Medicaid Expansion an Investment in the Future

As one of many Americans who respect Rep. Henry Waxman's valiant efforts to expand access to health care for poor Americans, I take strong exception to the opinion-page column "Buster of State Budgets," July 29. To be sure, state Medicaid budgets have grown rapidly and states are struggling mightily to prevent budget deficits. But to attribute all of this to federal Medicaid mandates ignores many important factors.Earlier this month, the Office of Management and Budget attributed well over 50 percent of the growth in Medicaid costs in the past decade to inflation in health care. OMB also reports that the growth in Medicaid is due to successful lawsuits brought against many states for failure to reimburse hospitals. And the author does not even mention that the nation as a whole, and many states in particular, has been in an economic recession, which lowers tax revenues and drives up unemployment and the need for p ublic assistance. Investment in health care for children - including Medicaid - is among the most cost-effective investments Congress can make. Mr. Waxman is not the only member of Congress who has advocated Medicaid reform, and he and his colleagues are fiscally responsible in making sure Medicaid covers poor children today. Chester M. Weseman, Oakland, Calif.

US trade won't influence Vietnam The opinion-page column "Let's End 'Righteous Isolationism' Against Vietnam," Aug. 2, extends the faulty logic used to justify trade with Red China to socialist Vietnam. Both nations are currently in possession of lands taken through international aggression (China invaded Tibet in 1951 and North Vietnam invaded South Vietnam in 1975 in direct violation of the 1973 cease-fire) and both maintain brutal police states. Further, Vietnam continues to thumb its nose at the US about the MIA issue. The author seems willing to turn a blind eye to these facts because the other industrialized nations are now trading with Vietnam. He argues that through economic contact our democratic principles will become a force in Vietnamese thought. Much stronger elements in the Vietnamese national identity include how American democracy had a hand in assassinating President Diem in 1963, supporting the horribly corrupt regime that followed, devastating their country, abandoning them in 1975 despite promises other wise, and sending the boat people back. To the ruling class, national pride rests upon the fact that tiny North Vietnam defeated and humiliated the mighty United States. It is dubious to suggest that economic relations can override the memory of what the US has done to them. Chris Schulten, St. Louis, Mo.

Israeli immigration The series "The New Israelis: Soviet Jewish Immigrants," July 25, 26, 29, 30, and Aug. 1, is most informative but also disturbing. Even Israeli officials admit that the overwhelming majority of Soviet Jews would not have chosen to go to Israel had they been able to go somewhere else, such as the US or Western Europe. Fifteen Israeli peace leaders and academics recently wrote an open letter to Congress, saying US aid is making it possible for Israel to pursue its policy of gradually annexing the West Bank and Gaza Strip. They argue that Israel cannot both absorb the Soviet and other immigrants and continue building settlements in the territories. The letter asks Congress to make the $10 billion loan guarantees Israel will soon request conditional on an cessation of all settlement activity, calling this "the greatest service the USA could render Israel at the present moment." Mary Appelman, Downers Grove, Ill.

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