The Tattered Social Safety Net
In Massachusetts:
The August study on Massachusetts’s safety net system showed rising patient volume after the state’s health reform. The number of patients receiving care from community health centers jumped 31 percent from 2005 to 2009, while safety net hospitals experienced a 9.2 percent increase in nonemergency ambulatory care visits from 2006 to 2009, researchers from George Washington and the University of Minnesota found.
Lessons for ObamaCare:
The ACA scales back funding for disproportionate share hospitals — a special designation for hospitals with significantly higher shares of impoverished patients — while Medicaid is expected to absorb 16 million more people after 2014.
“The assumption that near-universal coverage will eliminate the need for extra financial help for safety net institutions is false, and Massachusetts provides the proof,” the health policy consultant said.
So true. But it’s a lesson the Obama administration is unlikely to learn.
In some cases, paying hospitals directly for treating indigent patients is more cost-effective than signing up people to Medicaid and then having Medicaid pay the hospital for care. But, there is always the risk that community hospital and clinics will lobby for political favors to protect them from market forces. Every time a community hospital starts to go under, there’s always a loud cry about how much worse off the community will be.
Ditto Vicki’s comment.
If Massachusetts’ revamped health care system is the closest thing to Obamacare out there, then why are more people howling mad about turning over control of their care? Isn’t Massacusetts cash-strapped as well as short on doctors? This is no answer.
I think things are going to get really, really bad for the safety net hospitals.
Worse than the Massachusetts data show because MA is a slow growing state. I looked at population projections for July 2005 through July 2010: MA grew 2.0 percent and US ex-MA grew 4.6 percent over the period.
Imagine how Obamacare will crush access to medical care in fast growing states like TX, if “universal” care can’t even be imposed on a static state like MA without immediate harm!
The spin is making me too dizzy to type.
Since when is having more people being seen at community health centers, a bad thing? It is the goal of some state Medicaid programs, and many states use Medicaid managed care to push more people into community health the centers. And the centers get far better Medicaid reimbursement than private physicians who, sensibly, refuse to see Medicaid patients. And ObamaCare puts a huge chunk of money into community health centers.
A lot of those are at safety net hospitals.
RomneyCare was to end the problem of uncompensated care by requiring insurance. So it put most people into Medicaid and called it good. They were insured, right? And if everyone is insured, there is no burden for caring for the poor–they have a third party payer just like everyone else. As a result, DSH was written out of ACA. Are they saying that the RomneyCare concept does not work?
In copying RomneyCare, ObamaCare is supposed to end the problem of caring for the poor for the entire nation. No one will be uninsured and Medicaid will pay Medicare rates. Presto, the tide of huge losses for hospitals will be rolled back as uncompensated care goes away. [Never mind that Medicare rates will probably soon resemble Medicaid rates…]
What is crashing the safety net is the push to put everyone on government health care, otherwise known as the “we pretend to pay for your medical care and you pretend to get medical care” model.
As the situation gets worse for safety net hospitals, there will be pressure on state and local governments to raise taxes.
Because most people on Yahoo anwesrs don’t know anything about socialism. I’ve seen that so many people here do not know the difference between socialism, communism, etc. There are people that just don’t like Obama and they will say anything to distract others from having any sort of productive dialogue. I am with you buddy. I have no idea how the Obama health reform is socialist . I also think that people are far too partisan and would rather align themselves with a particular party than what is actually good for the country.