Speaking to reporters at the National Governors Association in Milwaukee, Walker was askedThis gaffe prompted a press release from Mike Tate, head of the Democratic Party of Wisconsin, including a pretty good zinger:
about the idea of Republicans trying to block the federal budget to halt the Affordable Care Act, also known as Obamacare.
“Right now I’ve got my hands full being governor. I’m not real involved yet at the – strike that last word – at the federal level,” Walker said to laughter.
Wisconsin’s Republican governor is named frequently as a potential 2016 candidate for governor, though Walker has largely downplayed such talk. Walker’s own response to his use of the word “yet” shows he’s aware of how his comments can be read when speaking on national issues.
Even as he denies it, everyone knows Scott Walker is running for president -- he’s never here to govern Wisconsin because he's too busy raising campaign cash at Tea Party gatherings all around the country. So it’s pretty ironic that Walker's Freudian slip came on a day he was visiting Wisconsin.”But Marley's article contained a more subtle, but more significant gaffe.
Per the article, Walker went on to talk about Obamacare and Walker, predictably, took the insane, inane and wrong-headed approach:
“I’ll let them work that out for right now,” he said. “Obviously I have concerns on principle about he Affordable Care Act, not only in terms of the implementation, but I don’t think it’s good pubic policy to have the federal nor the state government dictate to me and my family what we do or what any other family in this state or this country does on health care. But I’d have to look at all the different options are going forward.”It's odd that Walker would take that stance, since dictating what poor people did regarding health care was exactly what Walker was doing for the vast majority of his time as Milwaukee County Executive, when he administered the GAMP program:
The program was called the General Assistance Medical Program orGAMP for short. The best description I've found of GAMP, and the benefits it gave to its consumers and to the taxpayers, comes fromThe Commonwealth Fund (emphasis mine):Given that he has experience running a government-controlled health care program and knows that it saves taxpayers money and provided affordable health care, there is no valid reason for Walker to reject it on a higher level.
Wisconsin's General Assistance Medical Program (GAMP) provides health care coverage to indigent Milwaukee County residents who are not eligible for other forms of public coverage (such as Medicaid and the State Children's Health Insurance Program) and are not enrolled in private coverage. The county redesigned the GAMP program into a community-based primary care model in the late 1990s to achieve two interrelatedgoals: to provide increased primary care services, and to do so via community-based clinics. The new design was intended to improve effectiveness and efficiency of care. Prior to this, indigent patients relied on the emergency room of the county hospital, which created access barriers for enrollees and cost inefficiencies for the county. Under the redesigned model,GAMP enrollees select a participating clinic as their primary care provider, which is then responsible for providing andcoordinating services. The clinic coordinates specialty care for the enrollee by working with specialists and hospitals that participate in the GAMP network. The program covered a total of 24,000 individuals in calendar year 2003, with some 10,000 to 12,000 individuals enrolled at any given time. All in all, GAMP estimated that it saved $4.2 million in 2000 (in comparison to the projected costs had the previous system remained in place). Administratorsbelieve that inpatient and outpatient costs have been controlled largely through a Utilization Management program that ensures delivery of care in the appropriate settings and using appropriate resources.In other words, the County designed and ran a health care system that limited people's choices by having to go through a community clinic first, and only if it was covered in the network. Yet, instead of leaving people without insurance and forcing them to go to hospital ERs, it saved $4.2 million. That's a big chunk of change for a relatively small amount of people.
Other descriptions of the program include the one from Milwaukee County itself and a report(pdf) from the state after the program just started. The County page calls the program as "nationally recognized." The state's report summarized the program with this sentence:
Inpatient hospital and specialty services constitute the majority of the GAMP budgetThe only reason GAMP ended was because Governor Jim Doyle was able to expand BadgerCare to cover these individuals, taking the load of the county.
although, the program has successfully used primary care services provided in community based clinics and selective utilization management techniques to control and reduce inpatient and outpatient hospital costs over the last two years.
In fact, the only reasons that Walker would have for turning rejecting Obamacare is that he is using the poor as political pawns (something he has done before) , pure malfeasance or both.