Country Roads by Pat Conrad MD

Well, I guess this is a different spin on it…

The Senate is pretzeled into a fine mess, with Dems shrieking about the GOP slaughtering hundreds of thousands with Medicaid cuts, and wimpy Republicans believing them.  Last October, the Kaiser Family Foundation predicted that Medicaid spending GROWTH would decrease from spending 10.5% to 4.5%, an electoral design of ObamaCare, wherein the federal share of spending would very conveniently drop just as the Great Compassionate was to leave office.  Congressional Republicans claim that their ObamaCare Lite will only slow the growth of Medicaid, leaving plenty of slop in the trough and more deficit and debt as far as the eye can see.  Add to that the billions more the Trump Administration is promising to fight opioid addiction, which will achieve the twofer of further punishing docs, while wasting more taxpayer money.

Never to leave a heart un-bled, Yahoo News has an innovative way to scare us all over any potential cut in this massive welfare program.  If we flirt with cutting Medicaid, this could threaten opioid addicts’ survival in West Virginia.  The article begins with a sob story over an ambulance crew being helped with a flat by a roadside mechanic save, only to then go to his house and save his OD’ing daughter.  That Lifetime Channel setup then leads to the real meat:  the EMS service “pays the bills largely through patient insurance — which in this mostly poor, rural area is Medicaid, a program that could see massive cuts under the health care bill championed by Senate Republicans anxious to deliver on their campaign promise of repealing the Affordable Care Act.”  They also fear the loss of the state grant that buys Narcan, even as that drug’s price has spiked.  I wonder if the drug maker saw a spike in demand as cover for a price jack?  After all, it worked for EpiPens, the Mylan CEO responsible being none other than the daughter of West Virginia Sen. Joe Manchin.  But I digress…

The EMS director laments, “If there are more Medicaid cuts, and no other help, this would be catastrophic for us, I don’t know if we could survive. We are talking about a potential situation where people would call 911, and there would be no one to help, whether it’s an overdose or a heart attack or a car accident or a broken hip. There would be no one. Can you imagine?”

Yes, as the EMS medical director in a very rural county with plenty of drug addicts, I certainly can imagine that a poor area can only provide scant resources over which different patient groups will compete.  And yes, I imagine without a blank check without end, some folks will actually die for lack of rapid medical attention.  The Hatfields vs. McCoys have now become the Cardiacs vs. the Addicts.  And what response does this silly author elicit?

“Not only are rural health care providers heavily dependent on Medicaid, many of those covered by Medicaid are the ones being treated for drug abuse. According to the West Virginia Department of Health and Human Resources, roughly 50,000 of those who are covered through the Medicaid expansion were treated for substance abuse last year — a number many state officials expect to increase amid a drug crisis that appears to be getting worse by the day.”  I read that as journalistic extortion, flatly threatening that if we don’t increase Medicaid funding (with money we don’t have), there will be even more untreated addicts prowling the backyards.

It is arguable that the existence of Medicaid has abetted and encouraged many self-destructive behaviors, including inappropriate demand for and access to opioids, often provided by the very docs who now worry they would be cut off from the government teat.  This story is another example of single-wing emotionalism that overpowers other serious questions.  For instance, who is going to pay for all of this?

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102300cookie-checkCountry Roads by Pat Conrad MD