Expand Medicaid and All is Good?

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Read this article from NBC News called States losing billions refusing to expand Medicaid, report finds and you will see what happens when the media reports one side of the story.   First, the “report” comes from the Commonwealth Fund, which is a notorious left leaning organization whose mission is:

The Commonwealth Fund is a private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.

Basically, you can tell their bias TOWARDS Medicaid just from this above statement.  That being said, let’s let that go of that for a minute.  If you read the article they paint the picture of how wonderful Medicaid is and how stupid some states are by not taking the money.   The history books is replete with stories of how our government has promised money to the states and then changed the rules later leaving the state stuck with the debt.  But I am not going to play economist or historian here.  I am not smart enough for that.  If Medicaid is so wonderful, for example, why do Maine hospitals keep crying that the state governments owes them money? Or, why do hardly any doctors see Medicaid patients anymore?  You see, this bribery by the feds is not so simple. The NBC article goes on to say:

But they also calculated savings. States would not only get the direct federal money, but would save the money that taxpayers end up spending on so-called uncompensated care – when sick or injured uninsured people show up in emergency rooms seeking treatment.

How do taxpayers save that money actually?   That money is a loss to the hospital.  Yes, I am aware the hospitals cost share all the time due to this but it is not a tax to the people.  Now if Medicaid is expanded, as the Commonwealth Fund recommends, the state will eventually have to pay more for this expansion because those same new Medicaid patients that were just added will go to the ER (like they always do because no docs can afford to see them) and then taxes ARE needed to pay for it.

I am not going to pretend it’s that simple.  The way the article reads, however, the states are stupid for not taking free money.  Where is this free money coming from? Once again, it is our taxes!

In my opinion, Medicaid expansion would be a mess.  Why?  I have seen Medicaid patients for twenty years and it is the only group where you can order any test on them with no questions asked.  It is the only group that pays NOTHING for their care and therefore has no problem over utilizing services (ER visits, meds, etc).   It can be a highly abusive group because they want what they want, when they want it and they want (and get) it for free.  And we want to expand it as is?   Don’t get me wrong, we need a safety net for poor people but the Medicaid system is broken and expanding it without fixing it is just ludicrous.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  2 comments for “Expand Medicaid and All is Good?

  1. Pat
    December 11, 2013 at 12:13 pm

    Unlike matter, wealth can be created or destroyed.

  2. Joel
    December 11, 2013 at 11:28 am

    Dimensions Healthcare runs hospitals in Prince George’s County, the hospitals are owned by the County, subsidized at thirty million annually, and bonds are issued to cover I think fifty million in debt. There is also a new $650 million hospital due to be built with taxpayer funds.

    But Doug, I am still unsure how funding for Medicaid would help taxpayers here. They will still lose money.

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