• Steve Junion, Ph.D.

Medicaid Myths and Logical Fallacies

Living in a state (Kentucky) where the current administration wants to have people on Medicaid begin to work sounds good at face value, especially to us good God-Fearing Folk (for those that don’t know me, that is policy sarcasm, not God sarcasm). The new laws have been delayed several times due to multiple reasons; however, it looks like the work requirements could roll out April 1, 2019. There are some exemptions that at least make something that is a policy disaster only slightly less tolerable.

After spending these past two years working almost solely with people on Medicaid, there are a few observations and insights that I would like to share.

First, I want to start with the logical fallacy or the error in reasoning that many in decision-making power are making from my perspective. The sad part is that I have heard each of the logical fallacies listed below at least a handful of times; otherwise, they wouldn't make the list. Moreover, this is just the short list!

Logical Fallacy #1: They (people on Medicaid) like being poor and living off the state!

Observations and Insights: No one and I repeat – NO ONE likes being poor! Seriously, the folks I speak with want to work; however, having to spend time being a caregiver or having a special needs child significantly impacts earning capabilities. These aren’t the only reason, but they are two I have experienced frequently.

Logical Fallacy #2: Just get a better job!

Observations and Insights: No, there are too many false trade-offs. If I get a $0.25 / hour raise, I might lose $3,000 in benefits for my children, including health care. They have to make conscious choices that lead them down two horrible paths.

Logical Fallacy #3: They just aren’t motivated to get to their doctor!

Observations and Insights: Spend a day riding with a single mom to her doctor’s appointment. She misses a day of work which means no pay. Because she doesn’t have a car, and if she isn’t aware of transportation benefits, she has to attempt to take public transportation or get a ride from a relative, neighbor or friend. The point is, the observations are limited.

Some of the most amazing people I have met over the last few years are people on Medicaid fighting to get some sense of normalcy (their words, not mine). So, what do we do as corporate, government, or other entities? We make it almost impossible for people on Medicaid to be successful. It’s sad, it makes me mad, and every chance I get, I try to continue to work to be the voice for those who don’t get to speak to those who have the power to make decisions.

It is time to partner with people on Medicaid to build empathy, innovate through co-creation, and make an impact at the individual and system level. If you serve people on Medicaid, start simple, ask a few questions and listen.

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