From Jim Gilliam's blog archives
Congress: Save $700 million by killing

January 5, 2006 12:12 PM

Bob Herbert's NY Times column today (which you have to pay for, so I'm not even bothering to link to it) describes how a new provision buried in the federal budget would require Medicaid applicants to produce a birth certificate or passport.

The Congressional Budget Office has estimated that the new provision would save more than $700 million over the next decade. But if illegal immigrants crashing the Medicaid program is not a big problem, where will the savings come from? How about from the reduction in enrollment of sick or otherwise troubled U.S. citizens who are poor and less than savvy about the arbitrary workings of the bureaucracy?

The budget bill is a good example of how the insiders and special interests get what they want in Washington, while ordinary people, who are supposed to be represented by the members of the House and Senate, get bludgeoned.

Some members of Congress wanted health care savings -- if there were going to be any -- to be achieved by such measures as negotiating better rates with large drug companies and managed-care facilities. But that's not the sort of thing that flies in this day and age. So the savings will be drawn like blood from the sick and the poor. [emphasis added]

More from the archive in Corruption, Health, Legislation.

Congress: Save $700 million by killing (01.05.2006)

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Read the 35 comments.


I'm outraged that Congress prohibited Medicaid from negotiating lower prices like the V.A. does. I can understand the objections of libertarians to providing the drug benefit to begin with (well, not really, but anyway), but if you're going to do it, why in the world would you prohibit the customer (the government) from negotiating the best price possible?

This law was written by people whose sole purpose was to line the pockets of their buddies in the pharmaceutical industry.

Thu Jan 5 2006 5:25 PM


Dude, in your blog you jump to the conclusion that the 700mil savings is coming from ripping off poor people that are citizens. Where is your source to show that we aren't spending that 700mil giving free medical care to illegal aliens that are abusing a program intended for U.S. citizens? Cite your sources before just jumping to the conclusion that the law won't help make sure that taxpayer dollars go to serve the citizens.

Fri Jan 6 2006 2:09 AM


You leave that uncommented as though it speaks for itself. Do you think it is horrible that the US Congress is trying to limit it's handouts to only those who are legally in America? Seriously?

And no one is "dying" because of this. Any dying person can go to any hospital in America and that hospital is legally requiring to treat them until they are stable and no longer dying...

Fri Jan 6 2006 7:43 AM

Jim Gilliam:

the article itself explains how undocumented immigrants are not overrunning the system, and that the people affected will be those that can't deal with the bureaucracy.

"I wondered what would happen to individuals who were bedridden, destitute, disoriented, enfeebled. They might receive care in theory. But would they really? Stepping on their care seems a heavy price to pay to address an issue that very few people view as a serious problem."

"I asked Abel Ortiz, who advises Gov. Sonny Perdue of Georgia on health care issues, if he was aware of any studies that showed whether significant numbers of illegal immigrants in his state were getting Medicaid benefits. He said no, although he added, 'We have some cases that have happened.'"

"Many poor people live far from the cities or towns where they were born and do not have ready access to their birth certificates. And, as the center said, a large number of African-American women, especially in the South, were unable to give birth in hospitals because of racial discrimination. Many of them never received birth certificates for their babies."

this is one of those classic scenarios where it "seems reasonable" on paper... congress votes for it so they can tell their constituents they are being tough on border issues, and it's really poor Americans who get screwed.

and the money is being considered a "savings" so it is *not* being put to use elsewhere helping poor people.

damn ny times charging for their editorials. i just shouldn't talk about them at all.

Fri Jan 6 2006 11:54 AM


"Where is your source to show that we aren't spending that 700mil giving free medical care to illegal aliens that are abusing a program intended for U.S. citizens?"

The idea that a significant amount of illegal aliens is willing to risk discovery and deportation by applying for Medicaid is unbelievable on its face.

Fri Jan 6 2006 12:03 PM


"damn ny times charging for their editorials. i just shouldn't talk about them at all."

They should charge a more reasonable rate and in a more convenient fashion. If it only cost me a nickel to follow the link, I'd do it in a heartbeat. Online newspapers should create an organization for managing these micropayments. You just provide your credit card to the organization, while member newspapers have to post the price of each pay article. You press a button on the web page to purchase the article, and it creates a transaction file in a special folder on your computer. You run your standalone newspaper paycenter application to view any unpaid open transactions and make the micropayment. The newspaper gets notified, and you get to read the article.

OK, it could be simpler than that, but why haven't online newspapers adopted some sort of system like this? A dollar for an article (or whatever it is) is exorbitant. It's the whole Steve Jobs/99 cent downloads thing. Don't charge me the price of a newspaper just to read a single article. Charge me a reasonable fractional price, and you'll be getting micropayments up the wazoo.

Better yet, give me lifetime access (in the archives) to the article, and I'd be willing to pay more.

Are you reading this, Steve Jobs? Can you help us out here?

Fri Jan 6 2006 12:16 PM


"Many poor people live far from the cities or towns where they were born and do not have ready access to their birth certificates."

Are you kidding me? I had to show my birth certificate just to get a drivers license and again to get a passport. I was born in a completely different part of the country. I have plenty of family and friends who are from small towns or no longer live near where they were born. I had to show a marriage certificate just to get my wife a membership at a local gym at the discounted rate. Perhaps you think rich people fly in their private jet planes to pick up their birth certificate in another state whenever they need it, but no such means exist for poor people to acquire their documents?

Maybe what you are really saying is poor people are too disorganized or stupid to manage their own identification? Perhaps you are assuming that all poor people can't read or write, and would therefore never hold on to any form of documentation. Thinking that low income people are somehow incompetent at dealing with paperwork almost veiled bigotry and racism.

Or maybe you are just against any kind of reform that would ensure tax dollars are not going to people that are not qualified to receive them? How else do you propose that we ensure that taxpayer money is given to the appropriate citizens if a passport or birth certificate is too much to ask? National bar codes stamped on our necks?

Fri Jan 6 2006 5:12 PM

Tom from Madison:

Jim is simply being realistic in showing that the demands for documentation will wrongfully exclude many people--there's no racism, veiled or otherwise, involled.

Poor people do live qualitatively differently lives. Another huge class of people lacking documentation are Katrina victims whose records were swept away.

The xenophobic, self-righteous attitude coming from the immigrant haters is hypocracy in the extreme. How about practicing the virtue of charity? We Americns are still wealthy enough to help the needy UNCONDITIONALLY. It's time to put the needs of the neediest before the avarice of the greediest.

Sat Jan 7 2006 2:07 PM


The xenophobic, self-righteous attitude coming from the immigrant haters is hypocracy in the extreme. How about practicing the virtue of charity? We Americns are still wealthy enough to help the needy UNCONDITIONALLY. It's time to put the needs of the neediest before the avarice of the greediest.

That's a brilliant plan. So just throw all validation and requirements for anyone to receive taxpayer money? OK, so let's just have anyone that shows up get a check for unemployment or Social Security benefits? Why not?! Heck, why don't I just run down to the unemployment office and as for my handout, no questions asked?

If you want to create a charity for illegal aliens, be my guest. You might even get tax exempt status. Or run for office and get a bill passed to setup their own program.

But to say that it's OK to pillage existing programs setup for the domestic poor is just ridiculous. With no laws and no rules, how are we supposed to keep any of these programs from going bankrupt? Get realistic.

Mon Jan 9 2006 1:10 AM


“The xenophobic, self-righteous attitude coming from the immigrant haters is hypocracy in the extreme. How about practicing the virtue of charity? We Americns are still wealthy enough to help the needy UNCONDITIONALLY. It's time to put the needs of the neediest before the avarice of the greediest.”
- Par for the course from Tom, labeling those who disagree with his point of view with distasteful and degrading terms.

Tell you what Tom, you donate all your $$$ to the illegal invasion since your all about charity and I’ll join the minutemen.

Tom, please be as charitable as you can when some illegal (or anyone for that matter) breaks into your home, invite them in, feed them give them your: clothing, credit cards, money, let him/her/them borrow your car, I’m sure since you’ve been so generous they’ll bring it back as soon as their done with it.

“We Americns are still wealthy enough to help the needy UNCONDITIONALLY.” Please tell me Tom, when haven’t we? (Remember: Katrina, earth quake in Pakistan, the tsunami victims) I’m all for extending a helping hand BUT for those who didn’t –flip the bird- to American sovereignty.

“It's time to put the needs of the neediest before the avarice of the greediest.” – How many more jobs are going to be stolen, how many more illegal need to be turned into indentured servants, how long is the government NOT going to enforce laws/fines for businesses that use illegal immigrants in this way?

How do you like taking the food out of the mouths of those (American) people that actually need that/those jobs? Don’t you think we have enough domestic “poor” to take care of without letting the illegal invasion overwhelm all our domestic support systems?

One reason we pay soooo much for health care is because these people need to be taken care of but they have no way to pay, so who does Tom? We do.

Good fences make good neighbors; I hope that fence gets built ASAP (You gotta wonder why the Pres of Mexico is opposed to the border fence)

Yes, this all comes from the son of an immigrant!

Mon Jan 9 2006 9:01 AM

Mike of the Great White North:

Hell has indeed frozen over. I'm agreeing with NJ.

Illegal immigration has 2 letters that divide it from being legal. I find it hard to sympathize with them whatsoever.

Case in point. My uncle came to Canada on a work visa for 5 years. He loved this country, worked hard every day, paid taxes, etc. He had overstayed his visa, was picked up on a traffic violation and was ordered deported. That was the same year when a convicted offender who was ordered deported back to Jamaica ended up killing a Toronto police officer, Const. Todd Bayliss.

Its about the rule of law, specifically that no one should be above it. With the same amount of vitriol that i attack Bush with for all his abuses against rule of law, human rights and the constitution... the same must be applied by those who 'jump the que'. There are thousands of people who would give up an arm or a leg to become a Canadian or US citizen. How many go through the regular channels and are denied, only to try again the lawful abiding way. Then you see these scraps, running accross the border, invading your southern border, becoming a political force and demading rights as they are not even citizens. They send their money back to their home countries, taking revenue away from the local communities that it would have been spent in.

Forgive me, but i am totally with both NJ and Lou Dobbs on this one. You do have a serious problem with illegals.

Mon Jan 9 2006 1:16 PM


W O W - I"m actually at a loos for words Mike?!?!?

Mon Jan 9 2006 2:05 PM

Tom from Madison:

If I see an accident victim in the street, my first action is to save that person. I'm suggesting that if your first action is to check whether that person is a legal citizen, yout moral compass needs re-calibrating.

Mon Jan 9 2006 3:56 PM


The issue is (TOM) thet they should be here to have the accident to begin with.

Mon Jan 9 2006 4:23 PM


OOPs typo - the statement should read "The issue is (Tom) That they should'nt be here to have the accident to begin with"

Mon Jan 9 2006 4:27 PM

Tom from Madison:

So NJ,

would you leave illegal aliens to die? I wouldn't.

I really believe in the words "culture of life"--not as a campaign slogan, but as a principle. Do these words only apply some of the time and only in certain places?

Mon Jan 9 2006 4:47 PM


If I see an accident victim in the street, my first action is to save that person. I'm suggesting that if your first action is to check whether that person is a legal citizen, yout moral compass needs re-calibrating.

Again with the bogus emotional arguments. We're talking about whether illegal aliens are qualified to receive Medicaid!! That has nothing to do with helping a man run over by a car. If anyone shows up at the emergency room with a life threatening injury, the hospitals and doctors are bound to save the persons life

That was already discussed on this thread. Get back on topic. No more pie in the sky debate about needing to be nicer, more charitable, and help dying people in the streets.

Why won't you admit that there is nothing wrong with ensuring that taxpayer funds set up for Medicaire is actually going to those legally entitled to those funds?

I swear, some folks will throw out common sense for fear of jeopardizing their ideologogical views.

Mon Jan 9 2006 8:49 PM

Tom from Madison:

I can agree to REASONABLE attempts to ensure benefits go to those receiving them. Too often this gets twisted into reasons for denying care to the truly needy who really can't prove they are citizens by the means required by the bureaucrats.

Now, will you concede that emergency room patients need to be treated even when they are illegal aliens? Or do you think they should be allowed to die?

Mon Jan 9 2006 11:02 PM


Duh! I already said that. You're just trying to change the subject again. No one wants to prevent qualified citizens from receiving their benefits and no one wants to leave critically injured humans to die. (Funny that the same can't be said of the radical left that believes it's perfectly OK to terminate a baby if it has a birth defect.)

Typical that you won't offer any better ideas for verifying proof of citizenship. I asked if you had any better ideas and clearly you have none, so you've conceded that there is nothing wrong with the proposal. This whole blog and thread was a sensationalized bunch of nonsense drubbed up by the illegal alien lobby.

You're either a shill for big business that relies on illegal alien labor or a shill for the radical left that depends on illegal alien votes to win elections. You see any attempts to close loopholes in existing laws that can be used to benefit illegal aliens as bad because it might be a further dis-incentive for them to come over the border and work for less than minimum wage and vote for your party.

Mon Jan 9 2006 11:52 PM



Then you being "REASONABLE", would you agree that after the person is treated & released from the hospital they/that person should be sent back to their country of origin?

P. S. Tom not once did I say/write anything about denying medical treatment to anyone.

Tue Jan 10 2006 12:02 PM

Tom from Madison:

I'm glad we agree on treating the truly needy.

Perhaps we can also agree that the sheer number of illegal aliens makes it impossible to deport them all.

Your claim that illegal aliens are voting in significant numbers in elections is unsubstantiated. That might be easier to prove if we had uniform paper trails in every state. Do you support that?

Tue Jan 10 2006 12:09 PM

Mike of the Great White North:

There was never an argument here about leaving people to die on the streets. This is about whether or not illegals would risk their health and lives to avoid seeking treatment if it meant deportation.

Doctors are duty bound to heal the injured, whether they can pay or not. The financial aspect is dealt with later. Just so we're clear.

I have always supported Canada's public health system because i always believed money should not be a determining factor in whether people live or die, or get good or poor health care.

However, just as the welfare system demands accountability and proof of it's recipients that they are entitled to the benefits by being said citizens of said country/province/state... healthcare is no different when public money is used to suppport the system.

Simply put, i demand accountability... and if my paycheque is being taxed to fund OHIP, then gosh darn it, i want to make damn sure that those who use the system are doing their fare share as well. If all of a sudden a stream of americans from Detroit or New York suddenly started crossing the border and going to Ontario's hospitals and walk in clinics because they heard it was 'free', got their check ups and exams, and went right back home, OHIP would collapse.

And thats the reality of your problem that needs to be addressed. Either you fix the problem at the border to begin with, or you have to make the tough stands inside of your communities to stem the bleeding.

Tue Jan 10 2006 12:29 PM


Mike - Yes, that's exactly the issue and thank you for your insight and the good analogy to Canada's system.

Tue Jan 10 2006 1:00 PM



How can we have "unform paper trails" when these people are ILLEGAL - get it their numbers change, we get stats after the fact. Thats like saying we know how many illegal guns are out there by the number of people we arrest, its a base line, a minimum.

(And you havent answered my question)

Tue Jan 10 2006 1:15 PM

Tom from Madison:


concerning voter fraud, those who say it's widespread need to make the case somehow. Otherwise it's simply an unproven allegation.

Regarding the question of proving who's qualified to access health care, how about accepting birth certificates but not requiring them? Many other forms of "proof" of citizenship can and should be accepted.

This is necessary because many people, especially the elderly really can't prove their citizenship with a birth certificate. My 97 year old grandmother [who has Alzheimers disesae] and her 93 year old sister are examples. Both are living in a Milwaukee nursing home. Their birth certificates were lost in a church fire many years ago. It's unreasonable to deny them benefits because they lack a birth certificate. biggest issue with Medicaid is the huge cost over-run and the provision that prevents the federal government from negotiating the best price. This is a huge giveaway to big Pharma and a huge fleecing of the taxpayers.

Wed Jan 11 2006 9:02 AM


concerning voter fraud, those who say it's widespread need to make the case somehow. Otherwise it's simply an unproven allegation.

I agree there are a lot of bogus claims of voter fraud. Nebulous claims about "disenfranchised" voters are thrown around to make it sound scary and drum up outrage.

But then there are serious shenanigans. In King County WA, the number of votes cast and counted in the 2004 gubenatorial race exceeded the actual number of registered voters in the county. That's hard data.

There is a reason why folks are against requiring any kind of identification to register to vote. It allows them to sign up dead people, fake people, and illegal aliens to cast votes for their candidate.

Kind of off topic, but what the heck.

Wed Jan 11 2006 4:09 PM



Leave it to you to find the most outlandish, most extreme, one-in-a-million shot to prove your point. These two grannies have no other family?! Have no other papers (SS#, Deed to a home, DL, Their child’s (rens) birth certs. w/their names on it?) What I want to say is that there are other ways – birth certificates are not the be-all & end-all of official ID. Naturalized citizens don’t have domestic birth certificates. In my state I need to show 3 or 4 different forms of ID just to renew my driver’s license (even with a mil ID).

I agree also on Medicaid I think Medicaid is a waste of tax payers money, it does not deliver what was promised to the recipients when they were working – a BRILLIANT example of the government not being able to do what it was supposed to do BECAUSE this shouldn’t be under gov’t control, if you get uncle Sam out of the health care industry you’ll see prices go down while at least maintaining current levels of care B4 private companies pick up the slack, commerce like capitalism abhor a vacuum, something someone, some company will be there to provide the service because there’s a need and because of that need comes service because of the service/competition quality & price will be reasonable and will generate revenue for profit & taxes.

Sometimes government acts like a bull in a china shop, this is one of those times.

Wed Jan 11 2006 4:14 PM



Please keep in mind that there will always be those that fall thru the net, the responsibility should fall primarily to the family and it is government’s role is to… make it easier (tax incentives/credits, grants) for that family to take care of their loved one. In the case of someone with no family private charitable organizations should be first in line also with local government providing assistance.

Wed Jan 11 2006 4:31 PM

Tom from Madison:

My only point is it is not hard to create a compassionate government program if you begin with the end in mind and are willing to try to make it work.

The government could use it's pricing power and authority in the public interest to negotiate the lowest price for consumers. Furthermore it could eliminate the insurance company middle men. This would be a government accountable to the people.

This model can and does work--primarily in Europe. It could work in America to if it were given the chance. The right wing is heavily invested maintaining a high cost, privately funded system.

Wed Jan 11 2006 4:39 PM



You miss the point entirely, government is not he answer it’s the problem when it comes to social issues and private industry this only leads to high prices and bad service (DMV).

My philosophy of government is that it provides the OPPORTUNITY for people to achieve, to make their fortunes, to become productive – not to wait for handouts

Case in point the oil industry, in my opinion no other industry is more regulated then the oil industry. It is told where to drill, how to drill and I believe how much to charge – if not it is HEAVILY taxed.

Recently the press tried to make a big deal about “big oil” making record profits (they only make approx .15 per gal) this summer but no one asked how big a tax bill was paid by them or what kind of revenue the government collected.

So the next time you or some one you know bitches about gas prices remember this.

Thu Jan 12 2006 12:53 PM

Tom from Madison:


I'm disagreeing with you directly, not missing the point.

Life expectancy is longer in Europe, Canada, and Australia where there are Democratically elected governments administering universal health care systems. Other stats are better as well including neo-natal survival. Maximizing profit to drug companies and insurance companies doesn't maximize longevity.

Regarding energy, big oil is a big part of the problem. Big oil has become so powerful that the President is more worried about the well being of Saudi Royals and investor-class Americans than average American citizens.

We are damaging the environment and bankupting ourselves at the same time because of blind faith in markets to lead us to the promised land.

We need less dependance on oil from ANY source, not just foreign oil. Government funding and regulation has created the market for recycling, cleaner vehicles, and alternative energy.

I'm not saying we need more government, but we certainly need the right government. I don't want to return to the bad old days of robber barons and child labor. Does anyone?

Thu Jan 12 2006 4:20 PM



The reason people live longer in Europe and other places is more attributable to diet & culture rather then government subsidies, the Mediterranean diet is a fad here but in Europe it’s a way of life, even in Canada with it’s strong European influence the culture has been brought up in that manor also, and no bureaucracy can take the credit.

Thu Jan 12 2006 4:35 PM

Tom from Madison:


1) We have 45 million people who don't have health insurance. You don't think that has anything to do with it? Australians and Swedes certainly don't eat a Mediterannean diet. Japanese also live longer.

2) Diet doesn 't account for neo-natal birth rate.

3) Consider how much more the US spends per capita in Europe. At the very least, we ought to be studying the what is going on where people are living longer and better than we are.

Thu Jan 12 2006 5:08 PM



Didn’t I say "Europe and other places", I guess that does mean: Japan, Sweden and so on (other places).

I can’t say anything on neo-natal birth rates at this time.

"Consider how much more the US spends per capita in Europe." all the more reason to get the government out of the medical industry, all that $$$ and what/where has it gotten us?

I do agree with you about going to other places to study their ways, I just disagree with the way you want it done.

Thu Jan 12 2006 7:27 PM

Tom from Madison:


I'm not happy that Europeans have a higher standard of living than Americans, but they do. We are wasting a lot of $ on inefficient PRIVATE delivery of health care.

It's inefficient because powerful insurance and drug interests are maximizing their profits--not the benefit to consumers. In other developed countries people have chosen to use their representative government to maximize the benefit to themselves. As a result they're spending less and living better. We should take a lesson!

Fri Jan 20 2006 12:13 PM

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