Photo by Kathleen Kelly via Creative Commons.

Kentucky, like our country as a whole, suffers from many ailments. One of the most devastating is a profound lack of basic empathy. This empathy deficit does real-world damage, hurting the most vulnerable among us, and our abysmal health care system is the most obvious example.

Some of this deficit is caused by ignorance. A common criticism of government-provided medical payments (such as Medicare, Medicaid, or maybe someday, universal single payer) is that it is unfair to force anyone to pay for another person’s health care.

Well, if you have private insurance, you’re already paying for other people’s health care. Insurance works like this: A lot of people pay various amounts into a big pot of money. Then, when one of the people that pays into the pot gets sick, they get to pay their medical bills using money from the pot – even if the amount they spend is more than what they’ve personally paid in. Some people who pay in will go their whole lives without spending much money from the pot. But the pot will be there when they eventually need it (and everybody will, because humans are mortal). At a basic level, as long as more is being paid in to the pot than is being paid out, this collective system works well, whether it’s for-profit or publicly run.

But there are those who understand perfectly well how insurance works yet resist providing benefits to others anyway. In their minds, the poor and the sick deserve to go bankrupt or die due to illness or injury because they don’t work hard enough or they make bad decisions.

This twisted view assumes that the only possible reason someone would be poor is because they are lazy, and the only possible reason someone would be sick or injured is because they are careless.

Anyone who has ever consciously interacted with another human being knows that this isn’t true. Kids are born into poverty, jobs vanish, diseases are genetic and contagious, the healthy get sick, and accidents happen. Ascribing fault to every person who is poor or sick simply ignores reality.

Not that reality has ever been a concern for Kentucky Gov. Matt Bevin. He also apparently ascribes to the belief that money is the true measure of a person’s worth and health is the measure of their responsibility. His Medicaid plan would deny critical health services to those who are so poor they can’t afford even small monthly payments, and it would force many to jump through unnecessary hoops just to prove their worthiness for basic medical treatment.

Compare this to the health care system for those who are not poor. As long as you pony up enough money for private insurance, nobody expects you to do anything else to prove your value as a person. Nobody even asks you where you got the money. That’s a relief to a lot of folks, I’m sure, because if you think the only way to get rich in Kentucky is to be an honest hard worker, well, you must not read the news very often.

Gov. Matt Bevin

Gov. Bevin’s Medicaid plan, which already has been tested in Indiana, won’t alleviate poverty or increase personal responsibility. It will just kick lots of people off of Medicaid and deny them any affordable health care at all. It will drive the poor closer to bankruptcy and the sick closer to death. Emergency rooms will fill up once again, and costs will rise for everyone.


Ultimately this is a question of empathy. Why should we punish anyone with bankruptcy and death simply because they have the misfortune of being sick and poor? Providing medical care at a low cost doesn’t incentivize people to be poor, nor does it incentivize them to make bad health choices. It simply shows that we care for each other and we’re willing to help everyone when life gets tough.

America is the richest country on the planet, and has over 300 million citizens. That’s a lot of people with a lot of resources. Collectively, we could be the most generous provider of universal social benefits in the world, yet we lag far behind every single one of our fully industrialized peers.

Only in America is it a controversial position to say people don’t deserve to get sick and die simply because they don’t have enough money to pay exorbitant health care costs.

The best solution to all of this is, of course, a universal, publicly funded system: an insurance pool that includes every person in America, both rich and poor, healthy and sick, and eliminates any risk of medical bankruptcy or death due to lack of care. How do we know this? Because lots of other countries already tried it and it worked. They pay less for health care but get better results. Their middle classes are stronger. They have less inequality. They live longer and healthier.

Unfortunately, and despite fast-growing support for health care sanity, it may take many more years for our country and our state to join the rest of the civilized world.

In the meantime, as we continue to avoid the best possible solution just so that private companies can hoard profits (and executives can average $18,500 per hour), the very least we could do is not make the poor and the sick jump through cruel hoops designed to snatch away their only hope of affordable care.

Gov. Bevin should abandon his bogus Medicaid plan and do whatever it takes to ensure all Kentuckians receive quality health care no matter how sick they are or how much money they have. Basic empathy requires it.