The Coming Crisis in Medicaid
The Senate bill would increase eligibility for Medicaid to those who make 133% or less of the federal poverty level… [Yet] according to a Kaiser Foundation survey…33 states cut or froze payment rates to those who deliver health care to Medicaid patients in fiscal year 2009; even more states (39) are slated to cut or freeze rates for fiscal year 2010…Without delivery-system reform and adequate risk-adjusted reimbursement the current health-care legislation will have catastrophic effects on those of us who provide society’s health-care safety-net. In time, those effects will be felt by all of us.
What can I say? It’s a rationing system. You can think of Medicaid as a mini National Health Service.
Did anyone notice that in the House bill they actually get rid of SCHIP and put the kids in private plans? Yet everyone seems to be brain dead when it comes to Medicaid.
I haven’t seen any discussion at all of how bad it’s going to be when lower-middle-income families lose their employer coverage and are forced to join Medicaid instead.
What I mean is that I haven’t seen this discussed on Capitol Hill. Or anywhere else, for that matter, other than at this blog.
Things are going to get much, much worse for Medicaid patients after Congress insures another 25 million people without any increase in the number of doctors.
States with the most liberal Medicaid eligibility often have the lowest physician reimbursement rates. It’s a rationing technique, ensuring that most doctors refuse to treat Medicaid patients.
Ken has it right, coupled with Bruce and Tom’s points.
Across the country, states are going bankrupt one after another, being forced to cut the two largest parts of their budgets; Medicaid and education. So add whatever plans this President has for “improving education” and the resulting cuts will cause more education cuts and higher tuitions as well.
Dr. King had “A Dream” but not to be outdone this President has a “vision” to make the World perfect for all Nations and people in his first term”. I am beginning to think that he believes he is an equal to God! But until he feeds all the people with “7 loaves and 7 fish” from his mount on the Hill, he will quickly be “brought back to Earth” where he must deal with reality.
In Medicaid and Medicare, we have examples of the worse cost control plans known to man, with known Waste, Fraud and Abuse annual losses of between $300 billion and $800 billion every year. Add age 55 and up to Medicare while adding 25 million more to Medicaid will just increase these amounts to some $500 billion to$1 trillion a year, and the government has shown they have no idea of how to stop any of them, nor do they even try, Justice targeting $2 billion in 2010 fraud recoveries with a known increasing fraud value of $174 billion!
The “Obama Plan” can be likened to that of the crew of a sinking ship with two large holes in their ships hull; drilling more holes to “allow the water” more places to “drain out”, while adding more weight “freight” to the load with another plan for those not too old and not too poor to qualify for Medicare or Medicaid.
The President always preferred a single payer system and this is essentially what it seems to be headed for as the government will be the Payer in most of these plans. The reason single payer plans are cost efficient is that it is theoretically easier to control Waste, Fraud and Abuse when there is only one payer. But while the government is rapidly becoming the only payer, the plans remain separate and the government has no way to “match payments” made against each plan.
As is customary, when supply doesn’t match demand, a population section is left out, which is normally the poor and aged and will be so in this situation. The architects of this National tragedy perhaps are starting to realize that this group is the same ones who elected them and they look to reelect them based by the “promises they keep and the actions they take”. Will their 2nd chance come too late?