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Title: What if states ditch Medicaid?
Source:
Washington Post
URL Source: http://voices.washingtonpost.com/ez ... _if_states_ditch_medicaid.html
Published: Nov 9, 2010
Author: Suzy Khimm
Post Date: 2010-11-09 10:51:10 by go65
Keywords: None
Views: 11821
Comments: 46
The Medicaid expansion was meant to be one of the hallmark accomplishments of health-care reform. The Affordable Care Act will expand the program rapidly by subsidizing insurance for all Americans up to 133 percent of the poverty line, which will add an estimated 16 million new Medicaid enrollees. During the health-care debate, Democrats heralded the move for helping to bring the country closer than ever to achieving universal coverage. But the Medicaid expansion has also become one of the biggest points of tension between the federal and state governments. The federal government will cover all the costs of the expansion until 2019, but the states will eventually be responsible for shouldering part of the burden thereafter, as Medicaid has traditionally been a federal-state cost-sharing program. Many GOP state governments, along with a handful of Democratic ones, have complained that the expansion will bankrupt already cash-strapped budgets. Texas, however, has taken such protestations a step further. Conservative state lawmakers are now demanding that the state drop out of the program altogether to alleviate the state's $25 billion shortfall. If Texas went ahead with such a plan, it's unlikely that the Medicaid program would entirely disappear, but its reimbursement rates would fall so low without state support that almost no one provider would accept the coverage, as Mike Tomasky explains. What would justify such a move? The New York Times cites one veteran GOP state representative who's pushing the idea: "We need to get out of it. And with the budget shortfall we're anticipating, we may have to act this year." The underlying rationale is that sacrificing the health coverage of poor people would be a worthwhile move if it solves the state's budget crisis. If you're a purist in opposing the welfare state — even at significant human cost to the most vulnerable — it's a logical argument to make. But even if we all agree the goal is fiscal solvency, there's also a chance that gutting Medicaid could end up backfiring. The uninsured poor have already been resorting to hospital emergency rooms for care, and hospitals, in turn, have relied on state governments to cover the costs. If Medicaid coverage were pared back, the hospital ER would likely become the de facto safety net: The number of uninsured ER visits would invariably rise, and the state government would end up paying the price anyway. Texas's own comptroller, Susan Combs, has admitted as much: In a 2005 paper, she proposes that the state's Medicaid should be slashed and hospital reimbursements upped instead. But ER visits are extremely expensive, and they won't serve as a particular cost-effective solution to eliminating insurance, which at least gives patients other options for care. To be sure, there's no question that Medicaid has been costly for state governments, and it's understandable that the lingering recession would make state officials feel panicky about the future expansion. There are deeper programs still: the cash-strapped program only pays providers 66 percent of Medicare reimbursement rates, making it hard for Medicaid patients to find doctors who accept their coverage. Such dilemmas strengthen the argument for simply federalizing the entire Medicaid program, protecting it from the ideological and fiscal battles on the state level. But until the day comes that a better Medicaid overhaul is possible, states must also realize that simply trying to wash their hands of the problem by stripping Medicaid coverage from the poor — without providing a reasonable alternative — won't be the answer either. The uninsured poor will continue to get sick. They will continue to seek out health care. And many institutions — including state governments — will still end up paying for it.
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#1. To: All (#0)
The only way this plan would save the state money is if ERs are allowed to validate insurance before treating patients, and then turning those away who are not insured, or require payment up front.
W/O a replacement. You can turn out the lights.
First off. Notice all those Depression Era pics. There aren't any obese people. 8D
What did you and the rest of the recipients do prior to Medicaid, mcclown?
There were damned few in the '50's and '60's, mcclown.
The country is dying. All trends are trending badly. An ICBM was just fired off LA as China has just downgraded US Credit.
Yep, and damned few farm subsidies to promote high fructose corn syrup.
"With the Irish Patient now clinically dead, her grieving European relatives face the melancholy task of deciding when to remove her from life support, and how to deal with the extraordinary debts she ran up in the last months of her life. [..]" Get rid of Medicaid while we're trying to prop up our USEMPIRE/Top 50 000 and ignoring the Ecocide of the GoM. 8D
Who is forcing fatasses to ingest 4-5,000 calories per day?
Percent of Americans Who are Obese Another 30% of Americans are simply overweight. And these percentages are only expected to rise. Dr. Marion Nestle has deemed the obesity epidemic ... www.professorshouse.com › Family › Health › Articles - Cached - Similar Going to 42%. A Guarantee of widespread chronic illness. Drink soda. Get fat.
How many million people have perished as a result of the gulf oil disaster, mcclown?
Medicaid is a disaster. 50% of doctors already refuse patients that are on Medicaid. More doctors are ready to refuse Medicaid patients. States should drop it. They should also demand that the feds reimburse them for the taxes their citizens pay into the rotten system.
Single Payer Medicare/VA for All. People don't realize how close we came to Revolution in 1932-37. Get rid of the promise of Medicaid/Medicare/SS while funding the Banksters/bp/Israel/USEmpire. "For two years, politicians have danced around the nationalization issue, but ForeclosureGate may be the last straw. The megabanks are too big to fail, but they aren't too big to reorganize as federal institutions serving the public interest.[..]"-Ellen Brown
You'll need the replacement. And not have BigPharma/HMO's/Insurance involved. Look forward to hearing your reply. 8D
Just like Canada. They have great health care system, until you are really sick. Then you cross the border and rely on a ghetto hospital in Detroit to save your sorry ass.
Mandatory health savings accounts for all with a government health savings subsidy for low income people. It works in Singapore. Retiring Democrat congressman Brian Baird agrees: That's only for the same 1% Elite who are raping your nation right now. And you can give me the definition of Bernanke's job now. $600 Fucking Billion to his Wall St Buddies. Just like that. Highway robbers. And EVERY Canadian I've talked to LOVE their system. Unless you compare with the EU/Scandinavia. And NO ONE is fighting for America's. A 1/3 World Nation with China firing missiles now 35 off LA and the Pentagon doing bullshit about it. Single Payer Medicare/VA for ALL. And I've know Many VA patients. None complain about the price. 8D
Mandatory!!?? You mean like in the IRS enforces payment? LMFAO And then a...wait for it...SUBSIDY!!?? So that holds down BigPharma/HMO/Insurance how? Why do we need ANY of the above if the US is footing the bill? And I'll be checking Singapore, but CityNations can't be compared to NationStates. The CN's have too many advantages. 8D
Nope. My sister is an emergency room nurse in Detroit. 40,000 Canadians cross the border every year and declare an "emergency" so that they can get help in an American hospital rather than sitting on a waiting list to die in Canada.
Both of them, mcclown? Appears the MD's aren't quite as enthralled. N.L. doctors to resign in protest : Breaking News | Canadian News ...Nov 5, CBC News - Health - Resigning doctors vow to leave N.L.Nov 5, 2010 ... Doctors who announced that they are resigning to protest the provincial government's latest contract offer say they are serious about ... www.cbc.ca/health/story/2010/11/05/nl-thirteen-doctors-1105.html 2010 ... Breaking News contains Canadian News,Canadian breaking news. www.breakingnews.ca/?p=260576 - Losing N.L. doctors will harm patients: MD - Yahoo! Canada NewsNov 8, 2010 ... The doctors resigned Friday to protest against the provincial government's ... Harper vows to stand up for Israel The Canadian Press ... ca.news.yahoo.com/.../canada/canada_newfoundland_nl_doc_resignations1108 - Canada -
You are the Stalin / Hitler totalitarian that wants to hold people down. Not me. Medical savings accounts would free people to make their own choices as healthcare shoppers. Singapore has demonstrated this. Unfortunately, brain dead totalitarians like you worship at the feet of D.C. politicians. Our goal has to be to neuter people like you so that Americans can move forward.
Nope. More Americans cross into Canada. From Seattle to N Dakota to Duluth to Buffalo. Canada loses money on this exchange. This is insane. The US will default as it's citizens get poorer by the day. Our Life Expectancy is dropping as I type. and a 'waiting list to die'. Please. I'll need specifics. Like Canada doesn't do hip surgery on 90 year olds.
I'll bet that some of your friends are black and Jewish too! ROTFLMAO!!!!!
To get healthcare services? No. Cite it. Right now. Where's the reference? Right now. Show us.
Excuse me? ;} So as the US Treasury is now footing the Entire Housing/Banking/Health Industry, why is it that ONLY the Rich get the Communism while the Bottom 99% get Free Markets. And how do the Bottom 99% come up with the $$$ to start this Medical savings account?
To get healthcare services? No. Cite it. Right now. Where's the reference? Right now. Show us. 44 - Palin says her family went to Canada for health care when she ... Mar 8, 2010 ... To this day more Americans go to Canada for health care than the reverse. .... in the US hence the reason to cross the border into Canada to ... voices.washingtonpost.com...-she-used-canadian-h.html Anything else? ;} And I can get 100 Celebrex for $100 less. Free Shipping.
You said more Americans cross over to Canada to get healthcare services than Canadians who come to the U.S. to do the same. Cite that statistic. Show us the reference. Right now.
Common sense. Prescriptions alone make Group bus tours a Big $$$ Bizness. More tomorrow. Hasta Manana. 8D
You are nothing but a bullshitter. I won't respond to you any longer. just like lucy's mom. Maybe you two can form a liars club and spin each other into the ground.
That's not even remotely true.
Gawd you are such a fookin disingenuous asshole. Where were they living at the time? Where was the nearest doctor?
One other thing you don't possess, mcclown.
It's absolutely true. There is ample statistical evidence to support this assertion. Here's how it works in Canada: You get a serious illness. They put you on a six month to two year waiting list. Many people die on this waiting list. Every year, about 40,000 are smarter than that. They cross the border into the U.S. They go to a hospital emergency room. Tests are taken, and U.S hospitals do something about it. Here are some interesting statistics for cancer: Prostrate cancer mortality rates are 604% higher in the U.K., 457% higher in Norway, and 184% higher in Canada than the U.S. Breast cancer mortality rates are 88% percent higher in the U.K, 52% higher in Germany, and 9% higher in Canada than the U.S. ditto for colorectal cancer -- higher in Canadian and European socialist systems than the U.S. When the socialist scum destroy our healthcare system, Americans won't be able to simply drive over the Ambassador bridge to Detroit to get treated. We'll have to get on a plane and fly to Costa Rica or Panama. Most people won't be able to do it. They'll just die instead.
So all those Canadian folks I've corresponded with as of late on various cancer forums in support of a close family member of mine are lying when they tell me about the treatments they are receiving (which are the same as what we're getting in the U.S.)? Would it be fair of me to pull statistics showing that preventable deaths are higher in the U.S. then elsewhere? That about 22,000 people per year die in the U.S. as a result of not having insurance? Do you want to compare bankruptcy rates? The number of uninsured? We've been through this before, and if I recall correctly you have advocated a Singapore-style system. Prostate cancer rates there are increasing while they are falling in the U.S. (see: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2642843/) Did you just shoot your own argument apart?
FYI http://www.ctv.ca/CTVNews/MedExpress/20080716/cancer_statistics_080716/ Now how much of GDP does Canada spend on healthcare compared to the U.S.?
There is no way of proving that.
How do these individuals know their care is better than ours? They don't. Statics demonstrate that our care is better. One of many examples, from the left-wing daily newspaper in Detroit: Canadian s visit U.S. to get health care Hospitals in border cities, including Detroit, are forging lucrative arrangements with Canadian health agencies to provide care not widely available across the border. Agreements between Detroit hospitals and the Ontario Ministry of Health and Long-Term Care for heart, imaging tests, bariatric and other services provide access to some services not immediately available in the province, said ministry spokesman David Jensen. The agreements show how a country with a national care system copes with demand for care with U.S. partnerships, rather than building new facilities. (When the leftist destroy our healthcare system where we will go to "cope" with the lack of service???) Michael Vujovich, 61, of Windsor was taken to Detroit's Henry Ford Hospital for an angioplasty procedure after he went to a Windsor hospital in April. Vujovich said the U.S. backup doesn't show a gap in Canada's system, but shows how it works. "I go to the hospital in Windsor and two hours later, I'm done having angioplasty in Detroit," he said. His $38,000 bill was covered by the Ontario health ministry. (Where will YOU get heart surgery when the leftists destroy the U.S. healthcare system???) Dany Mercado, a leukemia patient from Kitchener, Ontario, is cancer-free after getting a bone marrow transplant at the Barbara Ann Karmanos Cancer Institute in Detroit. Told by Canadian doctors in 2007 he couldn't have the procedure there, Mercado's family and doctor appealed to Ontario health officials, who agreed to let him have the transplant in Detroit in January 2008. The Karmanos Institute is one of several Detroit health facilities that care for Canadians needing services not widely available in Canada. Canada, for example, has waiting times for bariatric procedures to combat obesity that can stretch to more than five years, according to a June report in the Canadian Journal of Surgery. As a result, the Ontario Ministry of Health and Long-Term Care in April designated 13 U.S. hospitals, including five in Michigan and one more with a tentative designation, to perform bariatric surgery for Canadians. The agreements provide "more immediate services for patients whose health is at risk," Jensen said. Three Windsor-area hospitals have arrangements with Henry Ford Hospital, Detroit, to provide backup, after-hours angioplasty. Authorities will clear Detroit-Windsor Tunnel traffic for ambulances, if necessary. The Detroit Medical Center also provides Canadians complex trauma, cancer, neonatal and other care. "In the last few years, we've seen more and more Canadian patients," said Dr. J. Edson Pontes, senior vice president of international medicine at the DMC. They include Canadians such as Mercado, whose care is reimbursed by Canada's health system, as well as people who pay out of pocket to avoid waiting in Canada. Pontes declined to give revenue figures for the DMC's international business, but said the program "always has been a profitable entity." About 300 of the DMC's 400 international patients last year came from Canada, he said. Tony Armada, chief executive officer of Henry Ford Hospital, said the hospital received $1 million for cardiac care alone. Critics of a health care system like Canada's -- a publicly funded system that pays for medically necessary care determined by provinces -- often cite gaps in Canada's care to argue that the United States should not allow its current debate over health care to move it to a socialized system. No plan currently under discussion in Congress calls for a universal plan like Canada's, but opponents fear socialized medicine, anyway. Canada's U.S. backup care "speaks volumes to why we don't need government to take over health care," Scott Hagerstrom, the state director in Michigan for Americans for Prosperity, said of the Canadian arrangements with Michigan hospitals. "Their system doesn't work if they have to send us their patients." But Dr. Uwe Reinhardt, a Princeton University health economist who has studied the U.S. and Canadian health systems, said arrangements with cities like Detroit "are a terrific way to manage capacity" given Canada's smaller health care budget. "This is efficient," he said. "At least in Canada, you don't worry about going broke to pay for health care. You do here." Pat Somers, vice president of operations at Windsor's Hotel-Dieu Grace Hospital, one of the hospitals that sends patients to Henry Ford, said the issue of finding ways to pay for and prioritize care requests is not in only Windsor. "The ministries are quite aware of" waits for care in Sarnia and Hamilton, she said. "That's why we are investing in a wait list strategy" to best determine how to prioritize cases for people who need hip and knee replacements, cataract surgery and treatment for cancer, for example. Mercado, 26, faced a longer wait because he could not find a matching blood donor, even though his family conducted a broad search. He said doctors told him money was limited for transplants, particularly ones using unmatched donors, which are riskier. After his family's doctor wrote the Ontario ministry, the agency agreed to pay $200,000 for the operation. The family, their church and Mercado's school, Conestoga College in Kitchener, raised another $51,000 to cover expenses going back and forth to Detroit. "I think of this every day as a gift from God," Mercado said.
How many illegals and indigents does the US treat compared to Canada? How many medical schools and top rated medical facilities are in Canada? How many biomedical research firms are there in Canada? How many pharmaceutical firms? Why are Canadian doctors resigning? Canada has a population about equal to that of the state of California. http://www.city- journal.org/html/17_3_canadian_healthcare.html M. D. Anderson in Texas, a prominent cancer center, spends more on research than Canada does.
You are nothing but a bullshitter. And Fuck You also. I told you that I was going to bed. Be back in the AM. I didn't tell you that Google is no help when it comes to Comparisons of US/Other Health Systems(You have to know beforehand almost exactly what the article is before the search. In other words, Google will not offend it's Host Nation. 8D Now where was I. Oh yeah, telling you that Canada's System is better than ours. Debunking myths about Canadian health care Are Canadians flooding into the United States to get better health care? No. Are Canadian doctors immigrating to the United States to work for our health-care system? No. 2010 By Ezra Klein | October 12, 2010; 10:53 AM ET http://voices.washingtonpost.com/ezra-klein/2010/10/debunking_myths_about_canadian.html
Phantoms in the snow 25 comments October 11, 2010 at 9:27 am Aaron Carroll Based on the comments I’ve seen over the last week, many of you are still going with that well used meme in the health care debate that people in other countries – frustrated by wait times and rationing – come to the United States for care. These are almost always anecdotal stories and you should know by now how much stock I put in anecdotes. AND I rest my case on GOOGLE CENSORSHIP, LMFAO Useful Idiots 8D http://theincidentaleconomist.com/wordpress/phantoms-in-the-snow/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+TheIncidentalEconomist+%28The+Incidental+Economist+%28Posts%29%29 graph_myth29 The important line to watch is the yellow one, which is the net loss of docs to Canada. Even in the worst year, fewer than 500 more docs moved out of Canada than moved in. But, since 2003, there has been a net movement of docs into Canada. Docs are not fed up with Canada and moving away. If anything, it’s the opposite. The US is a 1/3 World Nation. The Middle Class has been destroyed. All your Fucking Non College $30 per hour jobs have been exported and are not coming back. College Ed jobs are now disappearing as well. But you Useful Idiots keep waving the Flag like it's a Talisman to ward off those Evil Naysayers. 8D All Day Long.
they aren't all crossing over the border to go to ghetto hospitals when they get sick as you have claimed. That claim is patently false. yes, some do cross over, but the vast majority get adequate treatment in canada, and the country has a higher life expectancy than the U.S.
Comments (42 - 46) not displayed.
Top • Page Up • Full Thread • Page Down • Bottom/LatestThe uninsured poor have already been resorting to hospital emergency rooms for care, and hospitals, in turn, have relied on state governments to cover the costs. If Medicaid coverage were pared back, the hospital ER would likely become the de facto safety net: The number of uninsured ER visits would invariably rise, and the state government would end up paying the price anyway. Texas's own comptroller, Susan Combs, has admitted as much: In a 2005 paper, she proposes that the state's Medicaid should be slashed and hospital reimbursements upped instead. But ER visits are extremely expensive, and they won't serve as a particular cost-effective solution to eliminating insurance, which at least gives patients other options for care.
On January 3, 2011 the GOP assumes responsibility for deficit spending.
#2. To: go65 (#0)
#3. To: go65 (#1)
#4. To: mcgowanjm (#2)
You can turn out the lights.
#5. To: mcgowanjm (#3)
First off. Notice all those Depression Era pics. There aren't any obese people.
#6. To: All (#3)
#7. To: Ibluafartsky (#5)
There were damned few in the '50's and '60's, mcclown.
On January 3, 2011 the GOP assumes responsibility for deficit spending.
#8. To: All (#6)
#9. To: go65 (#7)
Yep, and damned few farm subsidies to promote high fructose corn syrup.
#10. To: go65 (#7)
Yep, and damned few farm subsidies to promote high fructose corn syrup.
#11. To: mcgowanjm (#8)
Ecocide of the GoM.
#12. To: go65 (#0)
(Edited)
"To compel a man to furnish contributions of money for the propagation of opinions which he disbelieves is sinful and tyrannical." -- Thomas Jefferson
#13. To: All (#10)
#14. To: jwpegler (#12)
Medicaid is a disaster.
#15. To: mcgowanjm (#13)
Single Payer Medicare/VA for All.
"To compel a man to furnish contributions of money for the propagation of opinions which he disbelieves is sinful and tyrannical." -- Thomas Jefferson
#16. To: mcgowanjm (#14)
You'll need the replacement.
"To compel a man to furnish contributions of money for the propagation of opinions which he disbelieves is sinful and tyrannical." -- Thomas Jefferson
#17. To: jwpegler (#15)
Just like Canada. They have great health care system, until you are really sick. Then you cross the border and rely on a ghetto hospital in Detroit to save your sorry ass.
#18. To: jwpegler (#16)
Mandatory health savings accounts for all with a government health savings subsidy for low income people.
#19. To: mcgowanjm (#17)
(Edited)
That's only for the same 1% Elite
"To compel a man to furnish contributions of money for the propagation of opinions which he disbelieves is sinful and tyrannical." -- Thomas Jefferson
#20. To: mcgowanjm, jwpegler, All (#17)
And EVERY Canadian I've talked to LOVE their system.
#21. To: mcgowanjm (#18)
(Edited)
So that holds down BigPharma/HMO/Insurance how?
"To compel a man to furnish contributions of money for the propagation of opinions which he disbelieves is sinful and tyrannical." -- Thomas Jefferson
#22. To: jwpegler (#19)
Nope. My sister is an emergency room nurse in Detroit. 40,000 Canadians cross the border every year and declare an "emergency" so that they can get help in an American hospital rather than sitting on a waiting list to die in Canada.
#23. To: mcgowanjm (#17)
And EVERY Canadian I've talked to
"To compel a man to furnish contributions of money for the propagation of opinions which he disbelieves is sinful and tyrannical." -- Thomas Jefferson
#24. To: mcgowanjm (#22)
(Edited)
More Americans cross into Canada.
"To compel a man to furnish contributions of money for the propagation of opinions which he disbelieves is sinful and tyrannical." -- Thomas Jefferson
#25. To: jwpegler (#21)
You are the Stalin / Hitler totalitarian that wants to hold people down. Not me.
#26. To: jwpegler (#24)
(Edited)
More Americans cross into Canada.
#27. To: mcgowanjm (#26)
"To compel a man to furnish contributions of money for the propagation of opinions which he disbelieves is sinful and tyrannical." -- Thomas Jefferson
#28. To: jwpegler (#27)
more Americans cross over to Canada to get healthcare services than Canadians who come to the U.S. to do the same.
#29. To: mcgowanjm (#28)
(Edited)
Common sense.
"To compel a man to furnish contributions of money for the propagation of opinions which he disbelieves is sinful and tyrannical." -- Thomas Jefferson
#30. To: jwpegler (#15)
Just like Canada. They have great health care system, until you are really sick. Then you cross the border and rely on a ghetto hospital in Detroit to save your sorry ass.
On January 3, 2011 the GOP assumes responsibility for deficit spending.
#31. To: mcgowanjm (#26)
Palin says her family went to Canada for health care
#32. To: mcgowanjm (#28)
Common sense.
#33. To: go65 (#30)
(Edited)
That's not even remotely true.
"To compel a man to furnish contributions of money for the propagation of opinions which he disbelieves is sinful and tyrannical." -- Thomas Jefferson
#34. To: jwpegler (#33)
It's absolutely true. There is ample statistical evidence to support this assertion.
Here are some interesting statistics for cancer:
On January 3, 2011 the GOP assumes responsibility for deficit spending.
#35. To: jwpegler (#33)
(Edited)
Canada has some of the best cancer survival rates in the world, and doctors are pointing to our much-maligned public health-care system as the reason.
In a report on worldwide cancer survival rates, Canada ranked near the top of the 31 countries studied with an estimate five-year survival rate of 82.5 per cent.
For breast cancer, Cuba had the highest survival rates -- another country with free health care. The United States was second, and Canada was third, with 82 per cent of women surviving at least five years.
On January 3, 2011 the GOP assumes responsibility for deficit spending.
#36. To: go65 (#34)
That about 22,000 people per year die in the U.S. as a result of not having insurance?
#37. To: go65 (#34)
So all those Canadian folks I've corresponded with
"To compel a man to furnish contributions of money for the propagation of opinions which he disbelieves is sinful and tyrannical." -- Thomas Jefferson
#38. To: go65 (#35)
Now how much of GDP does Canada spend on healthcare compared to the U.S.?
#39. To: jwpegler (#29)
Common sense.
#40. To: jwpegler, All (#37)
Phantoms in the snow 25 comments October 11, 2010 at 9:27 am Aaron Carroll
#41. To: jwpegler (#37)
How do these individuals know their care is better than ours? They don't. Statics demonstrate that our care is better.
On January 3, 2011 the GOP assumes responsibility for deficit spending.
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