Wednesday, August 22, 2012

A Stand-Alone Newsbite for My Ol' High School Classmate Charlie Reussner


Charlie!

Ol' pal, ol' buddy, ol' high school classmate and present-day FaceBook friend of mine...

(*WINK*)

This is a "newsbite." It's a fine example of the many "newsbites" I provide access to (all for free - and no ads!) each day on my blog!

Indeed, it's exactly the sort of info that you - and folks like you - should consider as you go through life on ideological auto-pilot.

(*CHUCKLE*)

Seriously, dude... I know it's true that "you can lead a horse to water but you can't make him drink," but never say that no conservatives have ever reached out to you out of the best of motives!

Enjoy...

Medicaid is cumbersome, complex, and wasteful – already the worst health care program in the country.

DOES ANYONE DISPUTE THIS? ANYONE AT ALL...?

But rather than making changes to improve or modernize this program designed to finance care for the poor, the Obama administration is trying to convince states to add at least 16 million more people to Medicaid - including families making more than $30,000 a year.

(*JUST SHAKING MY HEAD*)

That means the...patients enrolled today will be competing with millions of new Medicaid patients for appointments to see a limited number of physicians.

Those who have the greatest need and nowhere else to go are likely to have the hardest time getting care.

SO THEY'LL GO TO THE EMERGENCY ROOM... AND THE DYSFUNCTIONAL, COSTLY, WASTEFUL CYCLE CONTINUES...

(*SIGH*)

In its ruling in June, the Supreme Court made it optional for states to expand Medicaid to cover new enrollees. 

SO GUESS WHAT'S GONNA HAPPEN...

(*SMIRK*)

Even with generous federal funding...

"GENEROUS FEDERAL FUNDING" FROM A FEDERAL GOVERNMENT THAT CAN'T MEET ITS EXISTING PAYROLL AND EXPENSES AND HAS TO BORROW 43-CENTS OF EVERY DOLLAR SPENT ON OPERATING EXPENSES...

(*SHOOTING PAIN DOWN MY LEFT ARM*)

[S]everal states have said flatly they cannot afford the expansion, which would cost states at least $118 billion through 2023.

OH! WHAT A SURPRISE! 

(*SNICKER*)

NOW... LET'S DEAL WITH SOME OTHER FACETS OF REALITY:

First, there simply aren’t enough doctors to handle this influx of new patients. Given Medicaid’s abysmally low payment rates, private doctors won’t be able to afford to take much more of the exploding caseload.

A recent article in Health Affairs found that nearly one-third (31%) of physicians are not accepting any new Medicaid patients. 

WHAT'S PLAN B - ENSLAVE PHYSICIANS? PUT 'EM TO WORK AT GOVERNMENT FACILITIES AT SET SALARY - EITHER THAT OR THEY LOSE THEIR LICENSES... OR WORSE?

Sandra Decker, an economist with the Centers for Disease Control and Prevention, used a survey of 4,326 office-based physicians from across the country to find that just under 70% said they were accepting new Medicaid patients. That number was significantly lower than those accepting privately-insured subscribers (81%) or Medicare patients (83%).

NOW THAT'S INTERESTING... THAT LAST COMPARISON... MORE DOCTORS ACCEPTING NEW MEDICARE PATIENTS THAN PRIVATE PATIENTS. MY GUESS... THAT STAT IS CONNECTED TO MEDICARE FRAUD... TO THE FACT THAT A BAD DOCTOR (EITHER "BAD" IN TERMS OF SKILLS... "BAD" IN TERMS OF BEING DISHONEST... OR "BAD" IN BOTH RESPECTS) WILL MORE LIKELY GET AWAY WITH SCAMMING MEDICARE THAN PRIVATE INSURANCE COMPANIES.

(*SHRUG*) 

HEY... MAKES SENSE... RIGHT?

The problem is particularly acute in states that have the lowest reimbursement rates for physicians.

WOW... WHAT DO YOU KNOW! REIMBURSEMENT RATES MATTER!

(*SNORT*)

Many states that plan to expand Medicaid under ObamaCare are those with low Medicaid reimbursement rates. In California, for example, up to 1.6 million residents are expected to gain coverage under the state’s Medicaid program, called Medi-Cal, but fewer than 60% of providers accept new patients in the program.

OH, YEAH... SOME "COVERAGE" THAT'S GONNA BE!

That’s largely because California reimburses doctors 38 cents for every dollar private insurance pays. 

(*SMIRK*)

New York, which is anxious to further expand its Medicaid rolls, pays doctors only 29 cents on the dollar.

OH... MY... FRIGGIN'... GOD...

(*JUST SHAKING MY HEAD*)

A Medicaid card clearly will not guarantee access to a physician.

SO WE'RE BACK TO THE EMERGENCY ROOMS...

Where would these newly “insured” Medicaid patients go for care with fewer doctors willing to accept new patients? 

BACK TO THE EMERGENCY ROOMS... WHICH WILL NOW BE EVEN MORE CROWDED... WHICH WILL NOW BE EVEN WORSE "LOSS CENTERS" FOR THE HOSPITALS...

(*PAUSE*)

FOLKS... 

(*SIGH*)...

ECONOMIC REALITY... ACKNOWLEDGE IT!

Safety-net hospitals that provide care to the poorest and most vulnerable in our society already are stretched to the limit financially. Adding millions more people to Medicaid will put crushing new demands on them.

In addition, at least 30 million people will remain uninsured after the law is fully in effect, based upon optimistic projections from the Congressional Budget Office. These uninsured will continue to need care, often without the ability to pay.

(*SARCASTIC CLAP-CLAP-CLAP*)

ObamaCare adds a further distortion: To help pay for its expanded coverage, the health law cuts existing payments to hospitals that provide care to a “disproportionate-share” of uninsured patients. 

BUT... BUT... BUT... WHAT ARE THEY SUPPOSED TO DO - BREAK THE LAW BY TURNING EMERGENCY ROOM PATIENTS AWAY ON THE BASIS OF EITHER NO INSURANCE OR LOW-REIMBURSEMENT MEDICAID INSURANCE...?!?!

So there will be less money to compensate hospitals for patients who will still show up needing care.

(*JUST THROWING MY HANDS UP*)

Studies consistently show that Medicaid patients have the worst health outcomes of any group in America, worse than those with private insurance and, in some cases, worse than those with no insurance. A large study by the University of Virginia found that surgical patients on Medicaid are 13% more likely to die than those with no insurance at all and 97% more likely to die than those with private insurance.

WELL... I'D GUESS THIS IS CONNECTED WITH THE "LIFESTYLE" OF MEDICAID PATIENTS. THAT SAID, IF ANYTHING, OBAMACARE SHOULD WORSEN OUTCOMES AS IT FURTHER STRESSES OUT THE SYSTEM.

The problem is particularly acute for Medicaid recipients who need to see specialists. One Florida doctor reported that, after a long battle with the state over payment for treating a patient with complex lung disease, he received a check from Medicaid for one penny.

FOLKS... IT WOULDN'T MATTER IF THE CHECK WAS FOR $100... OR $1,000... OR...

(*PAUSE*)

AS LONG AS YOU HAVE A MULTI-TIER PRICE/REIMBURSEMENT SCHEME GOING - AND NO LEGAL SLAVERY - ALL "PRICE CONTROLS" ARE GONNA DO IS FURTHER DISTORT THE SYSTEM! JEEZUS... WE'VE SEEN THE TRUTH OF THIS EVERY TIME IT'S TRIED!

Medicaid patients will find access to care restricted in other ways.

OH, YEAH! READ MORE ABOUT WHAT GOVERNMENT "COVERAGE" MEANS IN THE REAL WORLD! (READ ON!)

States already are restricting access to drug services for existing Medicaid beneficiaries.

Kaiser Health News reports that “Illinois Medicaid recipients have been limited to four prescription drugs [per month] as the state becomes the latest to cap how many medicines it will cover in the state-federal health insurance program for the poor.” 

ILLINOIS...? HMM... NOW REMIND ME... WHY DOES "ILLINOIS" SOUND SO FAMILIAR...?

(*SMIRK*)

A total of 16 states impose monthly limits on prescription drugs for beneficiaries, “and seven states have either enacted such caps or tightened them in the past two years.”

(*PURSED LIPS*)

Despite these many problems, many states are tempted and are seriously considering whether to accept the generous 100% federal matching money ObamaCare initially offers...

I*N*I*T*I*A*L*L*Y...!!!

...if they expand eligibility for Medicaid up to 138% of poverty (more than $32,000 for a family of four).

(*JUST SHAKING MY HEAD*)

FOLKS...

(*JUST THROWING UP MY HANDS AGAIN*)

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