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Southern Governors Secede from Medicaid

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Re: Southern Governors Secede from Medicaid

Postby snoqueen » Wed Jul 11, 2012 8:59 pm

That's sounds reasonable for a dr with their own practice but how does that apply to a dr staffed at a hospital, or a salaried doc at the VA?


I think if the patient is a vet he/she can get medical care through the VA and doesn't need to sign up with Medicaid at all. If I'm wrong about that please correct it. (The salary thing really makes a difference in cost and in treatment, incidentally, and one wishes it were a part of healthcare in other settings.)

The same cost factors I listed (and more, most likely) apply with any healthcare provider -- outpatient clinic, urgent care center, hospital. It's hard to separate the office visit itself (the doctor/provider's fifteen minutes) from the whole rest of the bill and be left with anything meaningful. As soon as you do that, it's not much different from using the emergency room for routine care: The other patients and their insurance policies are subsidizing those who are indigent or minimally covered (that is, by Medicaid).
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Re: Southern Governors Secede from Medicaid

Postby Donald » Wed Jul 11, 2012 9:28 pm

I'm tired of docs whining about the rate they get under Medicaid. If some docs don't want to provide medical care to the most needy, these docs should get out of the medical "business" entirely. They are in it for the wrong reasons.

Medicaid does not exist to enrich the medical community. It exists to provide medical care to poor folks. The more you pay the medical provider the fewer people get covered. Before Medicaid there was "charity care" or a mish mash of state/county programs that rarely guaranteed any payment whatsoever. They ought to be thankful for what they get.
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Re: Southern Governors Secede from Medicaid

Postby pjbogart » Wed Jul 11, 2012 11:00 pm

I really wish my grandfather were still alive. He practiced medicine from about 1948-1990. He was well off, but he wasn't rich, at least not by today's standards.

I hate to put words in a dead man's mouth, but I was practically raised by my grandparents and I never once heard him complain about not being paid enough. He'd probably complain about his church, the Episcopalians, marrying gay folks but the dude was born in 1917 so I'm willing to forgive him that.

If a doctor turns away a person in need of medical care because they don't have the ability to pay, or the ability to pay enough, that doctor should have their license to practice medicine revoked. Period. They take an oath, and no where in that oath does it mention their expected compensation.

Show me a doctor who can't pay their mortgage and I'll show you a really big mortgage.
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Re: Southern Governors Secede from Medicaid

Postby Huckleby » Thu Jul 12, 2012 8:58 am

Donald wrote:I'm tired of docs whining about the rate they get under Medicaid. If some docs don't want to provide medical care to the most needy, these docs should get out of the medical "business" entirely. They are in it for the wrong reasons.

Medicaid does not exist to enrich the medical community. It exists to provide medical care to poor folks.


Your indifference to medicaid rates effectively results in a crushing tax on decency.

Primary care doctors, the ones who are most needed to treat the poor, are not overpaid, medicaid issue aside. When you tell them to "just be a good person and accept medicaid patients" the result is a massive shift in income from selfish people to the more giving. IT's already a struggle to get Med Students to pursue primary care careers.

Would you accept a 50% cut in your salary and donate the proceeds to the poor?

No, we can't just add tons of people to medicaid and let the chips fall where they may. There will have to be money spent on resources and incentives to make this all work. OBamacare makes some efforts, not sure if it will be enough.

The long term solution will be to get rid of medicaid. If the Obamacare insurance model works and costs come under control, just subsidize poor people to get insurance. (Other countries don't have a seperate, inferior program for the poor. We need to eliminate our patchwork.) If the subsidized insurance model fails in long run, then a switch to single payer for all will be way to go.
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Re: Southern Governors Secede from Medicaid

Postby Meade » Thu Jul 12, 2012 9:07 am

The governors can do it because the Supreme Court ruled last month that states can opt out of the expansion without paying a penalty.

How is opting out of the expansion "seceding from Medicaid"?
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Re: Southern Governors Secede from Medicaid

Postby wack wack » Thu Jul 12, 2012 9:09 am

Donald wrote:I'm tired of docs whining about the rate they get under Medicaid. If some docs don't want to provide medical care to the most needy, these docs should get out of the medical "business" entirely. They are in it for the wrong reasons.

Medicaid does not exist to enrich the medical community. It exists to provide medical care to poor folks. The more you pay the medical provider the fewer people get covered. Before Medicaid there was "charity care" or a mish mash of state/county programs that rarely guaranteed any payment whatsoever. They ought to be thankful for what they get.


The issue isn't just the rate of Medicaid, which already isn't anywhere near sufficient to run a business, it is the timeliness and regularity of payment. if Republicans want to know what REAL "uncertainty" in business is, they should go work in a long-term care facility which accepts Medicaid patients for a year.
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Re: Southern Governors Secede from Medicaid

Postby Huckleby » Thu Jul 12, 2012 9:53 am

Meade wrote:How is opting out of the expansion "seceding from Medicaid"?

Oh please. Texas currently barely participates in medicaid. A quarter of the children in this wealthy energy state lack any sort of health insurance!

Texas refusing to accept federal funds to provide medicaid to all their poor people can be reasonably described as "seceding from Medicaid."

But it is all bluster. For several reasons, Texas won't really be able to follow through on this morally reprehensible stunt. Details upon request. We've certainly seen the dark side of the Republican ideology on display.
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Re: Southern Governors Secede from Medicaid

Postby Meade » Thu Jul 12, 2012 10:32 am

That's bull, Huckleby. Texas is not seceding from Medicaid. Perry simply refused Obama's attempted expansion invitation. And there is not one single child in Texas who will be denied medical care at any Texas hospital emergency room now or tomorrow.

California is expanding its Medicaid program. Anyone in Texas who doesn't like the Texas program is free to relocate to California.
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Re: Southern Governors Secede from Medicaid

Postby Henry Vilas » Thu Jul 12, 2012 10:45 am

Meade wrote:And there is not one single child in Texas who will be denied medical care at any Texas hospital emergency room now or tomorrow.

That's your answer for our crisis in health care coverage?

45,000 American deaths associated with lack of insurance
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Re: Southern Governors Secede from Medicaid

Postby ilikebeans » Thu Jul 12, 2012 10:46 am

Meade wrote:And there is not one single child in Texas who will be denied medical care at any Texas hospital emergency room now or tomorrow.

So you're advocating the defunding of preventative care in favor of letting conditions get so bad that an incredibly expensive trip to the emergency room is the only course of action?

Whatever happened to the conserva, er, sorry, *moderate* right-wing mantra of "WHAT ABOUT THE CHILDREN???"

Oh, that's right, it only applies to pre-birth.
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Re: Southern Governors Secede from Medicaid

Postby Meade » Thu Jul 12, 2012 10:59 am

You two seem to be assuming that without a government program, it is impossible for children to receive health care, preventative or otherwise.
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Re: Southern Governors Secede from Medicaid

Postby Henry Vilas » Thu Jul 12, 2012 11:01 am

Meade wrote:You two seem to be assuming that without a government program, it is impossible for children to receive health care, preventative or otherwise.

So tell us your non-government plan for health care coverage.
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Re: Southern Governors Secede from Medicaid

Postby Peanutbutter » Thu Jul 12, 2012 11:02 am

Meade wrote:without a government program, it is impossible


That should be on the next liberal bumpersticker.

Assuming that a liberal has room for one more bumpersticker. :lol:

Image
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Re: Southern Governors Secede from Medicaid

Postby DCB » Thu Jul 12, 2012 11:03 am

Meade wrote:That's bull, Huckleby. Texas is not seceding from Medicaid. Perry simply refused Obama's attempted expansion invitation. And there is not one single child in Texas who will be denied medical care at any Texas hospital emergency room now or tomorrow.

California is expanding its Medicaid program. Anyone in Texas who doesn't like the Texas program is free to relocate to California.

And anyone who wants to pay lower taxes can hire a tax accountant or hide their money in the Cayman islands.
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Re: Southern Governors Secede from Medicaid

Postby Meade » Thu Jul 12, 2012 11:35 am

DCB wrote:And anyone who wants to pay lower taxes can hire a tax accountant or hide their money in the Cayman islands.

Not anyone though, right? To do that, one has to create a fairly large amount of wealth. Only crooks like Romney can do that.

Another strategy for paying lower taxes is to have voted for Obama in 2008. That way, the economy goes into and stays in recession, people have less income, causing them to be bumped down into lower tax brackets, and - Presto! - lower taxes!
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