Just how anti-government is the anti-government crowd?

An ad has been running in my local newspaper for a free workshop to help seniors and their children learn how to protect their assets from nursing home costs. Or, more precisely, the workshop will tell you how to qualify for Medicaid to pay for your long-term care while preserving as much of your kids’ inheritance as possible.

The ad tells readers to “protect what is yours”. Okay, your home is yours, but so is your physical condition, and if that condition lands you in a nursing home, so is the bill for your care. That may be a bit harsh, but the ad makes it sound like the nursing home or the government is out to take your property from you. What is really going on is that you’re being offered information about how you might be able to transfer a financial liability from yourself to the rest of us tax payers.

The ad raises some very interesting questions, particularly given the current anti-government fervor dominating so much of our public discourse these days. Medicaid is welfare. When it was enacted as part of LBJ’s Great Society, it was the anti-poverty companion to Medicare. How odd it is at a time when criticism of government spending on entitlements is at such a fever pitch to see an ad so clearly aimed at middle to upper middle class property owners running in a newspaper serving such a staunchly conservative region. I’ll bet the workshop is a hit.

Perhaps some workshop attendees will feel that they’ve worked hard all their lives and never relied on the government for a hand-out, so why shouldn’t their children inherit their property instead of losing out to the nursing home? That sounds like an argument for getting the government involved in spreading the costs of health care more equitably among all of us, given the randomness of the conditions that require expensive care, including nursing home stays. Or is it more about Medicaid only really being welfare when people who don’t pay taxes use it?

Then there is the question of the imbalance between our spending, whether public or private, on health care for the aged versus spending on the health, well-being and education of the young. And what about the role inherited wealth plays in the ever growing gap between the rich and the poor?

And while we’re talking about long term care, how many nursing home stays result from illness related to tobacco or obesity? Plenty. So doesn’t government have a legitimate role in promoting healthy living through policy interventions, particularly if we expect government to pick up so much of the tab?

There’s plenty of room for honest debate about the role and size of government, but until we read an ad like the one described above and recognize the irony and hypocrisy laced throughout it we might not really be ready for that debate.

As the baby boom generation ages and the number of children living in poverty rises, we as a society need to more carefully consider how we allocate resources at either end of the womb-to-tomb continuum. Hopefully, we won’t waste too much more time on the notion that government is the problem rather than a very critical part of the solution.