Karen, do you think those who have enrolled in Medicaid think of it as an entitlement? I wonder whether a large proportion see it as a requirement imposed on them?
Interesting question. It never occurred to me that anyone enrolled in Medicaid would think of it as a requirement. One does not have to sign up. One only has to sign up if one wants the benefit. Which makes it a benefit. To which one is entitled if one is in the class of eligibles.
Suppose they put a requirement on Medicaid that the able-bodied put in five hours a month of community service as a prerequisite? How many would drop that coverage until they got very sick?
Back before Medicare expansion and the effort to get people enrolled, apparently many did not sign up until they needed significant care and the hospital got them signed up. That would seem the rational thing to do. Once enrolled, however, there is no reason to drop coverage. There is no benefit in doing so and it requires some work, I presume, to get off the rolls so inertia would take over. That work would be less work than doing community service, of course, so the incentives would change.
I don't know if Medicaid recipients routinely make rational choices. There is some thought out there in economics that the long-standing notion of people, in general, as rational entities isn't valid.
As for how Medicaid recipients think, I am only guessing. I simply have no occasion to associate with them or any poor people. Never have had, not as an adult anyway. I have one cousin who I think was enrolled in Medicaid before she reached Medicare age. We never discussed it. So what do I know?
Not sure why you're interested in getting people off the rolls. If they need medical help, they will stay on. If they don't, then they're not using services so it hardly matters that they are on the rolls.
As for "entitlement," I was using the word in the federal budget sense, not in the sense of an individual feeling that he has a right to something. Once a group of people is awarded a government entitlement, a large part of the community feels that it can't renege or that those who want to renege are being unfair. They feel that way even if the affected group doesn't much care. To renege is not moral.
|
