise the local taxes. This situation means that society is paying high cost emergency room bills for simple health care, like colds. These poor people would be able to go to day time clinics and get treated much cheaper if they had Medicaid insurance.
Therefore, a simple financial cost/benefit analysis will show that society actually gains happiness, as measured by money, when Medicaid is expanded.
I know that some people will argue that it is unfair to compel people to pay taxes which will be used to support others. They will argue that people should be free to choose who they help. However, sometimes we need to put the overall good of our society in front of individual rights. Not every issue should be decided by vote of the majority. In some instances, society should be able to compel action from its citizens in order to prevent harm to those who are not able to protect themselves.
Anyone on Medicaid is by definition poor, and many children are covered by Medicaid. Put yourself in the position of a single mother with a sick child. You will have no problem taking that child to the emergency room even if you know you cannot pay the bill. The life of the child is much more important to you. If you take this scenario and take the emergency room care out of the picture, there is no telling what that young mother will do to get treatment for her child. Multiply this by millions of individuals. The result is a breakdown of social order, and no one wants anarchy.
And finally, social progress requires liberty, but what is liberty if your children die young? Society needs healthy young people to continue to survive. According to the healthinsurance.org’s Texas government Medicaid website, almost 5 million individuals are covered by Medicaid. That is almost 20% of the population. The State of Texas cannot afford to cancel Medicaid and put the health of a fifth of its population in danger. This is certainly true since the federal government is willing to pay more than $65 billion for Medicaid expansion. Society will be better off with Medicaid expansion, and the overall happiness will increase. The effect on individual rights of the taxpayer is important, but not more important than the lives of children.