Medicaid Cuts: Teeth Pulled, Transplant Called Off

[Purveyor]

CHICAGO (AP) — In Illinois, a pharmacist closes his business because of late Medicaid payments. In Arizona, a young father's liver transplant is canceled because Medicaid suddenly won't pay for it. In California, dentists pull teeth that could be saved because Medicaid doesn't pay for root canals.

Across the country, state lawmakers have taken harsh actions to try to rein in the budget-busting costs of the health care program that serves 58 million poor and disabled Americans. Some states have cut payments to doctors, paid bills late and trimmed benefits such as insulin pumps, obesity surgery and hospice care.

Lawmakers are bracing for more work when they reconvene in January. Some states face multibillion-dollar deficits. Federal stimulus money for Medicaid is soon to evaporate. And Medicaid enrollment has never been higher because of job losses.

In the view of some lawmakers, Medicaid has become a monster, and it's eating the budget. In Illinois, Medicaid sucks up more money than elementary, secondary and higher education combined.

"Medicaid is such a large, complicated part of our budget problem, that to get our hands around it is very difficult. It's that big. It's that bad," said Illinois Sen. Dale Righter, a Republican and co-chairman of a bipartisan panel to reform Medicaid in Illinois, where nearly 30 percent of total spending goes to the program.

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http://www.wnep.com/news/sns-ap-us-medicaid-cuts-states,0,7413855.story

[OHdem10]

1. Do not forget--last week it was reported that Texas just wants to

get rid of Medicaid.

[abelenkpe]

2. We need single payer. nt

[DJ13]

3. Yes we do, desperately

[Recursion]

7. We could start out by opening it up to the people who can't afford insurance

And fund it out of general revenues, with Federal grants tied to state funding levels.

What would we call it? Hmm... well, it's about medicine, and it would aid people... how about "Medicaid"?

[Hello_Kitty]

8. And it's what half the "30 million who will now be covered under this historic law" will be getting

Your point?

[Recursion]

12. Yep

A public option would have been even worse, if it doesn't have dedicated funding.

[Hello_Kitty]

15. Wow, so you're admitting millions are going to get substandard health care under this plan

You are right about the need to adequately fund a public option.

[Recursion]

17. As opposed to "none" currently

And they'll probably get good care for a while, until it bankrupts the providers.

You are right about the need to adequately fund a public option.

I'm not so much worried about "adequate"; I'm worried about "dedicated". If it is part of the general budget, it will be cut, and we all know that.

Medicaid can only pay as little as it does because providers are recouping their losses by taking private insurance patients. As the number of people on Medicaid goes up, that stops being true. And I don't think anybody knows what's going to happen there.

[Hello_Kitty]

18. What good is 'coverage' if no one accepts it?

And if you are concerned about dedicated funding streams don't those concerns apply equally to the subsidies going to low income people to purchase private insurance? Can't they be cut just as easily as any other part of the general budget?

[Recursion]

19. Less likely because insurance companies will lobby to have them kept

Same reason student loans are more or less safe.

Oh, and you can imagine what the insurance lobby will do the first time somebody tries to cut these subsidies. They'll drag out every Little Bald Timmy In A Wheelchair they can find and have him tearfully say how he hopes those mean Congressmen don't make him leave the hospital before he's better. You know, the shit MoveOn.org should have been doing last year.

[Hello_Kitty]

20. Why should insurance companies care as long as there's still a mandate?

They cut the subsidies and raise individual premiums at a commensurate rate.

[Recursion]

21. Because out of pocket premium cost is capped at 8% of income

or 8.5%, I don't remember. Unless wages magically start going up again, or delivery costs magically start going down, that won't be enough to keep the insurance companies solvent. The subsidies are there to make up the difference between the low-income plans and the cost of care for the people on them.

[abelenkpe]

23. My pop set up health insurance plans

for large and small businesses before he retired. He thinks insurance should be cut out of the deal altogether. Maybe that would help?

[Recursion]

26. It's definitely an inefficient way to pay for things

But then, that same critique includes Medicare.

[Hello_Kitty]

25. That can be changed. eom

[Recursion]

28. This is a trade off the insurers were willing to accept

Steady and predictable vs. outlandishly volatile income.

Corporations don't like change; once this is here they won't want to get rid of the piggy bank.

[Recursion]

4. What's Medicaid, again?

Face. Palm.

[abelenkpe]

10. At the federal level

so states can't slash benefits.

[Recursion]

14. Right, only the Feds can slash benefits

Just like private insurers, Medicare, and the VA, Medicaid or any public option would face the same actuarial realities and rising delivery costs. Cutting profits and marketing costs doesn't get us there, though obviously that would be better.

Worse, any public system that does not have a dedicated revenue stream is going to have the exact same problems Medicaid does: if it's part of the regular budget, it's going to be cut at some point.

[abelenkpe]

22. Cutting porofts, marketing costs and administration

would be helpful. I'm suggesting we need a dedicated revenue stream not subject to political posturing. the right always moves to de-fund social programs put in to place in an attempt to make them fail so they can push people towards privately run businesses. Then they de-fund the regulators who are supposed to protect consumers from the same private businesses.

You think we should scrap all government health care and leave it to private business? What would you do?

[Recursion]

24. I think we need to concentrate on providers

Actually I like best the model that Sanders snuck into the bill: the Federally Qualified Health Clinic (he tripled their funding).

You think we should scrap all government health care and leave it to private business? What would you do?

I think the right and the left have some ideas here that would work well together. The right is right (for once) about lack of price transparency. I have to choose treatment X vs. treatment Y and I don't even know what they cost (I mean, I may know what they'll cost me, but I have no idea what my insurance pays for them -- sometimes it's a trade secret). Copays are a way the insurance company has to nudge me towards less expensive options, but that's a pretty blunt instrument, you know? On the left side, a lot more of providers' direct salaries should be paid out of public funds, and they should be paid less on a for-service basis and more on a salary basis.

[zipplewrath]

5. Maybe we need some HCR

Just a thought and all. Maybe a major push to control the cost of health CARE.

[Recursion]

6. And yet people are supposed to love the idea of a public option?

Which would be funded the same way Medicaid is. This is why hospitals and other providers were so set on killing it.

[Hello_Kitty]

9. HCR is going to be adding 15 million new Medicaid enrollees to the system.

Raises the eligibility to 133% FPL.

[Recursion]

16. Don't I know it

And it's probably going to lead to a lot of provider consolidation. I'm hoping things come out better on the other end.

[Bluenorthwest]

11. People love the idea of getting good health care at a fair price

Like every other citizen of a democracy on the planet. Is it that hard to understand? What do you do for a living?

[Recursion]

13. I club baby seals

More to the point, I desperately want people to get good health care at a fair price, and I'm simply not convinced that private vs. public insurance is the problem: fee-for-service is the problem.

[SoCalDem]

27. Coming Soon ! to a neighborhood near you.... Frontier Medicine

:(