The Costs of Stinginess in Medicaid [NYTimes.com]

How much money does Arkansas save by offering stingier Medicaid than Vermont?

It looks like a straightforward calculation. Arkansas makes it tougher for children to qualify for Medicaid than Vermont does, and it spends much less on each beneficiary. Even though Arkansas’s poverty rate is double Vermont’s, Medicaid’s costs in Arkansas in 2012, the most recent year for which figures are available, were $600 less per resident than in Vermont.

But there is a price to pay for such parsimony. Children in Arkansas get fewer regular checkups at the doctor and dentist. More adults forgo care because of the expense. More Arkansans are overweight and have diabetes. More are disabled. They die younger.

This is not to pick specifically on Arkansas or to extol the virtues of Vermont. The contrast between these two disparate states frames a broader debate about the purpose of the American government. With a new Republican majority in Congress looking to further the cause of low taxes and less spending, it is easy to forget that tightfisted government imposes very real costs. That we can’t easily measure them doesn’t mean they don’t exist.

[For more of this story, written by Eduardo Porter, go to http://www.nytimes.com/2015/01...caid.html?ref=health]