Paul Hsieh, MD writes:
There will always be limits on who will or will not receive expensive medical treatments. We have no choice about that. But we do have a choice of whether those decisions will be made by patients based on their personal and economic priorities — or by government bureaucrats. The first protects the doctor-patient relationship. The second creates divided loyalties for doctors, who will always be serving two masters. As a doctor, I prefer the first. As a patient, you should too.
Read more: Should Doctors Limit Medical Care To Save Money For ‘Society’?.
David Catron in the American Spectator:
Buried beneath the avalanche of recent news reports about the latest Obamacare-mandated funding cuts to the Medicare Advantage (MA) program is a related but far more disturbing story — the Centers for Medicare and Medicaid Services (CMS) has taken a major step toward rationing medications to the elderly. Since passage of the Medicare Modernization Act of 2003, seniors enrolled in the Medicare prescription drug program have been guaranteed access to “all or substantially all” of the drugs in several classes of pharmaceuticals. President Obama’s health care bureaucrats, however, have proposed removing three of these classes from the “protected” list. …
Even some left-leaning media outlets are uncomfortable with the Obama administration’s rationing policy. …
It’s a little disorienting to find such an objective view in a publication that normally repeats Obama administration talking points verbatim, but there it is. Presumably, this departure from partisanship is an indication of just how far CMS has over-reached this time.
More: Drug Rationing for Seniors Begins | The American Spectator.
John R. Graham writes:
This result is important for anticipating the consequences of ObamaCare. About half of the 30-plus million people expected to get health insurance under ObamaCare will be enrolled in Medicaid, not private health insurance. Already, the Administration asserts that four million new Medicaid enrollees have signed up via ObamaCare (but this estimate has been questioned).
Nobody should be surprised: Despite politicians’ assertion that Medicaid coverage increases the likelihood of using primary care, rather than an ER, the evidence points clearly to the contrary. For example, in Massachusetts, ER use soared by 17 percent two years after Gov. Romney’s law mandating insurance coverage came into effect.
Read more: Least Surprising Health Research Result Ever
See also “Medicaid Expansion Drives up Visits to ER,” Wall Street Journal, January 2, 2014.
From the Wall Street Journal:
In many states, an elderly person may own a home valued at $802,000, plus home furnishings, jewelry and an automobile of uncapped value while receiving long-term Medicaid support. In addition, they are allowed to have various life-insurance policies, retirement accounts with unlimited assets, $115,920 in assets for a spouse, income from Social Security, and a defined-benefit pension plan. By most standards, such a household would be considered wealthy.
via Mark Warshawsky: Millionaires on Medicaid – WSJ.com.
via the National Center for Policy Analysis
Linda Gorman of the Independence Institute writes:
Medicaid expansion would limit access to care for the significant fraction of the currently uninsured who would otherwise be eligible for federal premium subsidies under ObamaCare. It raises costs for state taxpayers, increases costs for people who are hospitalized, and prevents state insurers from collecting millions of dollars in federal subsidy money.
Read more: How Colorado’s Medicaid expansion harms patients | Complete Colorado – Page Two.
Avik Roy & Grace-Marie Turner in National Review present 12 reasons Virginia, or any state (like Colorado), should not expand Medicaid:
- Virginia’s Medicaid spending will explode
- Medicaid harms the poor.
- Medicaid’s access problems will get worse as more doctors drop out.
- Claims about job creation are exaggerated.
- Claims about coverage expansion are exaggerated.
- Medicaid raises premiums for those with private insurance.
- Medicaid’s undercompensated care is a bigger problem than providing uncompensated care for the uninsured.
- Expanding Medicaid will expose [states] to immense amounts of fraud and waste.
- [States] will be exposed to higher Medicaid costs when Washington recalculates its matching payments.
- By rejecting the Medicaid expansion, Virginia encourages other states to do the same, reducing waste of taxpayer dollars.
- Medicaid will worsen the cycle of dependence and harm the economy.
- Exchanges will provide better health outcomes, far less fraud, and fiscal certainty.
Read details on each: Twelve Reasons to Say No – National Review Online.
For more on Medicaid expansion, see posts on Colorado Medicaid.
John C. Goodman writes:
The idea behind health stamps is straightforward. Like food, health is generally considered a necessity. So why not treat it the same way we treat food?
We don’t segregate grocery stores into those that sell to poor customers and those that do not. Grocery stores take all comers, and they charge the same price to each of them. … The [food stamp] program allows poverty and near-poverty families to have access to the full range of food products. Because they pay market prices, food stamp families are welcome customers at every grocery outlet. Although they live with more limited budgets, food stamp families are able to make tradeoffs in grocery choices—using food stamps in a way that meets their own preferences and needs. Competition for food stamp dollars forces stores to compete on price and, unlike healthcare, the prices are transparent. Every paper contains full-page ads in which price plays a dominant role.
This proposal makes certain that the poor have the wherewithal to pay for their healthcare not by forcing them to wait or take poorer quality, but with healthcare dollars. These healthcare dollars are full dollars to providers, insuring that the poor can complete for resources with all other buyers of care.
via Reforming Medicaid with Health Stamps | The Beacon.