I’m sorry, in all the excitement about Obama Care, I slipped up mentioning the Yugo, the infamous Serbian car which became famous in 1978 as a clunker of all clunkers. But if you like, we could mention the AMC Gremlin or Pacer or the Ford Pinto, as a fill in. All of these clunkers never had the chance for a rebirth like our government friend, Medicaid, the illegitimate second cousin to Medicare. Not that Medicare is standing strong on its own. Anyway, thanks to the great wisdom of the authors of Obama Care, Medicaid is getting top billing, and the similarities to the great auto clunkers is striking. Medicaid is the health program for low income Americans. The program is a joint venture between the federal and state governments and is administered by the states.
So what’s up with Medicaid? Well, it’s the new version of the clunker, or hoopty. Obama Care will increase enrollment in Medicaid by over 20 million people. The problem is, health care providers are already limiting the amount of Medicaid patients they accept because of low payment rates (according to an October 4, 2010 article titled “Obama Care’s Medicaid Policy: Putting the Doctors in Another “Fix”, from Heritage.org). To entice providers to accept more Medicaid patients, Obama Care requires that states -with federal dollars – raise primary care physician (PCP) payment rates for Medicaid to equal levels with Medicare rates for 2013 and 2014. That is fine, but Medicaid already has significant problems of its own. Medicaid spending has grown 6% per year for the last 20 years, and has resulted in 3 federal bailouts in the last decade. Also, many states reimburse Medicaid patients at very low rates. This causes many health care providers to refuse to treat Medicaid patients. And now Obama Care increases Medicaid dramatically, despite it’s enormous problems.
So Obama Care mandates that states increase Medicaid reimbursements for 2013 and 2014, with federal money. However, on January 1, 2015, both the mandate to match Medicare and the federal funding paying for it expire. Many Medicaid providers, who are paid on average about one half of commercial rates, are skeptical of this expansion with Medicaid. Medicaid is very paperwork intensive and it takes almost twice as long to get reimbursement from a Medicaid claim then it does with Medicare or commercial insurance companies. So Obama Care will be adding 20 million new Medicaid patients to the existing Medicaid role.
But now half of the Primary Care Physicians (PCP’s) in the U.S. are saying they are not willing to take on new Medicaid patients even if Medicaid rates match Medicare rates. This presents a problem as the current Medicaid patients in the U.S., 50 million, are already having huge problems getting adequate medical attention. Some of them have figured out one solution. They go to an emergency room at a hospital to get treatment.
Back to my auto clunker analogy. Picture yourself in a Yugo (Medicaid) and you get a jump start from a neighbor (the federal government), and you are sputtering along. But a block or two down the road you blow a tire and your car is getting ready to swerve off of a cliff (you need a financial bailout), but your neighbor is no where to be found. At the same time, you realize that there are thousands of other Yugos going off the cliff with you, so no one will even know you had an accident. You realize this when it is too late to stop the car and get out. As your car careens over the cliff, you remember the famous words of Ms. Pelosi: ” We need to pass Obama Care so the public can find out what’s in the bill.”
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Posted by Terry’s Mind