Skip to comments.Medicaid Backdoor to Government Health Care
Posted on 01/06/2014 5:10:48 AM PST by Kaslin
Now we have the latest in the long and growing list of unpleasant surprises about the Affordable Care Act.
It turns out that expansion of coverage of Medicaid for low income Americans increases rather than decreases visits to hospital emergency rooms.
According to just released results of a new study, published in the journal Science, based on 10,000 low income residents in Oregon newly covered by Medicaid, their emergency room visits were 40 percent higher than those with no insurance at all.
It was supposed to be the opposite. Supposedly a big driver of our high expenditures in health care has been due to those without insurance going to emergency rooms.
So get more of these folks covered with government health insurance, they stop going to the emergency room, and we all save money. Right? Wrong.
According to this study, increased ER visits, as result of expanded Medicaid coverage, increased spending by $120 per covered individual.
Several factors could be at work here.
One, it has been widely reported that physicians in private practice avoid Medicaid patients because of low reimbursement rates. So being covered by Medicaid does not necessarily increase the chances of personal care in a private office.
Another factor is appreciation that behavior is driven by cultural experience. Anyone that understands the culture of low-income America knows that these are not communities where health care is associated with private physician visits. It is associated with emergency rooms and hospitals.
It may well be as more lower income individuals get under the Medicaid umbrella, they simply feel even more comfortable doing what they always have done go to the emergency room.
If the results of this study provide a reliable snapshot of reality, we now face another huge and costly error in the assumptions that built and brought us Obamacare.
Those who created this law decided on a fix for the uninsured who earn too much to qualify for Medicaid but who are too costly to subsidize for private insurance purchased through exchanges. The brilliant decision was to expand qualifications for Medicaid up to those earning 138 percent above poverty.
In order to bribe states to expand their Medicaid programs to cover these individuals, the federal government (translation: we taxpayers) will cover 100 percent of the costs of expansion for three years, and then 90 percent thereafter.
Twenty-five states plus the District of Columbia have agreed to take the bribe.
So far, providing free government health care through Medicaid has been attracting far more new enrollees than individuals signing up on the exchanges. Estimates are there almost 2 million new enrollees through the exchanges and about 4 million new enrollees into Medicaid.
The Congressional Budget Office projects the number of enrollees in Medicaid to reach 91 million by 2023. And CBO projects annual growth in expenditures on Medicaid to be 8 percent per year, or more than double the expected growth rate of the American economy.
The bottom line is Medicaid is becoming a back door to get an increasingly large percentage of the American population on a single-payer government health care system and an increasingly large percentage of the American population on welfare.
Given the results of this new study, in all likelihood the costs of all this in dollars is grossly underestimated.
And given my experience studying welfare for 25 plus years, both initially as a recipient of it, and then as a critic of it, the human costs of all this are also grossly underestimated.
Less government would open the door to creative ways to deliver more and better health care, geared to the needs of different individuals. Vouchers for low-income earners solves the problem for these folks to buy insurance.
But if what we want is bigger government, more Americans addicted to it, and growing waste, deficits and debt, were on the right track.
Of course it is. Obama’s goal is to take any program that hands people money for doing nothing — Medicaid, SSI disability, food stamps — and expand it so that the whole country can sit on its collective ass and get a government check.
The one benefit with medicaid is that it pays the hospital ERs so they don't get stuck providing free treatment due to that Federal mandate on them passed into law in early 1980s.
A couple of observations here. The 25 states that took the 3-year Federal government assumptions of all Medicaid cost hopefully will cause a population shift.
This will happen because the other 25 states are going to balk at paying all these increased Medicaid cost, likely with reduced allocations from the Federal Government as punishment for not taking the deal. IOW, the losers are gonna go where the gravy is.
Secondly, a projected 91 million on Medicaid by 2023 is conservative in my opinion; there are about 50 million on it as of 2012. If you add the illegals that these 25 bribed states will allow on the program and the relaxed income rules under PPACA, I’d say that number will be near 70 million in just two years (2016).
In my opinion, the straw that will break our fiscal back is Medicaid and what the Federal Government and colluding states have promised. It is intended to, and will, create a healthcare disaster from which single-payer, Uncle Sam the doctor, will emerge.
We are in deep, deep kimchi....
I prefer this cost cutting measure.
Emergency Room abuse is fueled by ignorance and a sense of entitlement. How surprising that those with no experience or clear concept of how insurance works would continue old habits.
So long as the law requires hospitals to treat anyone who shows up, and kiss their behinds while doing so, freeloaders will continue to take whatever they can get away with.
Since the gubmint can dictate free treatment, why not require hospitals to operate 24-hour doc-in-the-box clinics near the ER’s? Intake personnel could steer the hoards of Medicaid mothers with colicky babies and people with colds to the D.I.T.B., and send genuine emergency cases only to the ER. Billions saved.
“Obamas goal is to take any program that hands people money for doing nothing”
And also to stock the gov’t. coffers with citizens’ money. I heard that when people are on Medicaid, when they die, their “estates”, such as they are, are automatically grabbed by the government.
Steer as many people as possible to the Medicaid option, and it’ll be mo’ money for the dems to spend.
This isn’t rocket science, services are more readily used if the user doesn’t directly have to fork out for the service.
Loans (i.e. credit cards), ANY Government service, etc...
It’s not just when you die. The government can place liens on your property and collect the money when you try to sell your house, get a home equity loan, cash out your pension plan etc. ... while you are still alive.
The relaxation of the eligibility requirements and the elimination of the asset test for Medicaid is sucking a lot of people in who actually have some assets (no matter how meager).
These results were self-evident BEFORE the law was even passed!!
When people heard that someone or some office was giving out “Obama Stash” money, instead of the expected 40-60 people showing up, they had over 400!
I know people, including myself (when I had no insurance), who LIMIT their ER/Doctor visits to either TRUE emergencies or when funds were available. That is human nature!
Now these people have FREE, UNLIMITED medical access (and not just the new Medicaid people - TRUST ME, those entitlement people who now have health insurance will be inundating ERs and Doctor offices as well), more importantly, they will go for every single little bump, bruise, sneeze or hang nail! The entitlement mentality has changed their human nature to: if it is now available, USE THE HELL OUT OF IT!
At least one of our local hospitals, maybe all 4 of them, does exactly that and has been doing it for many years.
"Urgent Care" is attached to the emergency room. Non emergencies are sent to Urgent Care. What's not clear to me is whether Urgent Care is required to see non emergency patients, who do not pay.
What you said is true. If I could get “free” steaks, I might be in line frequently.
Probably not though, I know nothing is “free”.
“...will be inundating ERs and Doctor offices as well), more importantly, they will go for every single little bump, bruise, sneeze or hang nail! The entitlement mentality has changed their human nature to: if it is now available, USE THE HELL OUT OF IT!”
This has been going on for a long time. I’d almost RATHER die than go to the emergency... and I HAVE insurance.
The ER is THEIR family doctor and they have been going there like that for a long time. Then they just walk away and ignore the bill for treatment.
Of course the cost for THEIR treatment is absorbed into the price that INSURED people pay for their OWN treatment.... so how many times DO we end up paying???
Think about it...You pay your own policy premium, your own deductible, your own doctor office co pay, your own out of pocket... AND, the gov’t taxes the living hell out of you so these losers can go to the hospital for FREE ... THEN you pay again when YOUR bill is padded so the hospital can recover their losses!!!!
I can’t find any reason why, upon noting the ER visit does NOT involve life-saving treatment, just reject the ‘patient’ outright (go see your primary/specialist/etc.) OR deny treatment.
Why/How can anyone with a runny nose tie up available ER time/personnel w/out repercussions??
IMHO, hospitals/etc. should have an in-house debt/bounty collector for the same. Especially for those that like to ‘joy-ride’ the ambulances for the ‘free ride’.
My guess is hospitals fear they will be sued, excoriated in the media, and punished by government if they ever turn anyone away. That is why I was proposing accommodating this ludicrous reality at lower cost.
I was surprised to learn via an acquaintance of my brother (acquaintance just left a job as an ER nurse out of frustration), that “reimbursement rates” depend on the satisfaction rating from service surveys of the deadbeats, many of whom complain no matter what. The hospital pressures the staff to arse kiss the frequent flyers and lowlifes, who have this game figured out. America is simply upside down.
Hospitals actually do have debt collections departments. But they can’t get blood out of a turnip, and most the the problem types have no income, no assets, etc., and live off “entitlements”. Sadly, a large portion of the population cannot create enough value to pay for their own lives.