Hospitals battle bid to rein in Medicaid

[babylonsister]

Hospitals battle bid to rein in Medicaid
By Barbara Barrett | McClatchy Newspapers

* Posted on Sunday, March 9, 2008




WASHINGTON - As the last months of the Bush administration dwindle away, the White House might yet face another showdown with the Democratic Congress, this one over changes in Medicaid rules that could affect millions of low-income children and adults.

In the past year, the administration has tried to change the rules in a way that would reduce Medicaid spending by $15 billion over the next five years. The federal-state program pays for health care for the nation's poorest citizens.

The rule changes have brought objections from health-care leaders across the country. But the Bush administration say the changes represent tighter controls on Medicaid's rising costs.

Some rule changes, which would be enacted around Memorial Day, would reduce payments to North Carolina by an estimated $320 million next year alone. Hospital leaders and local government officials across the country say that if Congress doesn't block the regulations, patients will lose, particularly the uninsured, who may be turned away.

The state hospital association says workers will be hurt, too. It estimates 3,000 to 6,000 hospital jobs could be lost, up to a thousand of those in rural areas.

more...

http://www.mcclatchydc.com/homepage/story/29858.html

[annabanana]

1. Where, Oh Where will we EVER find the MONEY to take care of these people?

Try Iraq.. apparently there are pallets of footballs made of the stuff lying around. Also I know that Exxon Mobile can chip in enough to keep people safe for a good 10 or 20 years.. all by themselves.

[Crunchy Frog]

2. They should just start opening euthanasia clinics.

It's the only way this counry is likely to address our health care crisis.

[bobbolink]

6. That's what I've been saying for years now... "You don't like having me around?

Then give me the damned pills so I can go without more suffering!"

That's the result they want, they just don't want to take responsibility for the results!

[Ilsa]

10. The GOP would open them and then KKKarl would say Hillary did it. nt

[Democrats_win]

3. This is such an important issue to many Americans. Go Dems, fight this!

[Warren Stupidity]

4. This is why we all need to be 'in the same boat' for health insurance.

Cutting health care funding ought to be the new third rail of politics.

[ileus]

5. Medicaid is already a lose lose for clinics and hospitals.

WE can't even collect a dollar co-pay from medicaid pts at the clinic.

[1776Forever]

7. A lot of this comes from duplicate testing & extra Dr. Visits from Medicaid providers.....

I have been doing some Doctorate program research as well as personal experience from my son who has Progressive MS and have found that since the Dr's who are participating in providing Medicaid for patients, which include a large majority of "foreign" Dr's or those that have recently started a practice, there is a huge amount of extra testing and many more visits scheduled by different specialist because that is how they make up the deficit from low payments. I was told by a HMO, which is how we do Medicaid now in Florida, Directer that they only pay .24 cents on the dollar compared to other plans or out of pocket payments. It isn't hard to see why they make the patients come in every month to get medication instead of giving them a 3 month or more script. I think if the Medicaid providers would pay more for these Dr's and demand that the double testing stop and the office visits are more reasonable I think we could bring down a lot of the costs.

[eilen]

8. I have worked in the state hospital in NY

and I can tell you that medicaid pts almost NEVER pay a copay for meds, even when it is just $1. The only medicaid pts that pay are those that have to reach a "spend down" prior to receiving benefits.

The doctors receive about $6 for each visit to a medicaid pt.

In other words, the compensation sucks and is unsustainable for any medical practice, hospital or pharmacy. We had a patient who was charged with medicaid fraud (drug seeking at several emergency rooms to sell her pills on the street). She was still allowed to return due to her chronic condition and I literally felt like her bartender giving IM Demoral 3x a day at a clinic. I totally lost any compassion I held for her. Her kids were never in school, she could afford designer clothing and the latest blackberry, she had her daughter pee in a cup for her, took chemo caps made for our cancer patients claiming she was a "patient" too. It was interesting she didn't need her 3x day demoral shot whenever she took week long trips to NYC. The money that was compensated was nil until end of year when the dept. submits the tallies appealing to the state legislature and receives what is termed "dish money" to help make up for the shameful shortfalls. Think about it, 15 visits a week, each one giving an IM shot at the least plus a pee test to ensure she is taking the oxycontin and not selling it.

Then there are the people who sell their meds and come back pitching scenes because the Dr. won't write for more and we have to call security, then they show up at the ED who turns them away unless some idiot resident admits them and inflicts that person on some unsuspecting medical surgical floor staff. The doc can't even "fire" the patient without finding someone else to take them over, and good luck with that.

I wish we had single payer so there was no confusion with clear lines of responsibility for both patient and doctor. I did not enjoy being the go between in social cases and having to take the verbal abuse and threats as a nurse (from both parties). Medicaid will pay more money for the taxicab to get the patient to the office or hospital and back than for the actual care given. People wonder why there is a nursing shortage.

[Thothmes]

9. Remember this thread if the Government ever becomes

the "Single Payer" for our health care.