The Missouri House of Representatives has shown some real political courage on the complicated issue of expanding the state’s Medicaid rolls. I say “complicated” because the proposal voted down by the House would have been paid for almost entirely by federal funds, so the legislators decided against spending “free money” — as if something like that exists. Combest has the links to all the stories.

If more elected officials started to acknowledge that there is no such thing as a free lunch, our fiscal houses would be in better shape. Missouri’s state budget is better off than those of many other states for a number of reasons, but one of them is when state officials made the difficult choice to tighten eligibility for Medicaid a few years ago. “But you’re balancing the budget on the backs of the poor,” some will no doubt say. “Preserving money for the truly needy” would be the best response, as would arguing, correctly, that when taxes are kept low, the economy will produce fewer needy people in the first place.

My own experience in government, although limited in the field of health care, tells me that local government funding for health clinics is among the most effective public money spent to help the needy in our community. It’s much better spent than just adding more and more people, who may or may not be truly needy, to the state dole.