Health Care

Health care is usually a state's second-largest spending area behind public education. The biggest health care issue for most states, given its impact on their budgets, is Medicaid, the cost of which is shared with the federal government, which created the program in 1965. States administer it subject to federal constraints and mandates.​​


The biggest problem in health care is pricing. Health care inflation has exceeded the general inflation in most years for decades because patients rely on others - Medicaid, Medicare, and private insurance - to pay their health bills. Private insurance (pre-paid health care) is a result of incentives created by the federal income tax code. Today, we don't want to pay for health care ourselves because it's so expensive, but it's so expensive because we do not pay for health care ourselves.

1889's Papers on Health Care

"Obamacare Medicaid Expansion: Still a Bad Idea" by Byron Schlomach refutes arguments by advocates of Medicaid expansion in Oklahoma, raises issues regarding its potential impact in making Oklahomans dependent as well as on the state budget, and asks hard questions about the need to send more money to hospitals when they are expanding right now. Summary


"The Profitability of Nonprofit Hospitals: Do They Really Need More Money?"  by Baylee Butler and Byron Schlomach documents the financial truth regarding Oklahoma's nonprofit hospitals from their publicly available Form 990 tax filings. It exposes the falsehood that nonprofit hospitals are near financial ruin and must have more taxpayer money to survive. Summary Erratum: This version corrects a digit in Table 2.


"Medicaid Expansion: Bad Policy by Any Name" by Byron Schlomach critiques a plan put forth by the Oklahoma Health Care Authority that effectively expands Medicaid under the federal Affordable Care Act, more commonly known as Obamacare.


​​"Certificates of Need: An Oklahoma CON that Needs Repealing" by Byron SchlomachPer Bylund, and Vance H. Fried provides a brief history of Certificates of Need (CON) in the U.S., Oklahoma's two CON laws, their economic effects, and recommends their repeal.  Summary