Reply #3: Your health care job assertation is not completely true

[Maine_Nurse]

In states like mine, we will end up with LESS health care professionals. It has already happened. The problem is that over 600,000 out of 1.3 million citizens in this state are already on Medicare or Medicaid (about a 50/50 split). Even though the numbers are slightly less than half, they actually account for significantly more than 1/2 of the care delivered here. In the northern areas, Medicaid recipients often make up 75% or more of a practice's patients. The bad part is that docs and facilities often get paid less than the cost to provide a service, especially under our Medicaid program. Even worse is that our state has been running 3-5 years behind in paying for services rendered for over a decade now. This has put a lot of primary care docs out of business and forced others to join hospitals as "affiliates", letting the hospital handle billing, receivables, etc. There have been quite a few nursing layoffs in the past few years because the cash flow simply isn't flowing. With lower reimbursement rates coming and Kaiser predicting another 50,000 Medicaid enrollees under the 2014 changes, it is only going to get worse here. We are also expecting Medicare coverage to expand further because we are an "old state" and that trend is still rising.