Ezra Klein reports on Jeanne Lambrew’s health speech from this morning:

She aggressively framed health reform as a response to the fiscal crisis. Every one percent drop in employment means 1.1 million more uninsured, larger Medicaid rolls, more people relying on COBRA as transitional insurance. She divided the stimulus spending into multiple parts. The first part she called “protection policies” to deal with that displacement: More money for COBRA and Medicaid. Allow unemployed adults to buy into Medicaid for one year (why only one year?).

The next set of policies are being framed as job creation. This includes workforce training programs, money for health IT adoption, money for prevention, and money for comparative effectiveness research. She noted that a Kaiser Family Foundation poll showed a solid majority of Americans saying the recession makes health reform more, not less, urgent. She also mentioned a study showing that half of families in foreclosure pointed to medical debt as a partial cause.

Reading the tea-leaves about the probability of comprehensive health care reform has been rather difficult. Reps. James Clyburn (D-SC), Henry Waxman (D-CA), and Pete Stark (D-CA) have voiced conflicting opinions on the probability of imminent reform and on Friday, Matt Yglesias noted that Ron Pollack, the President and CEO of Families USA, and a man with his ear close to the ground, has his own doubts about whether reform will actually happen. Pollack told a group of bloggers at his Health Action Conference, “it’s unclear if the president and key leadership in Congress are prepared to move on health care reform. There are real temptations to do something else earlier. Things like balancing the budget…”

Such temptations may spell doom to health reform efforts. As David Blumenthal and Paul Begala both noted at the very same event, health care reform must be done early, if it is to be done at all. The President needs to override the innate caution and concern of economists — or the other nay-sayers who may be asking Obama, ‘do you really want to hang your entire first term on risky health reform?’ — and use the presidential bully pulpit to mobilize public support for reform.

This is what Obama’s health team seems to be doing. By adopting the econ-health framework, Obama seems to be suggesting that the two issues need to be dealt with simultaneously. Moreover, Obama’s support for Tom Daschle, despite his tax problems, suggests that Obama may be on the reform-now bandwagon for the long haul.

This morning, as part of the on-going conservative campaign to cherry-pick and oppose isolated parts of the stimulus package, MSNBC’s Joe Scarborough went a step too far, arguing that extending federal funds to cover states’ Medicaid shortfalls “bails out states that haven’t made tough decisions”:

You brought up, for instance, Medicaid. What this spending does is it bails out states that haven’t made tough decisions. The Governors and the state legislators who were responsible aren’t going to be getting as much of the Medicaid money.

Watch it:

Scarborough’s attempt to apply the conservative dogma of ‘responsibility’ and ‘fiscal disciple’ to state Medicaid shortfalls is both confounding and cold-hearted. As Morning Joe guest and TIME columnist Joe Klein asked, “what are these tough decisions Joe? Is it a tough decision to deny treatment to somebody? I think a lot of people need medical care right now.”

Currently, 44 states are budget shortfalls and many are “scrambling for months to cut aid to schools, universities and, increasingly, residents who rely on the state for medical care.” Meanwhile, the economic crisis is making people sicker and increasing the rolls of the uninsured, forcing many Americans to rely on state-sponsored safety-net programs like Medicaid and SCHIP. Growing health costs are “the primary driver of the fiscal challenges facing the state and local sector over the long term” and according to the Kaiser Family Foundation, a 1 percent expansion in unemployment results in 1 million more people enrolling in Medicaid and SCHIP and increases state spending by $1.4 billion.

Far from rewarding bad behavior, giving states federal dollars to plug their budget holes: 1) allows states to keep up with growing enrollments 2) injects more money into the health care system 3) ensures that states aren’t forced to increase taxes or cut other essential services.

But Scarborough is a traditional knee-jerk ideologue, attempting to fit his square ideology into the round peg of today’s economic crisis.

The Wonk Room has long highlighted the importance of addressing health care reform in the midst of the economic recession. Earlier this year, the Boston Globe reported that the economic crisis is making patients sick, “spawning headaches and churning stomachs, and even causing bouts of anxiety and depression among people who never before sought psychiatric help.”

It’s the classic — what came first, the chicken or the egg? Economists argue that health care spending has contributed to our long-term economic instability, and the states are complaining that the sour economy has thrown people off their employer coverage and into state-funded programs.

Today’s USA Today points to yet another article that highlights the importance of addressing both crises immediately and simultaneously:

Signs abound that the battered economy is causing serious damage to the mental health and family lives of a growing number of Americans. Requests for therapists have soared, Americans say they’re stressed out, and domestic-violence and suicide hotlines are reporting increased calls.

Proponents of comprehensive reform — those who believe that “this is the moment” — should be using these write-ups in making the case for reforming the system now and doing so in a big way. After all, the two crises are like Siamese twins: it takes a whole lot of effort to separate them and you usually don’t see good results if you do.