A Washington Post columnist, Catherine Rampell, headlined on April 5, “The Great Medicaid Purge was even worse than expected” and reported:

It’s a tale of two countries: In some states, public officials are trying to make government work for their constituents. In others, they aren’t.

This week marks one year since the Great Medicaid Purge (a.k.a. the “unwinding”) began. Early during the pandemic, in exchange for additional funds, Congress temporarily prohibited states from kicking anyone off Medicaid. But as of April 1, 2023, states were allowed to start disenrolling people.

Some did so immediately. So far, at least 19.6 million people have lost Medicaid coverage. That’s higher than the initial forecast, 15 million, even though the process hasn’t yet finished.

Some enrollees were kicked off because they were evaluated and found to be no longer eligible for the public health insurance program — maybe because (happily!) their incomes rose, or because they aged out of a program. But as data from KFF shows, the vast majority, nearly 70 percent, lost coverage because of paperwork issues. …

These “paperwork issues” were added by self-alleged conservatives, or Republicans, in order to reduce the number of beneficiaries, supposedly in order to protect taxpayers against “waste, fraud or abuse,” by poor people, against taxpayers. Wikipedia’s article on Medicaid says:

Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing free health insurance to 85 million low-income and disabled people as of 2022;^[3] in 2019, the program paid for half of all U.S. births.^[4] As of 2017, the total annual cost of Medicaid was just over $600 billion, of which the federal government contributed $375 billion and states an additional $230 billion.^[4] States are not required to participate in the program, although all have since 1982. In general, Medicaid recipients must be U.S. citizens or qualified non-citizens, and may include low-income adults, their children, and people with certain disabilities.^[5] As of 2022 45% of those receiving Medicaid or CHIP were children.^[3]

Medicaid also covers long-term services and supports, including both nursing home care and home- and community-based services, for those with low incomes and minimal assets; the exact qualifications vary by state. Medicaid spent $215 billion on such care in 2020, over half of the total $402 billion spent on such services.^[6] Of the 7.7 million Americans who used long-term services and supports in 2020, about 5.6 million were covered by Medicaid, including 1.6 million of the 1.9 million in institutional settings.^[7]

Medicaid covers healthcare costs for people with low incomes, while Medicare is a universal program providing health coverage for the elderly.

Medicaid is means-tested (it’s for only poor people), whereas Medicare is not. President Lyndon Baines Johnson introduced Medicaid in 1965, and Medicare in 1966. President Franklin Delano Roosevelt had introduced the federal taxation-based trust-funded Social Security retirement program in 1935; and both of those Presidents were Democrats, which used to be the Party that had some ideological commitment to workers, whereas the Republican Party, ever since a Confederate’s (pro-slavery) bullet assassinated the first (and the only progressive, or pro-democratic) Republican President, Abraham Lincoln, in 1865, has been, and is, committed only to investors, which is to say, only to the class of only rich individuals, the owners of businesses — managers instead of workers and consumers.

There are just two basic philosophies of government: either it is democratic, meaning one-person-one-vote rule (rule equally by all residents), or else it is aristocratic (rule unequally by residents on the basis of each person’s wealth), meaning one-dollar-one-vote rule (which is the way that a corporation is run: the more shares a person owns, the more of a say in managing it the individual willl have). The Democratic Party used to believe in democracy (government rule as being a right that each resident has equally), and the Republican Party after Lincoln was shot has always believed in aristocracy (government rule as a privilege that only certain residents have, they generally being the rich ones, but also sometimes only Christians). Consequently, the Democratic Party was “populist,” and the Republican Party was “elitist.” (Republicans — after Lincoln — were the Party of “business,” meaning of the owners of corporations.)

In America, as in all countries, there is also race as a political factor, and it’s traditionally categorized as being based upon either nationality or else religion of a person’s ancestors, or else (for instantaneous categorization) the individual’s appearance marks one’s ‘race’. But, whatever a ‘race’ is, racism or support for race being considered as a qualification for receiving a benefit from government or else as being a qualification for exclusion from receiving that benefit, can be supported both by populists and by elitists.

However, whereas racism is intrinsic to aristocracy, it is not intrinsic to democracy. Aristocracy believes in hereditary right, such as to pass wealth on to one’s children, whereas democracy rejects that and can survive only where intergenerational transmission of privately acquired wealth is by law either severely limited or else totally prohibited. And that exclusionary right for an aristocrat, to pass on to the next generation the person’s private wealth, is what produces, after many successive generations, increasingly concentrated wealth, and increasingly widespread poverty, which then institutionalizes aristocratic government and rule by privilege, instead of rule by individuals’ work and merit. Consequently, any democrat (or populist) who tolerates aristocracy, is tolerating the end of democracy.

For example, many of America’s Confederates considered themselves to be democrats but supported slavery of Blacks. Not only the Confederate aristocracy did. But — just as in Israel, there is no democracy, because only the Jews can vote there — the Confederacy was no democracy, because only the ‘Whites’ could vote there.

Similarly, Germany’s Nazis weren’t only the aristocracy, but also many Germans who considered themselves to be populists, and Hitler exploited this widespread illogicality among the public, in order to create his extremely elitist-racist-imperialist (or ideologically nazi) nation.

The theory behind the cutbacks in Medicaid is that the poor are to blame for their poverty. Any aristocrat believes it to at least some extent, despite its being stupid. It is stupid because any aristocrat knows that money is power: the power to hire people to do your will, and to fire ones who won’t or can’t. Any aristocrat experiences that reality all the time. The most-powerless individuals in any society are the poorest. Obviously, something causes a person to be poor, but heredity — being born poor and surrounded by only poor people — will always be the biggest portion of that cause. The people with the power are the aristocrats, the super-rich few who own the vast majority of the nation’s private wealth. They create — and, by means of their lobbyists and media and politicians, constantly impose — the system that produces, the ever-increasing concentration of wealth and so of power. The poor don’t, and can’t. And won’t. Consequently, any theory that the poor ought to be blamed for their poverty is an obvious lie, which benefits the richest. Of course, an individual also has some effect on his or her getting and staying out of poverty, but, in an aristocracy, the system itself has a much bigger effect on that.

By contrast against the aristocratic view, an intelligent democrat acknowledges (not merely to oneself but also publicly) that money is power, and consequently blames the super-rich — the very few who possess most of it — for society’s problems. Not the poor. And not any ‘race’. This isn’t to say that there aren’t intergenerational factors that help to explain how wealthy a given individual is — of course, there are (and that is the problem). But whereas a democrat tries to reduce them, an aristocrat tries to enlarge them. And that’s the ideological difference between an aristocrat and a democrat.

If America’s supposed effort to increase economic opportunity for poor people is to rely upon the poor ‘raising themselves up by their own bootstraps’, then it isn’t relying upon the billionaires to have the responsibility for solving this problem. But they, the super-rich, are the ones who actually caused the problem by their controlling not only their corporations but the press, and the lobbyists, and the politicians, who have so deceived and so controlled the public, as to have instituted this widely oppressive system, which the poorest suffer the most. It would not exist in an authentically one-person-one-vote government and nation and culture. It can exist only in an aristocracy (which is what post-WW2 America is).

The most efficient way to minimize social inequality is to replace aristocracy with democracy. It’s that simple, and that difficult. Only the super-rich possess the means to do it, but none of them actually wants to. Are all of them psychopaths? They benefit from the system that they have imposed. They benefit not only in wealth but in their corporate protective immunity from having to go to prison for any corporate crimes they require their subordinates to do in order to generate their wealth. For example, on April 10, Good Jobs First headlined “The Trillion-Dollar Mark: Corporate Misconduct Cases Reach a Dubious Milestone,” and reported:

Regulatory fines, criminal penalties, and class-action settlements paid by corporations in the United States since 2000 have now surpassed $1 trillion. Total payouts for corporate misconduct grew from around $7 billion per year in the early 2000s to more than $50 billion annually in recent years, according to a new report by Good Jobs First.

This amounts to a seven-fold increase in current dollars — a 300% increase in constant dollars.

These figures are derived from Violation Tracker, a wide-ranging database containing information on more than 600,000 cases from about 500 federal, state and local regulatory agencies and prosecutors as well as court data on major private lawsuits.

• Explore Violation Tracker.

The database shows that 127 large parent companies have each paid more than $1 billion in fines and settlements over the past quarter-century. The most penalized industries are financial services and pharmaceuticals, followed by oil and gas, motor vehicles, and utilities. …

Among the findings:

• Bank of America has by far the largest penalty total at $87 billion. It and other banks, both domestic and foreign, account for six of the 10 most penalized parent companies.

• Other bad actors include BP (mainly because of the Deepwater Horizon oil spill), Volkswagen (because of its emissions software cheating scandal), Johnson & Johnson (largely because of big settlements in cases alleging its talcum powder causes cancer), and PG&E (due to cases accusing it of causing or contributing to wildfires in the West).

• Recidivism is a major issue. Half a dozen parent companies—all banks—have each paid $1 million or more in over 100 different cases, led by Bank of America with 225. Two dozen parents have at least 50 of these cases on their record.

• All of the top 10 and 95 of the 100 most penalized parent companies are publicly traded. The most penalized privately held company is Purdue Pharma, which is going out of business for its role in causing the opioid crisis.

• In more than 500 of the cases involving criminal charges, the U.S. Justice Department offered the defendant a deferred prosecution or non-prosecution agreement. …

That’s $1T during the reported 23-year period, and these fines are mere wrist-slaps to those stockholders’ annual profits. But the victims lost vastly more than that, and this report made no mention of anyone having gone to prison for any of these corporate crimes, though at least two of them did — Bernie Madoff and Sam Bankman-Fried, both of whom had robbed their fellow-investors. But, for example, the Purdue Pharma case had killed at least hundreds of thousands, if not millions, of people, and yet none of the Sackler family that owned it, and that drove their employees to perpetrate it, had even a possibility of going to prison for any of those deaths, nor for the vast other harms that their personal wealth-building had driven.

In an aristocracy, the only super-rich who ever get imprisoned are ones who have harmed other corporate investors — never ones who have harmed or even killed vast multitudes of the middle and bottom economic classes.

Remarkably, the corrupt Democratic Party President of the United States has taken to the hustings in his fake-‘populist’ re-election campaign by citing a 2021 White House economic study, which calculated that America’s billionaires are taxed at far lower rates of income than regular Americans are. It found that if the 400 richest (highest-wealth) Americans (all of whom were multi-billionaires, and not merely billionaires, and who donate collectively around 30% of all of the money that is expended in U.S. political campaigns) had been taxed including their “income” from the corporate stock that they own (which now and always has essentially never been taxed because there are so many ways to avoid ever being taxed on it), then they were collectively being taxed at only an 8.2% rate on all of their income. It was a sound study. However, the billionaires-controlled think tanks and media slammed it by deceiving their public about it. For example, PolitiFact rated Biden’s statement “False” because (and this displays its contempt for the intelligence of its readers): “Under the current tax code, the top 1% of taxpayers pay an effective tax rate of 25% on the income the government counts.” But that’s exactly what the White House economists had been criticizing! They were criticizing the current tax-laws in the U.S., which DON’T include as reported income those stock profits.  For once (while campaigning for re-election), Biden told the truth, even though it’s a truth that his billionaire backers want the public NOT to know. (And PolitiFact is funded by numerous billionaires, both Democratic Party ones such a Soros’s Open Society, and Republican ones such as the Charles Koch Institute.) Is it any wonder, then, why the U.S. wealth-distribution is becoming increasingly skewed to the billionaires, even though so much of their wealth is being hidden and not even reported to the Government?

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