From Health Care Debates to Medicaid Policy Reforms
Homeschool debate students develop research, advocacy, and communication skills, skills in high demand at think tanks, consulting firms, and education foundations. The recent NITOC tournament featured hundreds of debates on reforming federal heath care policies. Economic Thinking with Ziggy Online Debate is hosting a post-NITOC tournament this motion:
Motion: Medicaid Managers should be allowed to utilize annual Roth Health Savings Accounts for enrollees’ primary care costs.
The news is full of anger, accusations, and confusion over proposed Medicaid cuts. However John Goodman, a former high school debater, makes the case for: How To Get $880 Billion in Savings from Medicaid Without Cutting Any Actual Benefits (April 28, 2025). Two of the recommended reforms:
2. Let them have a Roth HSA. Medicaid managed-care insurers should be able to make deposits to health savings accounts (HSAs), which can be designated for numerous purposes, including purchasing all primary care. Any money not spent can be withdrawn by the consumer for other purposes without taxes or penalties. This arrangement would be voluntary. It would be an opportunity, not a requirement.
3. Give them access to direct primary care. This is 24/7 access along with a doctor’s phone number. Medicaid could supply the funds or let enrollees make monthly payments from their Roth HSA. In all cases, they should be able to pay the market price, so that doctors will compete for their business. (Cost in Wichita: $50 a month for a mother and $10 for a child.)
Medicaid costs could be further reduced, I argue, by reforming Standard of Care: advise patients suffering with obesity, diabetes, and cardiovascular disease to cut carbohydrates, seed oils, and highly processed foods. Recommend more eggs and less cereal and let people learn for themselves about their metabolic health. Allow healthy food in federally-regulated hospitals, nursing homes, schools, prisons, and for the military.
Consider OwnaHealth’s partnership with Bronx, New York Medicaid provider Essen Health Care. OwnaHealth provides nutrition advice (cut excess carbs) and CGMs for the sickest on Medicaid. Nina Teicholz writes in Medscape: “Of the 78 patients initially on insulin, 62 were able to stop this medication entirely.”
Why not share this with others on Medicaid?