Harvard study says lack of Medicaid expansion in red states will kill thousands

[kairos12]

http://www.rawstory.com/rs/2014/02/06/harvard-study-says-lack-of-medicaid-expansion-in-red-states-will-kill-thousands/
snip:
Thousands of Americans will die as a result of red state governors’ refusal to expand Medicaid and extend health coverage to their states’ neediest citizens, according to a study by researchers at Harvard University and the City University of New York.

This article reflects the Rethug two health care priorities:
1. Accelerate the race to the bottom for being the worst provider of health care for their poorest citizens.
2. Number 1 Rethug health care plan, "Hey Poor and destitute, hurry up and die."

[Fred Sanders]

1. Thousands of people killed, tens of thousands of lost jobs in healthcare but the mass media is still

heavily invested in clinging to its defence of lying about the CBO report actually increasing employment....

[elleng]

2. As Grayson said,

DIE.

[Hoyt]

3. The study will just make the right/white wingers smile.

[Gothmog]

4. We are pushing a program called "Texas Left Me Out" to try to motivate these voters

40+ organizations are participating in this program. Here is a youtube video from a press conference on this program

http://www.youtube.com/watch?feature=youtu.be&v=NeAUx4kvy-I&desktop_uri=%2Fwatch%3Fv%3DNeAUx4kvy-I%26feature%3Dyoutu.be&app=desktop

[proverbialwisdom]

5. OTOH...

http://www.latimes.com/opinion/la-le-0206-thursday-medi-cal-obamacare-20140206,0,163251.story#ixzz2sYyLcelP

Letters: Obamacare's Medicaid expasion is no victory
Re "State aid is relief, burden," Feb. 3

Feb 6, 2014

Let me get this straight: The expansion of Medicaid is being touted as "one of the great successes of the Affordable Care Act." Medicaid is a second-tier program of inferior quality for poor people of all races, especially blacks and Latinos.

While some may see the cementing of the Medicaid program deeper into the structure of the U.S. healthcare system as one of the Affordable Care Act's positive effects, others are likely to see it as an indicator of an increased level of healthcare inequality (based on income inequality) in this country.

Reginald Clark
Claremont

*************

Your article on Obamacare and Medi-Cal described people forced to accept Medi-Cal assistance in paying for health insurance.

The article failed to mention that both California and federal laws impose estate recovery: that is, on the death of a recipient and his or her surviving spouse, the state is required to make a claim on the estate for the cost of aid provided, up to the amount of the estate.

Although those eligible for Medi-Cal may not have substantial estates, and allowances are made for certain dependents, people should not be forced to accept Medi-Cal and have their estates subject to recovery.

Gordon Gerson
Pacific Palisades

http://www.latimes.com/local/la-me-new-medi-cal-patients-20140203,0,6224799.story#axzz2sYy77fz5

Medi-Cal seen as relief for some, confusing burden for others
Many Californians now qualify for Medi-Cal under Obamacare, but for some embarrassment and complex sign-ups overshadow the aid.
By Eryn Brown
February 2, 2014, 7:33 p.m.

Business owner Lori Golden wasn't looking for charity.

But the 62-year-old Northridge resident said that's what it felt like when she tried to buy an Obamacare health insurance policy through the Covered California exchange — and instead learned that her income was so low it qualified her to receive benefits through California's healthcare program for the poor.

"I'm upset. I sort of feel like I'm being forced to go into Medi-Cal," Golden said.

Supporters of national healthcare reform tout the expansion of Medicaid — called Medi-Cal in California — as one of the great successes of the Affordable Care Act.

<>

The low-income insurance program, once mainly for women with children and people with disabilities, is now open to any adult earning less than 138% of the federal poverty level (in California, $32,499 a year for a family of four and $15,856 for a household of one.)

Also newly eligible are children in households earning up to 266% of the poverty line. That means a family of four making a little more $60,000 a year can be split in two, with parents able to buy subsidized coverage but children receiving theirs through Medi-Cal.

Martin Gross, a self-employed lawyer and Obamacare proponent in Mar Vista, bought Kaiser Permanente policies for himself and his wife through Covered California.

But when his 16-year-old son qualified for Medi-Cal, it gave him pause.

"I said, 'Wait a minute — I'm not that poor. Why is my son on Medi-Cal?' " he recalled. "I wasn't crazy about it. It was a hit to my ego."

Gross said he would have liked to have had the option of paying what he used to for his son's coverage.

<>

[Hoyt]

6. Those are problems, but Medicaid is better than no insurance.

If one has a sizable estate, I'm not sure they should be signing up for federal/state supported Medicaid. They could buy an exchange policy with no subsidy if they have that many assets.

While I think we will be better off with single payer and universal coverage, until we get there, I think the estate recovery issue is being overplayed. Although I am sure there are times where it is unfair, but states can waive the recovery in such cases. http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Estate-Recovery.html

I suspect those who can't get any coverage in the states that have not expanded Medicaid, would gladly accept estate recovery to have coverage.

As to Medicaid providers are "inferiror/substandard," it has been my opinion that providers who do not accept Medicaid -- because of lower payments, large number of "black and latino" patients, and worse -- are in the wrong business.

[proverbialwisdom]

7. OTOH...

Egregious examples exist of Medicaid 'providers' in the wrong business, too, and it's my impression that these cases involve the corporate model of healthcare.

http://www.nieman.harvard.edu/reports/article/100963/Revealing-How-Dentists-Profit-By-Abusing-Children.aspx

EDITOR'S NOTE
The Washington Post reported this story on February 28, 2007 in a story, “For Want of a Dentist.”

Revealing How Dentists Profit By Abusing Children

In ‘Drilling for Dollars,’ a local TV reporter presented shocking visual and audio testimony about a situation in which children were being needlessly treated and harmed because of corporate greed.

By Roberta Baskin

When I walked off the news set after reporting on Small Smiles, a chain of Medicaid dental clinics for children, the makeup artist was sobbing. “How could they?” she said. A producer sitting outside the editing room was in tears. Each was reacting to the wretched screams of children during dental treatments—screams they’d heard as my story aired.

This story about Small Smiles began for me in May 2007. I had returned to WJLA-TV, an ABC affiliate station that I’d left 17 years earlier to do investigative reporting at the networks. The news director, Bill Lord, encouraged me to return to my “local roots” and enthusiastically assured me that there would be time and resources to do the kind of digging that could hold the powerful accountable and make a difference in the Washington, D.C. community. Although I worked on other projects, the Small Smiles investigation became my benchmark.

<>

McDaniel explained that production goals were set each day by corporate headquarters in Colorado. If the dentists exceeded them, the staff received big bonuses. She had no doubt this encouraged thousands of dollars a month in unnecessary work. She told me corporate contests were held among the clinics. Performing the highest number of baby root canals was the goal, because Medicaid reimbursed top dollars for them. The Langley Park Small Smiles clinic won the contest and had a trophy to show for it.

<>

How was it that Small Smiles could be so profitable just treating Medicaid children? Earlier in 2007, a 12-year old Maryland boy died from untreated tooth decay. The infection traveled to his brain, causing an abscess. In the aftermath of his death, a shocking statistic had emerged. Four out of five dentists refuse to treat Medicaid children because it’s just not profitable enough. Government reimbursement rates are far less than what private insurers pay. Small Smiles made up for that in volume by maximizing the amount of work they could do per visit. This strategy proved to be so profitable that the company’s goal was to continue opening three new clinics every month. As I dug more deeply into the finances of the company, I discovered The Carlyle Group was a major investor along with an Arab bank in Bahrain called Arcapita, which invested $460 million in the enterprise.

<>

But this winter has been bittersweet. WJLA-TV decided to shut down the investigative unit—and thus end my job at the station. The station’s owners described such reporting as “a luxury” they can no longer afford.

<>

Roberta Baskin, a 2002 Nieman Fellow, has won more than 75 journalism awards and serves on the boards of the Journalism & Women Symposium, Images & Voices of Hope, International Communications Forum-America, the Robert F. Kennedy Journalism Awards Committee, and the Nieman Foundation’s Advisory Board. “Drilling for Dollars” won a 2009 Alfred I. duPont-Columbia University Award.

[proverbialwisdom]

15. UPDATE.

http://www.publicintegrity.org/2014/03/11/14395/dental-chain-may-be-booted-medicaid-program

Dental chain may be booted from Medicaid program
By David Heathemail 5 hours, 37 minutes ago Updated: 5 hours, 37 minutes ago

[img][/img]
There are 43 million American kids eligible for Medicaid or similar coverage, but finding a dentist willing to accept the program’s lower rates for dental care can be tough. (Frontline)

Small Smiles, which has been under federal scrutiny for years for performing unnecessary dental treatments on children, could be barred from the Medicaid program beginning next month.

The inspector general of the Department of Health and Human Services notified the chain last week that after years of monitoring, the company remains out of compliance with the terms of a 2010 settlement of a whistleblower lawsuit brought by the Justice Department.

The decision affects one of the nation’s largest dental chains, with clinics in 20 states. It could force thousands of children in low-income families to find a new dentist willing to treat them.

Small Smiles will be excluded from the Medicaid program in early April unless it appeals the decision. The owner of the company could not be reached for comment Monday.

The settlement of the Justice Department lawsuit required Small Smiles to refund $24 million to the Medicaid program for performing unnecessary treatments on children and to submit to independent monitoring to assure the problems are fixed. Last week’s letter cited a series of ongoing quality and reporting problems at Small Smiles clinics.

Small Smiles was first accused of paying dentists bonuses to hit production targets in a 2007 television news report. The Center for Public Integrity and PBS Frontline exposed similar practices at another chain, Kool Smiles, in a 2012 report titled “Dollars and Dentists.”

Small Smiles’s owner eventually sold its assets in May 2012 to a venture capital firm in Nashville called CSHM LLC.

<>

[VWolf]

8. Harvard.

What do they know.

[grahamhgreen]

9. As will lack of Medicare for all, btw.

[bigdarryl]

10. If the democrats can't run on that they deserve to LOSE!!!

[sakabatou]

11. That may be what some Repubs want

[imthevicar]

12. The Only way the GOP would give a rat's ass is

If they were standing in the Unemployment line.

[GeoWilliam750]

13. Democrats vs Republicans

Democrats: People before property
Republicans: People are property

[randr]

14. The Right Wing Death Squads at their finest