From the January 22nd, NEJM titled Medicaid and the US Path To National Health Insurance
All I can say is, he doesn't have clue. If this country's hospitals and physicians were to try and operate economically on the payment scale of Medicaid, you would have to travel hundreds of miles to find anyone to take care of you. For many states, Medicaid payment wont even cover the cost of doing business. Running a doctors office takes money. With overhead expenses often 50%, 60%, 70%, Medicaid payment won't even cover the cost of rent.
In my community, no comprehensive care physician takes Medicaid, except the federally subsidized sliding scale clinics, and then EVEN THEY receive a higher payment scale for Medicaid. It's amazing to me. The federal government subsidizes a higher pay rate for Medicaid to their own subsidized clinics.
What does that say about the current payment scales of a program this guy wants to expand. I think this guy needs to live one year with Medicaid to understand what his proposals mean in reality. Insurance without access will only lead to more emergency medicine and higher costs. Expanding Medicaid is NOT the answer. You will witness the FREE=MORE phenomenon on an expanded grand scale.
Addendum: Here's a great Op-Ed from the WSJ about its failures.
I'm confused... isn't the biggest problem with Medicaid the fact that it is underfunded? If healthy people were buying into it then it would be better funded and would provide better services. It doesn't seem fair to say that since your personal experience with Medicare has been poor that it won't ever work and that the author doesn't have a clue.
ReplyDeletealso what is the deal with all the ads on your web site?
Anonymous,
ReplyDeleteFirst of all there is a difference between Medicaid and Medicare in both payment and patient population - don't confuse the two programs. Medicare is run by the Federal government and is for the disabled and those over 65. Medicaid is run by the individual states with Federal dollars for assistance. Medicaid rates are much lower to Physicians, hence Happy's statement that Medicaid doesn't cover actual costs (it doesn't). A practice could not keep its doors open only taking Medicaid - the practice would go bankrupt and fast. I read the mentioned editorial and the author did state that the big problem with his plan is that doctors won't take the Medicaid rates, but he glossed over this problem. This problem can be fixed by MANDATING that anyone who takes Medicare must take Medicaid. Economic realities don't hamper government mandates (see rent control, minimum wage, etc). A good place to start learning about economics is Thomas Sorrell's "Basic Economics." Also, try running a medical practice to understand the difficulties of unfunded mandates (see required free interpreters for patients who don't speak English).
I have medicaid....I also have high blood pressure and tthink I have diabetes. I also have just went to the E.R. and got x rays for my back cause the nerve pain was horrendous....the x rays revealed sclerosis of the hip and disc displacements in three places. My chiropractor is very nice...he says I should be on medicine for my blood pressure and the sclerosis should be tested for cancer....none of the doctors I have seen will order this or even test me for diabetes. They just say it is very hard to order expensive tests for someone with medicaid. I guess my children will lose their mother before anyone takes medicaid seriously but lets face noone will ever take medicaid seriously...it is looked down upon like we are poor. We are not my husband works for waste management and makes very good money ...but they do not offer health insurance. He also had to sign a waiver for unemployment if he ever got fired...welcome to the hard economy times...
ReplyDelete