Home » Opinion | John David Dyche — Beshear’s Kentucky 2014: More Medicaid, fewer jobs

Opinion | John David Dyche — Beshear’s Kentucky 2014: More Medicaid, fewer jobs

By John David Dyche

LOUISVILLE, Ky. (Jan. 2, 2014) — The most recent Medicaid and job numbers paint a portrait of Kentucky as Steve Beshear begins his seventh year as governor. It is not a pretty picture.

John David Dyche is a Louisville attorney and political commentator for WDRB.com.
John David Dyche is a Louisville attorney and political commentator for WDRB.com.

Since October, the state has added almost 75,000 to its Medicaid rolls. As of November’s seasonally adjusted numbers, 27,597 fewer people are employed in Kentucky than at this time last year.

If only Gov. Beshear pursued job creation with the same passion he brings to Obamacare! Beshear promotes expanded Medicaid as an economic development program, but has done little (aside from some foreign travel junkets) to put more people to work.

Expanded Medicaid is supposedly “free” to Kentucky for a while. The same trustworthy folks who said, “If you like your plan you can keep it” promise that the federal government will pick up the entire tab to start with and most of it thereafter.

But soon Kentucky will have to pay part of the added expense. How will the state finance this new burden when it already could not afford Medicaid’s exploding costs?

Medicaid has long cannibalized money needed for more productive purposes. The state shells out about $1.5 billion each year for it, not to mention many billions more in federal funds.

Kentucky also cannot competently administer the Medicaid program it already has. Adding tens of thousands to its rolls will make the inefficient bureaucracy even worse.

The state also has trouble keeping enough good providers in the Medicaid program. The program pays so poorly that many are reluctant to treat Medicaid patients.

Then there is the fact that the best research shows that Medicaid does not produce better health outcomes for participants. Beshear has never explained why expanding Medicaid makes sense when the data demonstrate that it is literally not better than nothing when it comes to actually improving health.

This does not mean that government should not do something to help the poor have health care. But there are much better ways than Medicaid, as Avik Roy makes clear in his book “How Medicaid Fails the Poor.”

Roy proposes paying a primary-care physician $80 a month to see each patient and adding “a $2,500-a-year catastrophic plan to protect the poor against financial ruin.” He says, “The total annual cost of such a program would be $3,460 per person, 42 percent less than what Obamacare’s Medicaid expansion costs.”

But while Beshear is doubling down on dysfunctional, ineffective, and expensive Medicaid, the state is shedding workers and jobs. Over the past year the labor force has shrunk from 2,084,681 to 2,058,641 — the lowest number of people working or looking for work in Kentucky since February of 2010.

Employment has decreased from 1,916,869 to 1,889,272. The number unemployed has gone up from 167,812 to 169,369. The unemployment rate is also up from this time last year statewide and in 96 of the 120 counties. Kentucky’s unemployment rate is higher than the national rate, higher than all but six other states, and higher than the rates of all but one of its border states – Illinois.

In what may be the understatement of 2013, Monoj Shanker, an economist with the Kentucky Education and Workforce Development Cabinet, said, “The news is really not too good.” The real question is what Gov. Beshear is going to do about it.

The governor will soon lay out his agenda, if any, for the 2014 General Assembly session. He has yet to articulate, much less implement, a coherent strategy for sustained job growth.

Amazingly in view of his record, Beshear remains relatively popular. Kentuckians are apparently content merely to have a nice man in charge regardless of whether he actually does anything to make the state’s people more prosperous.

What will it take for Kentuckians to wake up, look around, and finally decide that the state deserves better leadership? Until then, Beshear and his unimaginative Democratic allies will continue to tout having more people on Medicaid and fewer people are working as some kind of success.

John David Dyche is a Louisville attorney and a political commentator for WDRB.com. His e-mail is [email protected]. Follow him on Twitter @jddyche.