None so deaf as those that will not hear.
None so blind as those that will not see.
— Matthew Henry. English clergyman, 1662-1714
The thing about ideology, about the unquestioning acceptance of a principle, is that it diminishes your ability to think critically. A biblical literalist, who takes as a principle that the Universe is less than 9,000 years old, blinds himself to the hundred of lines of evidence that support a universe whose age is measured in billions of years. The uncritical acceptance of the principle of biblical literalism blinds you to most of three centuries of science.
Ideology in religion is bad enough. Ideology in politics is much more serious. You can see the pernicious impact of ideology in the Republican caucus of the Alaska Legislature. WC isn’t talking about the excommunication of Rep. Lora Reinbold (R, Eagle River) for the sin of apostasy in voting against the Republican caucus’s budget. That’s merely symptomatic.
WC is referring to the Republican caucus’s position on expansion of Medicaid.
The party line is,
Obamacare Bad => Medicaid Expansion Bad
It doesn’t make sense; neither the premise nor the conclusion is true. But it’s ideology, it doesn’t have to make sense. The Christian creation myth doesn’t make sense either (13-year old WC to Sunday School teacher: “Who did Cain marry, anyway?”) It’s ideology, and ideology requires you to give unquestioning acceptance to the principles espoused by the ideology. Just ask Rep. Reinbold.
Worse, ideology closes you to considering evidence that contradicts the principles of your ideology. The evidence is pretty clear that Medicaid expansion would make some 40,000 low-income residents newly eligible, with initial costs fully paid by the federal government. Beginning in 2021, the State would have to pay 10 percent of the charges for the newly covered people. Governor Walker’s administration projects that even in 2021, paying that new 10%, the expansion will save the state millions of dollars annually, based on new federal funding that would pay for services currently covered by the state. Logic supports Medicaid expansion.
Common sense supports Medicaid expansion. The uninsured folks are getting sick now, and because they have no insurance and limited means, waiting until the sickness is critical – and more expensive to treat – to seek treatment. Earlier treatment would save money. And since they can’t afford to pay for the treatment they get, the costs get passed along to those who are insured, increasing our costs. Through 2021, we have the chance to pass along to the Feds every dime of the artificial insurance premium increase from carrying the costs of treating those uninsured folks. And after 2021, the State has to pay just 10% of the cost, not the 100% passed along now as higher health insurance premiums.
And now there is a third line of evidence to support the benefits of Medicaid expansion. The Robert Wood Johnson Foundation has performed a study of the economics of Medicaid expansion. The expansion would cost Alaska $143 million for the period 2013 – 2022. In return, the State would receive from the Feds $1.6 billion in Federal Medicaid monies and an additional $600 million in increased hospital reimbursements. Put another way, for every dollars the State spends it will receive beck in direct benefits $15.38. In addition, there will be new jobs and a healthier population meaning fewer days lost to illness and fewer deaths.
But the very strong evidence doesn’t matter to the Republican caucus because its decisions aren’t guided by evidence, they are guided by ideology and
Obamacare Bad => Medicaid Expansion Bad
Facts and evidence need not apply.
Matthew Henry, the cleric cited at the top of this post, used those quoted lines to attempt to persuade his 17th Century parishioners to follow unquestioningly the commands of the Bible. Interestingly, Rev. Henry’s father, also a Philip Henry, was exommunicated from the Church of England for failure to follow the Act of Uniformity of 1662, the Parliament-mandated forms of worship. WC admits to irony in citing it here.
WC wishes Governor Walker well in his effort to get the ideologues in control of the Alaska Legislature to expand Medicare. The Governor’s proposal is sensible, saves the state money and benefits a majority of Alaskans, who will either get coverage or get premium relief. But offering ideologue anathema is a hard sale.