I used to work for a hospital in the billing and collecting department. We used to hate dealing with Medicaid cases because they didn’t pay much. Of course, that’s assuming that the Medicaid office actually accepted the claim in the first place. It really depended on the state though. Some states like Ohio actually paid fairly well, so we didn’t mind them as much. Other states paid a per diem that barely covered the costs. And in other states, we didn’t even accept Medicaid patients, because those particular states paid so little that we would lose a considerable amount of money treating the patient.
And I’m not championing higher-paying government-run healthcare. The more Medicaid pays in reimbursements, the higher the state’s taxes must be, and that’s not good. But it’s just the way it is. Ideally, we wouldn’t have government-run healthcare, but we do. The reality is that hospitals and doctors have to deal with Medicaid patients more and more and have to accept Medicaid’s measly payment as payment in full. With Medicaid payments as small as they are, doctors and hospitals are refusing to treat people with Medicaid, because they lose money with them. The more Medicaid patients health care providers treat, the more likely those providers will be driven out of business, and when physicians refuse to treat Medicaid recipients, the patients go untreated and sometimes die as a result of non-treatment.
Doctors often prefer an uninsured patient to a Medicaid patient because the uninsured will pay cash for routine visits, and that’s so much easier than fooling with paper work for Medicaid and then getting paid next to nothing or just nothing at all in case the claim gets denied. There was an MIT study that found that 75% of physicians receive less revenue from Medicaid than they do from the uninsured. But others think that Medicaid has been a tremendous success, and that it needs to be expanded. The Huffington Post sings Medicaid’s praises:
“Medicaid is a lifeline for seniors, children, working families and people with disabilities. It creates jobs by pumping dollars into local economies. It keeps open the doors of local hospitals and community health centers. Medicaid keeps millions of middle-class families from going bankrupt from the high cost of nursing-home and in-home care. … Expanding Medicaid is a moral and fiscal imperative. …We can’t achieve shared prosperity and equal opportunity in this country if people can’t get quality, affordable health care.” [Emphasis mine]
When you can’t really justify the existence of a government program, just say that it “creates jobs.” And now they’re bringing morality into it. It’s our “duty” to expand Medicaid and force others into the program. It’s our “moral obligation” to funnel our tax dollars, nearly a half a trillion dollars a year into socializing the healthcare system in each state. It’s also a “fiscal imperative.” This is supposed to save us money? Instead of cutting the programs themselves, Medicaid is actually expanding their programs while simultaneously decreasing payments to physicians and hospitals. And as more states continue to do this, it will somehow create a “shared prosperity.” Yeah, a shared prosperity where everybody is equally poor, and most of the doctors have been forced out of business by Medicaid.
So many people have grown dependent on government programs that there seems to be no easy way out of this mess. It’s definitely a case where the cure is more painful that the disease itself. I think the cure is in part to let these unConstitutional programs phase out. If a state or a country is in a debt crisis, you don’t fix it by making healthcare programs bigger and paying out less to doctors. There’s no morality in that, and it’s certainly not good for the economy. Take care of those who have grown dependent on state healthcare, but work to phase out the programs and offer others the freedom to take care of themselves as they see fit. The less involved the government is in our healthcare system, the more affordable, efficient and better quality the care itself will be.