Medicaid, and they think this is going to work.

[plt42]

Like I said. Democrats know every goddamn thing. One of them will be along shortly to explain it to us..

Okay... now that is funny... sad but FUNNY!

 

[Claudette]

The growing number of physicians who do not accept new Medicaid beneficiaries because of costs "is a large, little-discussed hurdle to some ambitious efforts to broaden health care coverage," the Wall Street Journal reports. According to the Journal, many state Medicaid programs, "straining under surging costs, are balancing their budgets by freezing or reducing payments to doctors," resulting in physicians -- particularly specialists -
Growing Number Of Physicians Not Accepting New Medicaid Beneficiaries Amid Federal Payment Cuts, Rising Health Costs

Medicaid is NOT the method by wich anyone should ever try reform healthcare, and to think that by giving people a Medicaid card they are suddenly going to have access to quality healthcare they are in for a very big surprise.

There is an existing Physician shortage now. What do the democwats think will happen when they cut the Doctors pay rate and then drop 30 million new patients into the system? Like I said. Democrats know every goddamn thing. One of them will be along shortly to explain it to us..

Couldnt' agree more.

I will be waiting with baited breath for them to explain it all to little old dummy me.

 

[Navy1960]

This is Medicaid in my state and notice that in one of the articles that our former Gov. is now everyones Homeland Security Director. You have our deepest sympathies.


The money, from the state’s health crisis fund, is expected to cover people who may be overcharged or overlooked in the next month, said Anne Winter, the governor’s policy adviser for health and human services. If the numbers continue to grow and the federal Centers for Medicare and Medicaid Services hasn’t yet straightened out the problem, she said more funds may be needed.

"We’re just going to start paying for those medications. We just have to," Winter said.

Because of confusion over which part of Medicare should cover their drugs, transplant patients were being denied lifesaving antirejection medication since the drug plan was launched Jan. 1. Dialysis patients on AHCCCS also were being denied.
Arizona pays for Medicare mess | Arizona local news - Mesa, Scottsdale, Gilbert, Tempe, Chandler | eastvalleytribune.com

All is not well in Senator John McCain's home state. Confronted with a general fund budget shortfall of more than $1.3 billion, the Arizona legislature in June enacted modest cuts (primarily in community college and prison budgets), a stepped-up traffic enforcement system to produce some $90 million in speeding tickets, and $2 billion in new debt--half of it to close the hole in the $10.9 billion budget. (The other half will fund university construction.) The budget is a stopgap measure that bodes ill both for next year's budget and for the state's fiscal future, and no Arizona politician pretends otherwise.

In a Wall Street Journal op-ed of uncommon chutzpah, Arizona governor Janet Napolitano attributes her state's travails to Washington's alleged failure to "pay its bills." Characterizing supposed cuts in federal transfer programs--including contemplated and rejected cuts--as federal "debts" to the states, she maintains that "Arizona would not be in deficit this year" if Washington paid up on only a few of its obligations.[2] The governor could not be more wrong. Arizona's fiscal crisis is due chiefly to the state's expansion of its Medicaid programs.
AEI - As Arizona Goes, So Goes the Nation

Now what do you think tens of thousands in additional new people on state Medicaid unfunded mandates is going to do to Arizona? Arizona is not much different than the rest of the nation when it comes to budget issues such as this, and now with the notable exception of say Nebraska which will all now pay for them, and La. which gets additional money from us to help them our states continue to have to lay off teachers, fire, police, and service people in order not to end up in bankruptcy which may be the eventual result. You see, it's easy for the CBO to say that the current bill does not effect the FEDERAL deficit, but the last time I checked this is the UNITED STATES , and I think the CBO may have forgotten the states part in that.

 

[PatekPhilippe]

As the state seeks ways to trim Medicaid, an increasing number of doctors frustrated with reimbursements are opting not to see new Medicaid patients. As a result, Medicaid patients often grow sicker while hunting for a doctor.

"The inability to find a Medicaid doctor drives up the cost for everyone because they then frequent the emergency room," Lewis said.

Dallas ranks last among 15 major cities in the percentage of physicians accepting Medicaid, according to a study by Merritt Hawkins & Associates, an Irving-based health care consulting and recruiting company.

In that study, 1,162 medical offices were surveyed between September 2008 and March. Dallas had a Medicaid acceptance rate of 38.6 percent, compared with the national average of 55 percent

Medicaid patients have trouble finding doctors in Dallas area | News for Dallas, Texas | Dallas Morning News | Dallas Business News

Giving someone an insurance card and telling them they are insured is one thing, having a place to use it is another. The current bill set to pass in the Senate aims to use Medicaid as the primary instrument to achieve it's goal of insuring many of those so called 47 million uninsured. When those uninsured get those Medicaid cards, I highly doubt that they will consider it reform by any stretch of the imagination.

In Oregon , 14 hospitals, four clinics and two health departments in rural areas are short a total of 70 physicians, according to the Office of Rural Health at Oregon Health & Science University.

Throughout the country, at least 1,500 positions for rural doctors are vacant, according to the Madison, Wis.-based Rural Recruitment and Retention Network.

“The people that have insurance live in cities,” said Roger Piepenbrink, a Navy-trained internist at Pioneer Memorial, who now is the town’s only such doctor.

“It’s hard to make a living off subsidized medicine,” he said. “You can make your overhead, but you can’t pay yourself.”
Doctor shortage takes toll in rural areas

If you have ever been to a DMV office on a busy day in a large metro area then you will get some idea of the Senate's vision of healthcare reform using the Medicaid model.

Now wait a second...in the Senate illegal alien healthcare bill it specifically EXPANDS mediciad..that's what Nelson sold his soul for.

 

[Navy1960]

Thats the point Philip, while the Fed. can stand up and tout how deficit reducing this is, and the President can say the same as well as the bills supporters, by expanding Medicaid all your doing when your reduce your burden is shift it over to the states. Expanding Medicaid will be a disaster of epic proportions even in terms of delivery, those who actually get the insurance are going to be very disappointed when they suddenly find out how hard it is to find someone who actually accepts it and the number of Doctors that do is not rising it is falling. Further, by cutting Doctors rates how many more Doctors are going to actually be accepting this form of insurance. Someone mentioned earlier that for many seeing a Doctor will be rare and for the most part it will set up a system of nurses and PA's providing primary care. Interesting concept but not very far from reality in that sort of situation. What the Govt. really has done here is provided the Insurance industry additional millions of customers now mandated to purchase their product, and sent the rest to a lower standard of care. So you will have those who can afford good care, and those who are stuck in the rest. The sad part of this is that by cutting Medicare to fund a large portion of the Medicaid offsets what your also going to end up with is low income Seniors in the same boat. Thats a real sad state of affiars in my opinion.

 

[PatekPhilippe]

Navy..it's the FEDS who are picking up the tab for the Medicaid expansion...Nebraska will never pay one red cent in expanded medicaid services EVER AGAIN!!!! Read it...I'm serious. Not only that but several other States are getting nearly the same deal!!!!!! Probably sold out for more money from American tax payers...
Who wins, who loses in Senate health bill - Health care reform- msnbc.com

 

[Xenophon]

The answer is obvious.

The next thing they will do is regulate Doctors who refuse medicare and make it impossible for them to work without accepting medicare patients.

 

[Navy1960]

Navy..it's the FEDS who are picking up the tab for the Medicaid expansion...Nebraska will never pay one red cent in expanded medicaid services EVER AGAIN!!!! Read it...I'm serious. Not only that but several other States are getting nearly the same deal!!!!!! Probably sold out for more money from American tax payers...
Who wins, who loses in Senate health bill - Health care reform- msnbc.com

While it's not in disupte that Nebraska, La., Vt. and several others got sweetheart deals on this bill. Here is a little more information in the matter.

Data compiled by the National Conference of State Legislators based on the U.S. Senate Finance Bill indicates the unfunded mandate could cost Arkansas $400 million.



“Arkansas is already facing budget cuts because of the current economic climate. These unfunded mandates will undoubtedly hurt Arkansas’ state budget even further. As our country deals with a soaring deficit we cannot expect hardworking Arkansans to fork over more money for legislation they overwhelmingly oppose. There are commonsense solutions for health care reform that aren’t budget busters that increase competition and drive down costs nationwide,” Boozman said.
Press Release : U.S. Congressman John Boozman : 3rd District Of Arkansas

If you have a chance go here to read some of the letters from the Gov. of these various states including my own on the matter. At least to me it's very clear that a vast majority of this bill will be cost shifted to the states and on the back of working Americans in the form of taxes.

 

[Navy1960]

The answer is obvious.

The next thing they will do is regulate Doctors who refuse medicare and make it impossible for them to work without accepting medicare patients.

You can almost see that comming, because once all those who get this new Medicaid find out that they simply cannot walk to the nearest Doctor and be treated then the noise level in congress will go up to force them to accept it.

 

[Charles Stucker]

What do the democwats think will happen when they cut the Doctors pay rate and then drop 30 million new patients into the system? .

Naughty Willow, using Democrat and Think in the same sentence.

 

[Claudette]

Navy..it's the FEDS who are picking up the tab for the Medicaid expansion...Nebraska will never pay one red cent in expanded medicaid services EVER AGAIN!!!! Read it...I'm serious. Not only that but several other States are getting nearly the same deal!!!!!! Probably sold out for more money from American tax payers...
Who wins, who loses in Senate health bill - Health care reform- msnbc.com

While it's not in disupte that Nebraska, La., Vt. and several others got sweetheart deals on this bill. Here is a little more information in the matter.

Data compiled by the National Conference of State Legislators based on the U.S. Senate Finance Bill indicates the unfunded mandate could cost Arkansas $400 million.



“Arkansas is already facing budget cuts because of the current economic climate. These unfunded mandates will undoubtedly hurt Arkansas’ state budget even further. As our country deals with a soaring deficit we cannot expect hardworking Arkansans to fork over more money for legislation they overwhelmingly oppose. There are commonsense solutions for health care reform that aren’t budget busters that increase competition and drive down costs nationwide,” Boozman said.
Press Release : U.S. Congressman John Boozman : 3rd District Of Arkansas

If you have a chance go here to read some of the letters from the Gov. of these various states including my own on the matter. At least to me it's very clear that a vast majority of this bill will be cost shifted to the states and on the back of working Americans in the form of taxes.

The States that got the sweetheart deals will make out fine. Its the other STates that will have to pick up the tab for those states as well as their own who will be screwed. The taxpayer once again will get fucked by these self serving assholes. Anything to pass the HISTORIC peice of shit they are pedaling.

 

[PatekPhilippe]

Navy..it's the FEDS who are picking up the tab for the Medicaid expansion...Nebraska will never pay one red cent in expanded medicaid services EVER AGAIN!!!! Read it...I'm serious. Not only that but several other States are getting nearly the same deal!!!!!! Probably sold out for more money from American tax payers...
Who wins, who loses in Senate health bill - Health care reform- msnbc.com

While it's not in disupte that Nebraska, La., Vt. and several others got sweetheart deals on this bill. Here is a little more information in the matter.

Data compiled by the National Conference of State Legislators based on the U.S. Senate Finance Bill indicates the unfunded mandate could cost Arkansas $400 million.



“Arkansas is already facing budget cuts because of the current economic climate. These unfunded mandates will undoubtedly hurt Arkansas’ state budget even further. As our country deals with a soaring deficit we cannot expect hardworking Arkansans to fork over more money for legislation they overwhelmingly oppose. There are commonsense solutions for health care reform that aren’t budget busters that increase competition and drive down costs nationwide,” Boozman said.
Press Release : U.S. Congressman John Boozman : 3rd District Of Arkansas

If you have a chance go here to read some of the letters from the Gov. of these various states including my own on the matter. At least to me it's very clear that a vast majority of this bill will be cost shifted to the states and on the back of working Americans in the form of taxes.

and it's clear to me...and hopefully the rest of Americans will WISE UP!!!

 

[Navy1960]

So as I see it we have some states that are more worthy than others when it comes to healthcare. Does anyone else see anything wrong with that? Here you are in a state that is laying off teachers, firefighters, etc. and now you have to not only pay your states budget shortfall but you also have to cover the cost of Medicaid in the state of Nebraska. Here in Arizona in one of our school districts they laid off 500 teachers at the beginning of the year because of budget issues. I'm surprised that anyone would ever support a bill that would bankrupt the very state they live in and NOT reform healthcare and raise thier taxes in order to say, we won and you didn't. The sad fact here is no one won here, except maybe the states that got all these sweetheart deals.

 

[Joe Steel]

Apparently, all the whining I'm reading in this thread is mostly about money. Essentially, those who already have health care don't want to pay for health care for those who don't, especially if they're poor and would get their care through Medicaid.

Don't worry. Money problems are easy to fix. Just raise taxes; especially on the rich but some on the middle class. They've been getting a sweet, easy ride for too long. It's time they put something back by paying their fair share.

 

[Xenophon]

The answer is obvious.

The next thing they will do is regulate Doctors who refuse medicare and make it impossible for them to work without accepting medicare patients.

You can almost see that comming, because once all those who get this new Medicaid find out that they simply cannot walk to the nearest Doctor and be treated then the noise level in congress will go up to force them to accept it.

Of course its coming.

And the result will be a serious drop off of available Drs as they leave the profession they can no longer make the kind of money they want to make.

Then the gov will allow the standards for Drs to drop, as they will need a lot of them fast, and many bargin basement Drs who passed hrough questionable medical schools mainly overseas will be allowed to malpractise leading to massive increases in medical malpracise lawsuites which will make the trail lawyers happy.

Its a win-win for the Dems, and a lose-lose for all of us.

 

[Navy1960]

Apparently, all the whining I'm reading in this thread is mostly about money. Essentially, those who already have health care don't want to pay for health care for those who don't, especially if they're poor and would get their care through Medicaid.

Don't worry. Money problems are easy to fix. Just raise taxes; especially on the rich but some on the middle class. They've been getting a sweet, easy ride for too long. It's time they put something back by paying their fair share.

Okay then let's talk about the healthcare itself..

In a class-action lawsuit filed four years ago, disabled or impoverished children whose healthcare bill is paid for by Medicaid claim they must endure long waits -- or long drives -- to find doctors or dentists who accept the insurance plan. They argue their medical care is at times so poor that it violates federal law.

Under the federal Social Security Act, states that accept Medicaid dollars must provide eligible children with access to reasonably prompt medical care equal to what is available to children with private insurance in the same area.
Federal trial will decide changes in Florida's child Medicaid program

The fact is that if the goal is to reform healthcare so that it's available for those that need and want it, and provides high quality and choice for those that have it then this bill is a massive failure. First of all by sending a vast majority of the poor and needy into Medicaid is not automatically an end to their need for high quality healthcare. In fact all it does is give them the ability to say they have healthcare insurance, but what good is that if the ability to use it or the quality of those accepting it is poor? Does this raise the standards of healthcare in our nation? No it doesn't. Further you mentioned who is paying for it, I have news for you, EVERYONE will pay for this, not just those rich people, but the vast majority of those people will be the middle class and working poor. So if you choose to call that reform then be my guest, however, I for one do not think that sending poor people to a bankrupt, low quality, system , that will result in job loss, lawsuits, and low standards of care is anything remotly close to healthcare reform, Further, cutting 500 billion dollars from an already bankrupt Medicare is not a good way to start making it financially secure in order to increase it's delivery ability. The bottom line here is this, the democratic party has long advocated from a public option for all Americans and even said so in their party plank for 2008 and in their zeal to have a legislative win even abnadoned that principle and the poor. So spare me the high moral talk about how this bill will help poor people because I for one do not consider sending poor and low income people to low quailty care anything near reform.

 

[Joe Steel]

Apparently, all the whining I'm reading in this thread is mostly about money. Essentially, those who already have health care don't want to pay for health care for those who don't, especially if they're poor and would get their care through Medicaid.

Don't worry. Money problems are easy to fix. Just raise taxes; especially on the rich but some on the middle class. They've been getting a sweet, easy ride for too long. It's time they put something back by paying their fair share.

Okay then let's talk about the healthcare itself..

In a class-action lawsuit filed four years ago, disabled or impoverished children whose healthcare bill is paid for by Medicaid claim they must endure long waits -- or long drives -- to find doctors or dentists who accept the insurance plan. They argue their medical care is at times so poor that it violates federal law.

That, more than likely, results from the bad habit of state legislators to balance their budgets on the backs of the poor. Reimbursement rates, as I'm sure you mentioned, are so low many doctors don't accept Medicaid patients. That results are long searches to find providers who do and long waits in their offices caused by the high volume of the desperately ill.

The fix is simple; raise reimbursement rates. If the federal grants aren't enough, pass a state tax to fill the gap. Providers will be happy to accept Medicaid. The ill will become healthy and everyone will be happy...except perhaps the deadbeats who don't mind children dying as long as their taxes don't go up.

 

[Navy1960]

Joe, the problem is that with the exception of Texas almost every state in this nation has a budget crisis and I don't think I need to point out Californias issues to anyone as it's been in the news so much. While your solution of raising rates to Doctors sounds like a good solution and is one that Doctors have been screaming for for years, the Doc Fix bill died in the Senate this year and in fact what is going to happen is those rates are going to go down in even further. The other issues sadly is a money issue like it or not, you simply cannot keep throwing money you do not have at an issue and hope it goes away without eventually paying your bills. As I told you before, those taxes your speaking of are not going to hurt the wealthy nor is this bill going to do anything to harm the Insurance companies, in fact it does the exact opposite , so I fail to see where a supporter of reform would be in favor of this other than support it because the people they voted for are in the appearence of a win.

 

[Joe Steel]

The other issues sadly is a money issue like it or not, you simply cannot keep throwing money you do not have at an issue and hope it goes away without eventually paying your bills.

It's not money we don't have. American health care costs are nearly twice those of the next costliest health care system. Our problem is not money, it's giving money to insurance company executives and shareholders. If we spent the money on the sick (in the form of physician fees,) we'd get a better system and it probably would be cheaper.

I'm aware the Senate bill doesn't do this. It gives far too much money to insurance companies. That's too bad but it can be fixed. This bill can be amended over the years to bring sanity to American health care. We can't amend nothing. We have to have a law before we can fix it. Better to put something on the books and work on it over the years than to do nothing and hope we can do something later.

 

[Navy1960]

Joe, how about sittng down and actually crafting legislation that does those things and reflects true healthcare reform. I have noticed that the House and Senate will be controlled by the Democrats for a little while longer so to simply state that if it's not done now it won't ever get done doesn't hold much sway and in fact bascially means this bill in it's current form is more about a win rather than about reform.