Tuesday, September 18, 2012

7. What Medicaid expansion means to doctors and patients

Yesterday we talked about how the government has been fixing prices in healthcare for years
through Medicare and Medicaid. Now, because private insurance companies know that we
lose money on these patients, they will pay us a bit more to see their patients. So, when the
government threatens to decrease reimbursement to Medicare providers, it is automatically
decreasing the amount we get paid by private insurers also. I’ll bet you didn’t know that you
were paying more for your private insurance premiums to make up for Medicare and Medicaid
patients did you?

Let me give you an example. In a well-established large community hospital in a fairly
large city, the breakdown of payers coming into the Emergency Room is this: 15% have
no insurance and do not pay anything for their care; 40% are Medicare patients ;20% are
Medicaid patients); and the remaining 25% are privately insured patients. So 75% of patients
seen in the emergency room in this typical hospital are actually COSTING the hospital
money. Now this is a private hospital, not a public inner-city trauma center. In an inner-city
trauma center it’s much worse. Name one other industry that does so much work, and takes
so much risk, to lose money.

So, Obamacare wants to increase the number of people who are insured by increasing the
number of people that will qualify to be on Medicaid—the worst paying government program
in existence. But, you say, at least you’ll get paid something for the patients that you don’t
get paid for at all now. Perhaps, but we will also have to file mountains more paperwork, deal
with thousands more pages of government regulation, and hire thousands more employees
(with benefit packages) to do all of this additional work. In the long run, we will be losing even
more money. Already 30% of US doctors don’t accept Medicaid. Now we’re going to increase
that by adding 19 Million more Medicaid patients? Just because you have an insurance
card, doesn’t mean you can find a doctor to take care of you. That’s what happening in
Massachussetts. The average wait time to see a primary care physician there is 48 days.
Why in the world do the Democrats think that we can solve the problem of the uninsured by
expanding a program that is already bankrupt and not working??? Expanding Medicaid is
NOT the answer!

(Note: This commentary is by Dr. Jill Vecchio.) 

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