Hearing arguments here that say expanding Medicaid is bad

[CreekDog]

people arguing this have been saying it should be Medicare instead, although low enough income Medicare recipients get Medicaid also.

since expanding Medicare was not on the table today, I'm trying to figure out if people are actually against expansion of Medicaid and would prefer to wait until we have the votes to expand Medicare.

I also want to know if you are against expanding Medicaid even if the more desired expansion of Medicare can't be passed for several years.

[Armstead]

1. IT can't be boiled down to a sound bite but I will try

Medicaid is a safety net, and it is necessary and important. If expanding Medicaid now can provide more short term help to people who need it, then that is a good thing.

However, the need for Medicaid is a symptom of what is wrong with the healthcare system. Rather than putting on a band aid on cancer and calling it a solution, it would be preferable to also deal with the systemic cancer itself.

The reason it may seem some are negative about expanding medicaid is this: The problem with saying "we're helping people by expanding Medicaid" is a shell game that distracts from the lack of more useful changes to the system. It's like saying "The house is on fire, but we're dealing with it by throwing a glass of water onto one corner."

[OHdem10]

4. Here is what I have heard as the major complaints:

I have over the past few months seen several Govenors from
different states on Television. The States at least many
appear to be in as much trouble as the Fed. Govt. financially.
They are up against budget problems. States have to match
the Federal Govt in funding Medicaid. If they have no money
to put in the pot, they say the Fed. Govt adding more clients
to their Medicaid Rolls will bankrupt them.

2. Medicaid does not reimburse doctors properly and on time.
Therefore many doctors in many states refuse to accept Medicaid
Patients. Some ask what good is being in Medicaid Plan if you
cannot find a Doctor to treat you?
Here in Ohio, we have lots of Doctors who refuse to treat MEDICARE
Patients. This is happening in many states.

These are serious problems which Congress must confront.

[juno jones]

5. Yep, medicaid patients will STILL be showing up at ER's

for treatment that could have been performed in a lower-cost enviroment.

And those much-vaunted community clinics will send 'em there because they don't deal with anything that can't wait a month or two for an apppointment.

[customerserviceguy]

7. I have to keep asking

how will cutting half a trillion dollars out of Medicare help the problem of doctors refusing to take Medicare patients? How would putting people who are 55-64 on Medicare improve their healthcare if we are cutting money out of that program?

I have one really radical suggestion for turning the tide on this, do away with the tort system as a way of dealing with medical malpractice for those on Medicare and Medicaid. Set up a system that resembles Workers Comp boards, where compensation is swift, and the results are not hidden.

[thelordofhell]

8. They are cutting money from Medicare Advantage

The private insurance company ran part of Medicare that has been fleecing Medicare for years.

[KrR]

26. WoW, only Medicare Advantage is being cut...

It was a giveaway to the insurance companies and a ripoff to its customers. It is also incremental privatization of Medicare. It is good that it is being rolled back.

[customerserviceguy]

27. Still, if Medicare Advantage is being cut back

won't that reduce payments to doctors/hospitals and/or increase costs to patients? Even if MA is a ripoff, don't they pay at least something towards patient costs, or medical bills?

I'm all in favor of the shady practices of these companies going away, but what about the part that actually gets spent on bills? How does that get replaced?

[KrR]

28. No they dont its a fraud.... n/t

[KrR]

25. What changes do you want then?

You are obviously against govt run health insurance. Thus you are against Medicaid, Medicare, and the Public Option.

[Armstead]

30. You keep twisting myt words -- Are you doing that on purpose?

I WANT single payer government run insurance. O would prefer it be universal, but if we are going to still have provate insurance, I want Medicare expansion and/or some form of "public option" as alternative choices.

I also recognize that medicaid is necessary to cover people who cannot otherwise get care.

But I believe our efforts should be on setting up expanded government run SOCIAL INSURANCE that makes coverage available and affordable to everyone. In other words, MORE MEDICARE.

The better our basic government run system is, the less need there will be for Medicaid, because more peoppel will have real coverage.

[Jersey Devil]

2. apples and oranges

Medicare is insurance and Medicaid is not and must be paid back if the person receiving it ever gets in a position where he can do so.
Medicaid is needed and should be expanded for the poor but it should not be confused with health insurance. Expanding Medicare would do nothing for those under the minimum age to get it (55 according to the last version of the Senate bill before it was removed).

[juno jones]

3. Medicaid isn't bad

But isn't all that and a bag of chips either.

Under current law, you DO wind up paying for it-or your family does when you kick.

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=433x85781

There's also the question of means testing. Under current rules you are tested again and again, every six months to make sure you don't make a penny above their limits. You can own no property and have no savings.

And Community Clinics are fine and dandy, but require a lot of reconfiguration to be brought on parity of services with private clinics.

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=7311928&mesg_id=7312718

If they can do away with the two-tier system, I'm for it. Until then, as someone who already must go to a community clinic and deals with it's flaws, I'll be watching where they take this.

[yurbud]

6. the obvious solution is to roll Medicaid, a public option, and Medicare into one

and require doctors and hospitals to accept those patients without prejudice.

So when a poor person or an old person staggers into an emergency room, they get to see a doctor instead of security.

[juno jones]

9. I agree.

Thanks, yurbud. :hi:

[Raineyb]

10. You do realize that Medicaid is not insurance right?

And that if you have a modicum of assets say 1500 dollars you can't get it?

Medicaid is not the panacea you seem to think it is.

[CreekDog]

11. Panacea, who said it is? I just think that whatever helps those with little money is a good thing

and should be expanded.

as soon as you learn of another system that does that which currently has a chance of being voted more money you let me know! :eyes:

[Raineyb]

12. Except it doesn't help you unless you drain every penny you have.

And sell everything you own. NO ONE should have to do that in order to get access to medical care. And to flippantly declare well you can get medicaid treats medicaid like a panacea.

[KrR]

13. You are very confused

Medicaid is being expanded to higher incomes that is the the whole point.

[Raineyb]

17. No I'm not.

THAT is the medicaid program. My sister was on Medicaid and they went after her for any penny she may have had. Do you really think the income levels is going to change that? I'm not inclined to agree. It's a welfare program whether they increase the limits or not, it's designed to be as punitive as possible. And even now not everyone who is in the income limits for Medicaid can actually get and use it.

[SpartanDem]

21. The asset /resource test would be eliminated

everyone up 150% FPL in House bill or 133% in Senate would get their health care through Medicaid

[KrR]

23. Medicaid is punitive?

I have no idea WTF you are talking about. Unless your sister is one of those people who hide their assets and weasel their way into Medicaid coverage. Then i would understand your cynical beliefs about it.

[CreekDog]

14. Again, why are you putting words in my mouth?

I said again and again things that don't sound anything like what you claim I say or feel. :grr:

Tell you what, you've obviously decided you can tell me what I think without me saying it, so why don't you start a thread detailing what I think.

It will save me time in that I won't have to post it and you won't have to worry about whether or not you are right about anything.

[Raineyb]

16. If you don't like how what you're saying is being interpreted then you should do a better

job of explaining what it is you think. I can only go by what I read.

Of course it's easier to slam me than to do something about the failings in your communication style but that's not my problem.

[CreekDog]

18. Oh come on, you are reading what I write and then attributing me with things I have written against

That's why I told you to just write a thread explaining to everybody what I think since you obviously don't want my opinion to get in the way of that.

:rant:

[KrR]

24. If Medicaid isn't insurance, then Medicare isn't either... n/t

[CK_John]

15. Medicaid is a state funded program. n/t

[CreekDog]

19. And federally funded program

it is a shared responsibility and will continue to be.

[Clear Blue Sky]

20. Finding a doctor under medicaid is the hard part.

Around here, many specialists don't take medicaid patients. Surgery centers don't accept medicaid patients. Very limited options and in many cases the options are second rate.

[ZombieHorde]

22. I am very happy Medicaid is being expanded. nt

[ipaint]

29. Please explain, what good is medicaid expansion with out enough

doctors?


"Nicholas D. Kristof, in a heartbreaking column in today’s New York Times, tells the story of an Oregon sawmill worker who developed an abnormal growth in his brain that prevented him from working or functioning normally. He lost his job and his insurance, and had to be rushed to the ER periodically. After he and his wife had spent all their savings, he wound up on Medicaid. Surgeons could have cured him with a procedure, but they refused to take Medicaid because it paid so little.

This is the story, not only in Oregon, but across the country. By one estimate, state Medicaid programs pay, on average, only 60 percent as much as private insurance does. As a result, many physicians will not see Medicaid patients. A recent study found that 28 percent of physicians don’t accept Medicaid patients, and 19 percent accept some. Only 40 percent will take anybody on Medicaid.

Primary-care physicians have an even more dismal track record. Forty percent of general internists, 35 percent of family physicians and GPs, 18 percent of pediatricians, and 28 percent of ob/gyns do not accept any Medicaid patients. Thirty-one percent of internists and FP/GPs take all Medicaid patients, 42 percent of pediatricians do, and 34 percent of ob/gyns do."

http://industry.bnet.com/healthcare/10001447/medicaid-expansion-may-fail-because-of-doctors-refusal-to-see-patients/
http://www.nytimes.com/2009/11/29/opinion/29kristof.html?_r=2