Medicaid and Viagra - I am Confused in Cairo Again...

Recently many blogs have referred to a study done in the state of New York showing that many convicted sex offenders were able to get Medicaid reimbursements to buy Viagra. People thought this was really shocking. Both liberals, especially feminist ones, and conservatives, quoted it.

I guess this is one single issue where I (normally the most liberal person I know) really have a conservative type of reaction - I am not so much exercised about sex offenders specifically getting government benefits to buy Viagra, as I am about anyone at all getting government benefits to buy such a frivolous medication that treats a non-medically threatening condition (impotence).

In fact, if we decide that Viagra or other erectile dysfunction drugs are, in principle, a Medicaid-reimbursable thing, how would we be able to differentiate between sex offenders and the general public without getting our society that much closer towards 1984? They already have these public shame programs towards sex offenders who have served their time, which don't seem to do much good in any practical sense, but satisfy our need for revenge - they would need a very complicated track-keeping system to make sure that Medicaid does not reimburse only a certain group for a certain drug, and I am not really in favor of all this monitoring.

But back to the idea of government funding for such a treatment on its face. Men won’t die if they aren’t able to perform, will they? Are other frivolous medications also covered by Medicaid - such as Retin-A or cosmetic surgery? How about Rogaine? If so, why? What is the possible argument for this?

It occurs to me that I know very little about how Medicaid works. I thought it probably was geared towards medical procedures and drugs that are needed because a person has an illness. I did not think it covered non-threatening things like men's inability to perform sexually, which may be too bad and annoying for them, but is not going to lead to death or even poor health.

I am actually in favor of socialized health care and I like the European model (I lived in France for a year, and while I saw some abuses of the system -- people getting out of work for weeks complaining of headaches, for example - nothing there compared to our heartless system where people without money could be refused treatment or go bankrupt when they have a medical emergency).

However, I simply don't think that taxpayer money should go to purely elective health treatments or medicines.

I also have heard, anecdotally, that some anti-depressants are not covered by Medicaid and therefore many mentally ill poor people end up on the street or suicidal because they cannot afford them. To me, this is a travesty and wrong. But I am hoping my informant was wrong, as many Americans don't seem to really know what government programs target and what they don't.

So if anyone feels like enlightening me on what is really going on with Medicaid in these areas, I would be most grateful. (I would particularly appreciate someone telling me that my informant is wrong - please, please help me think our system makes any sort of sense at all.)

I remain Confused in Cairo (one of my regular nicknames on the Internet).