New reports peg Medicaid’s future as dismal and unsustainable, as states struggle for ways to pay for the rising costs of caring for their poorest residents. The Deloitte Center for Health Solutions study, “Medicaid Long-Term Care: The Ticking Time Bomb,” estimates Medicaid costs will nearly double as a percentage of state budgets by 2030, or perhaps nearly triple.
Meanwhile, the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured estimates Medicaid expansion will cost $464.7 billion by 2019. The federal government will cover $443.5 billion (95.4 percent) and the states will cover the remaining $21.2 billion. Minnesota won’t expand its Medicaid program until 2014 because of budget fears. Connecticut will. (The Fiscal Times, MedPage Today, Reuters, U.S. House Rep. John B. Larson)
U.S. Senators, meanwhile, are looking to phase out federal subsidies Medicaid as a way of pushing through stalled legislation — the same package that had included the “doc fix.” Speaking of that, Sen. Majority Leader Harry Reid said the Senate may soon turn its attention away from that toward other issues. (Wall Street Journal, The Hill, ABC News)
*This blog post was originally published at ACP Internist*
We learn from the healthcare reform bill that the federal government will help subsidize Medicaid funding for all the new patients who qualify, but they will only do it for two years. After that, the states are on their own. Medicaid unfunded liabilities will crush state governments everywhere.
Why is Medicaid so expensive and going bankrupt? I’ll give you one example why. This is played out day after day, night after night in communities all across our country. And the only ones paying for it are you and me. The ones spending all the money have no incentive to stop.
I’m in the ER the other day when I see a chief complaint fly by on the radar. What is that chief complaint, you ask? Let me tell you a story.
Refused By Detox
The patient was so drunk even the community detox center refused him. So how did this play out? The patient was taken by ambulance from his home to a small-town community ER for altered mental status. There he was checked into the ER and seen by a small-town community ER physician, family practice resident, or PA or NP.
Diagnosis: Acute alcohol intoxication. Plan: Discharge to community detox center. Read more »
*This blog post was originally published at The Happy Hospitalist*
As we wrestle with political factions and mull over assorted ideas for reforming health-care in America, one simple solution bears discussion. Of course, we notoriously hate simple solutions. The modern American solution to simple solutions is to develop layers of complexity and inefficiency. I can only assume that in government, as in hospital administrations, this has to do with creating jobs. To the extent that it keeps nefarious, clever individuals off the street and occupies them in what passes for gainful employment, I applaud the effort. But it seldom solves problems, and typically creates them.
Nevertheless, I digress. My painfully simple solution is this. Allow every health-care provider to deduct, from their federal income tax, the care they provide for free to uninsured patients. It can be the Medicare value of the care; possibly even the Medicaid value. But in the end, a financially savvy doctor, dentist, therapist or any other health professional will end up paying no income tax. Read more »
*This blog post was originally published at edwinleap.com*