I was asked by al.com to provide factual information and a rationale supporting the Medicaid expansion in our Red, Red state (which can be found here). My rationale was in the form of the hypothetical tale of an industrial recruitment effort that failed due to the poor health of the workers, the poor state of the health care infrastructure, and the unwillingness of our state to take advantage of the opportunity (through the Medicaid expansion) to improve the current state of affairs.

The commenters have been, for the most part, kind although one (who goes by the “handle” Bendoveronce) did kind of get to me:

So the writer of this article would have us to believe that a business makes expansion decisions based solely on the health of the citizens where the expansion would occur? That is the biggest bunch of bs I’ve ever heard. He doesn’t have a vested interest in this insane thesis does he? After all he is a doctor.

My thesis was not that me and my colleagues needed jobs. It was that health care and education are two infrastructure elements that are necessary for industry recruitment, which I have heard said multiple times at meetings, in presentations, and such. Finding hard evidence for this was a lot harder than it should be. A lot has been written about the direct benefits as regards to payroll, Medicare and Medicaid money staying in the system, etc. The non-financial benefits less so. They fall out typically as described below:

Nonfinancial Linkages.
Besides financial linkages, the healthcare industry may influence local businesses and residents in other ways. These influences are especially important in two ways. First, health care may be a key asset in attracting other companies to the region. Evidence suggests that firms seek communities with many attributes, including a strong healthcare system (Doeksen 2000). A strong healthcare system can ensure access to care for employee recruitment and retention and potentially reduce costs for employers. Second, health care may be part of a quality of life strategy to ensure attraction and retention of population. A community attempting a retiree-based rural development strategy must consider the quality and quantity of the local healthcare infrastructure. Retirees often cite the importance of health care in choosing a location for a first or second home (Doeksen 1996). Finally, a comprehensive local healthcare system can potentially lead to improvements in worker productivity and reduced absenteeism through preventative care programs.
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