Saturday, July 14, 2012

Should Mississippi take the Medicaid money?

Bill Minor went nuts in his weekly column over the mere thought of state GOP leaders refusing to accept Medicaid expansion:

"Now the highest court in the land says it’s up to each state to accept federal funds with a tiny state match under an (almost) universal health care program covering persons with incomes of 138 percent of the poverty level. Every other developed nation has had universal care for years.

Our top three state governmental leaders (all Republicans) say the tiny state tax effort needed to expand the Medicaid program and significantly upgrade health care coverage for thousands Mississippians at the low end of the economic ladder--many who are employed but have no health coverage--will “bankrupt the state.” That’s pure hokum. Fear-mongering of the worst kind.

Injection of billions of federal funds under the Affordable Care Act into the nation’s economically poorest state will exponentially improve the health level of average Mississippians. At the same time, as non-partisan studies by several respected groups have shown, the state would get back far more money than it invests when the state match will reach a maximum of 10 percent in 2020. Notably, the major part of the program doesn’t begin until 2014. For the first three years the state gets a 100 percent federal match then it gradually reduces the next four years.."
Column

Well, here is what Mr. Minor calls "a sliver" or "tiny": $160 million. Of course, this is the same Bill Minor who said PERS was broke until Pat Robertson corrected him. $160 million is the amount of money Medicaid expansion will roughly cost the state each year. The federal government picks up the tab for the first three years. The state then has to pay 10% each year. However, $160 million is only a "sliver" and only requires "a tiny" tax increase so don't worry. So tell me, Mr. Minor, where does the $160 million come from? Your precious public education lobby shrieks that MAEP is underfunded by $300 million. Earlier post about MDE budget request. Public safety? Let's put more criminals on the street. Colleges? Yup, lets take more money away from higher education. Raise taxes? In case you haven't noticed, all the jobs are going to Texas where there is no income tax. In fact, the states that have either cut their tax rates or have no income tax have fared better in the recession than the states who raised them. See Illinois and California.

However, other more sober and literate in financial matters had a few things to say about the expansion as well. The Wall Street Journal weighed in yesterday in an editorial on this issue:

"Accepting these terms means states will lose the autonomy they had left to make Medicaid decisions in line with their own choices about taxes and spending. Medicaid is already the largest line item for most statehouses, a little under a quarter of the budget on average, and nationwide Medicaid costs are expected to jump by—this is not a typo—20% in 2012. This spending is starting to crowd out other priorities like K-12 and higher education, public safety and building roads...

ObamaCare attempts to bribe the states by footing 100% of the cost of new Medicaid beneficiaries for two years, and then the federal share will fall to 90%. Supposedly this honeypot is too good an offer to refuse compared to the normal federal matching rate that ranges from 56% to 85%. The hospitals, which want more Medicaid revenue and are especially powerful at the local and state levels, are also aggressively lobbying Governors to accept the "free" money.

Not so fast. One problem is that the 100% matching rate is like a subprime loan with a teaser rate and balloon payment. Once the states accede, Congress will inevitably renege, since the federal fisc is nearly as stressed as state balance sheets. The new subsidies also only apply to the newly coverable, not to the nine million or so people who are already eligible for Medicaid but haven't signed up....
" Editorial

Of course, don't tell that to Bill and Cottonchicken as they think money grows on trees or robbing Peter to pay Paul has no effect on the economy. The truth is, doctors and other health care providers do not make money on Medicaid. If anything, they lose money. Mississippi has struggled to meet the rising costs associated with Medicaid yet every year, it seems there is a Medicaid deficit the legislature must face. However, Bill Minor thinks asking where the money is coming from is "fear-mongering". Its a sad day when a reporter who was never scared of the Klan is scared of an honest question.

35 comments:

Anonymous said...

That doctors and hospitals don't make money on Medicaid is just not true. They may not make as much money , but unlike treating those with zero insurance or government coverage, they do get money.

Have you not noticed that our hospitals are expanding?

That those who are covered by insurance or are self-insured make up any difference in costs for hospitals and doctors continues to be overlooked.

There is a reason a hospital gown can cost you $80 a day.

Either we pay a tax, or our insurance costs and medical costs go sky high in a state where the poverty levels are so high.

We have to deal with rising medical costs. We have to face the fact that we are a state with a high poverty rate. We have to face the fact that a child's ability to learn and succeed is directly related to how healthy that child is in his or her developmental years.

Knee jerks reactions from both sides of the aisle aren't solving a serious problem.

Kingfish said...

BUT I didn't say hospitals, did I?

Kingfish said...

Asking where $160 million will come from is not a knee-jerk reaction.

Paul Mitchell said...

So, I am just curious, when the Ronnie Musgrove increased the state Medicaid rolls by 90k people, how many of our state are already on the books? Seems like it is getting close to 50% just from looking at who I see in the hospitals and doctor offices.

Burdened Taxpayer said...

Take a break and read today's Times-Picayune. Gov. Jindel slashed Medicaid by millions. It's a huge cut and he says their current system (not one down the line) is unsustainable. Even the LSU facilities were slashed multi-millions and they are closing a facility in Mandeville. This is just the tip of the iceburg for what is happening in our nation. Mississippi border counties need to setup roadblocks. Read this before you make up your mind on Mississippi.

Anonymous said...

"Bill Minor went nuts"....is that something different?

Kingfish said...

There is a reason why La is having to cut their budget so much. The recent highway bill removed the adjustment for all the Katrina aid La. received. Had nothing to do with Obamacare.

Anonymous said...

Please don't think for one minute that 90% of those currently on Medicaid appreciate the medical support. They are escorted to the ERs in new SUVs, they chat with friends on their latest iPhones, admit to being on disability since childhood due to ADD, Asthma, mental disability, etc. while demanding food and unneeded medical attention. It becomes a family reunion of sorts in the ER...won't cost them a dime, yet costs the taxpayer... It is shocking to know the percentage of Medicaid patients who abuse our system without hesitation. When asked why one took an ambulance to the hospital for a headache the response is almost always that they couldn't find a ride. Lap it up democrats....this is the monster you created.

Anonymous said...

10:02 doesnt hv a clue. 11% of billed charges is a big loss for the facility.

Anonymous said...

8:42 am...I do have a clue.

Billed charges isn't the same as actual costs.

Also, zero receivables is not better than 89% monies received.

AND, that is the reason for the fraud. The doctors qualified these people for Medicaid with with a diagnosis so they can get PAID.

I agree KF that $160 is a problem,but we can't solve the problems of health care costs in this Nation unless we look at the entire picture with political blinders.

And, politically, given the demographics and unemployment, the GOP is taking a big risk IMHO betting that the poor and unemployed won't vote this issue but will instead vote for the hope Romney will create jobs.

Indeed, it's what the GOP is doing at state levels that may determine the election.

Kingfish said...

So lets take the local liberals at their word, we need to pony up $300 million for MAEP and another $160 billion for the expansion when the 10% part paid by the feds transfers to the state. Where does the money come from?

Paul Mitchell said...

9:15, do you agree that profit is the only reason to start and maintain a business? Or are you one of those imbeciles that think there should be no profit in providing medical services? If the latter is true, I guess you wish that Yellow Fever, Cancer, AIDS, and Malaria, et cetera, continued to kill thousands every year in the United States.

Anonymous said...

In my opinion Bill Minor has always made outrageous comments because he panders to liberals and supports all the policies that are destroying this country. Diligent and intelligent citizens are hard working tax payers who are on hard times because they support the lazy sloths.

Now, since multitudes don't bother to work or to even look for a job, Medicaid and food stamps will continue to be utilized. Nothing will be done about the abusers of the system. There are even people who managed to get disability social security when nothing is really wrong with them, and their claims were ridiculous. For instance, they were approved by claiming to "have flat feet", to "have Fibromyalgia", or "can't read". Go figure. I know, it seems unbelievable.

It is depressing and hopeless in my view, that without being salvaged this country is reaching the point of destruction and with no return. But, forgive my despondency. I was fortunate to have lived in the golden years when leaders were admirable and respectable, and when they stood tall and took the high road. I am thankful for THAT.

Kingfish said...

I thought it was funny last year when he devoted a whole column to claiming PERS was broke thanks to Tate Reeves and Pat Robertson sent a letter to the editor that politely exposed him as not knowing what he was talking about.

Paul Mitchell said...

It seems that the powers that be at the nervous hospital would keep Bill Minor's straight jacket a little tighter so he could not get to the crayons anymore.

Anonymous said...

And, politically, given the demographics and unemployment, the GOP is taking a big risk IMHO betting that the poor and unemployed won't vote this issue but will instead vote for the hope Romney will create jobs.

But the biggest chance is being taken by Chaney here in the state. Democrat darling Nate Silver projects a Romney thumping of the white African-American POTUS by ~19% here in Mississippi. Chaney can end his political career ignoring the voter sentiment against President Incompetent.

Anonymous said...

Haha, Paul, love your comments, and couldn't agree more. Thank you for taking the time to provide great observations! Plaudits to you!

Anonymous said...

Mike Chaney could care less about reelection.
no
The MS Hospital Association & Blue Cross will take
care of him and his Great Grand kids for life.

Shadowfax said...

It's almost as senseless to make 'this' about Minor and Chaney as it is to make the national discussion about Bain Capital. All three are diversions, literal farts in a whirlwind.

Dylan W. said...

The $160 million will come from the ~$500 million we currently pay annually for uncompensated healthcare costs. We're going to save money on this. It's good policy.

Anonymous said...

Just hearing the names "Bill Minor & Ronnie Musgrove" in the same sentence makes me laugh out loud.

Now RINO Mike Chaney will be forever associated with these two superstars of Mississippi political history.

Anonymous said...

We're going to save money on this

You must be one of the naive souls who can find the JFP website.

Kingfish said...

Noted economist Rims Barber says thi will pump hundreds of millions of dollars into the state economy.

Rims Barber essay

Anonymous said...

Noted economist Rims Barber......

That's funny !

Anonymous said...

I always think of Rims when I see fellow liberal crybaby Warren Yoder driving around town in his high end Benz coupe.

meople said...

Paul u are killing it. Wish I saw more of your humor on here.

Anonymous said...

Butthead: " Ahh, huh, Ahh... Huh huh.... he said Rimz
Barbour"

Anonymous said...

Basically for one reason or another the people who work will have to pay for those who, with some false since of entitlement, refuse to work. Of course they will say that Obamacare is a great thing, they don't have to pay for it. (And before you start, if they wont pay for the insurance what makes you think they will pay the tax if there is no penalty?/ PLUS how many of them file taxes anyway??)
Also I'd like for anyone to pick out a division of government that operates within it's budget. I don't believe there is one.
There is not a pull rope with an unlimited amount of funds. You CAN NOT operate that way. It HAS to come from somewhere, but then again if your not putting anything in what do you care.

Anonymous said...

"ObamaCare attempts to bribe the states by footing 100% of the cost of new Medicaid beneficiaries for two years, and then the federal share will fall to 90%. Supposedly this honeypot is too good an offer to refuse compared to the normal federal matching rate that ranges from 56% to 85%. The hospitals, which want more Medicaid revenue and are especially powerful at the local and state levels, are also aggressively lobbying Governors to accept the "free" money."

Brilliant observation.

Anonymous said...

That the discussion is about personalities rather than the issue is exactly why we are in trouble in this country.

Please explain why the ability for small businesses to pool together and create . say, a "retail pool" for example , so they could buy insurance plans at GE's rates would be bad?

Do any of you understand that Mississippians pay the among highest health insurance rates in the Nation and has few options for health coverage? And, by the way, tort reform didn't FIX it!

Electing people because you "like" them didn't work well for insurance commissioner. Competence and someone willing to look out for YOUR ass instead of their pocketbook and re-election might be a good place to start.

What is it about paying for the uninsured, both with higher insurance costs and higher medical costs ,is it that you can't understand?

And, medicine wasn't a BUSINESS when I was growing up, it was a PROFESSION. And, NO, maximizing profit was NOT the goal! Doctors, lawyers,and ministers too , for that matter, had a higher calling than greed and self-aggrandizement.

Hospitals wanted to get enough revenue to improve health care delivery, not to increase salaries and build fancier buildings . That we have FOUR competing hospitals in Jackson, in a community of half a million and there are not regional hospitals of the same quality as any one of the four is ridiculous and a terrible use of limited resources...right up there with having more IHLs and community colleges than the population can afford.

We USE to understand that some things , like health and the law and our souls were too important to be only about profit.

There's a difference between earning a comfortable living and getting as much as you can out of the consumer. There's a difference in SERVING the community and filling your pocket.

And neither Gil Carmicheal nor Thad Smith were in politics for themselves but for Mississippi. So they knew when they actually discussed issues, they could arrive at a solutions in the best interest of the State and address any concerns they had.

Shadowfax said...

You pissed in your whiskey by wrapping up with an endorsement of Gil Carmichael. Could you not have found a better example than Amtrak-Bill?

Anonymous said...

That the discussion is about personalities rather than the issue is exactly why we are in trouble in this country.

Please explain why the ability for small businesses to pool together and create . say, a "retail pool" for example , so they could buy insurance plans at GE's rates would be bad?
REPLY: THEY ALREADY CAN AND FREQUENTLY DO. THERE IS NO NEED FOR A GOVERNMENT RUN BUREAUCRACY TO HELP PRIVATE ENTERPRISE BE MORE CREATIVE AND EFFICIENT.

Do any of you understand that Mississippians pay the among highest health insurance rates in the Nation and have few options for health coverage? And, by the way, tort reform didn't FIX it!
REPLY: MISSISSIPPIANS HAVE THE HIGHEST RATE OF OBESITY RELATED DISEASES IN THE COUNTRY INCLUDING DIABETES. ALSO, MISSISSIPPIANS HAVE A HIGH RATE OF CANCER. ADDITIONALLY, THE COSTS OF CARING FOR THE LARGE NUMBER OF UNINSURED IN MISSISSIPPI IS PASSED ON TO THE REST OF US IN THE FORM OF HIGHER HOSPITAL CHARGES AND DOCTORS FEES. THE HIGHER COST OF INSURANCE IS BECAUSE IT COSTS INSURANCE COMPANIES MORE TO INSURE MISSISSIPPIANS.

Electing people because you "like" them didn't work well for our insurance commissioner. Competence and someone willing to look out for YOUR ass instead of their pocketbook and re-election might be a good place to start.
REPLY: I CANT’ ARGUE WITH THAT.

What is it about paying for the uninsured, both with higher insurance costs and higher medical costs, is it that you can't understand?

And, medicine wasn't a BUSINESS when I was growing up, it was a PROFESSION. And, NO, maximizing profit was NOT the goal! Doctors, lawyers, and ministers too, for that matter, had a higher calling than greed and self-aggrandizement.
REPLY: PERHAPS YOU ARE ROMANTICIZING THE PAST A LITTLE BIT. I REMEMBER LOTS OF DOCTORS AND LAWYERS DRIVING EXPENSIVE, GAS GUZZLING CARS IN THE 1960'S. I SUSPECT MAKING A BUCK WAS NOT ENTIRELY FOREIGN TO THEIR THINKING.

Hospitals wanted to get enough revenue to improve health care delivery, not to increase salaries and build fancier buildings. That we have FOUR competing hospitals in Jackson, in a community of half a million and there are not regional hospitals of the same quality as any one of the four is ridiculous and a terrible use of limited resources...right up there with having more IHL’s and community colleges than the population can afford.
REPLY: MAYBE, BUT EVEN IF YOU ARE RIGHT, SINCE ALL THE ILLS YOU PERCEIVE IN MODERN HEALTHCARE STARTED ABOUT THE SAME TIME THE GOVERNMENT JUMPED IN TO IT WITH BOTH FEET, DO YOU THINK MORE OF THE SAME MIGHT JUST GET US MORE OF THE SAME?

We USE to understand that some things, like health and the law and our souls were too important to be only about profit.
REPLY: PREACH IT BROTHER!

There's a difference between earning a comfortable living and getting as much as you can out of the consumer. There's a difference in SERVING the community and filling your pocket.
REPLY: THAT’S GENERALLY TRUE BUT EVEN JOHN WESLEY SAID, "IT IS THE BOUND DUTY OF ALL WHO ARE ENGAGED IN WORLDLY BUSINESS TO OBSERVE THAT FIRST AND GREAT RULE OF CHRISTIAN WISDOM WITH RESPECT TO MONEY, 'GAIN ALL YOU CAN.' GAIN ALL YOU CAN BY HONEST INDUSTRY. USE ALL POSSIBLE DILIGENCE IN YOUR CALLING. LOSE NO TIME. IF YOU UNDERSTAND YOURSELF AND YOUR RELATION TO GOD AND MAN, YOU KNOW YOU HAVE NONE TO SPARE." IN AN ECONOMY THAT GENERALLY GIVES MONETARY REWARDS FOR HARD WORK AND GOOD SERVICE TO OTHERS, MAKING MONEY IS MERELY THE BYPRODUCT OF SERVING OTHERS WELL.

And neither Gil Carmichael nor Thad Smith were in politics for themselves but for Mississippi. So they knew when they actually discussed issues, they could arrive at a solutions in the best interest of the State and address any concerns they had.

Shadowfax said...

Gil Carmichael was a small-time thinker. The kinda small-time guy whose greatest dreams were being president of Rotary-Local and the common man waving and calling his name when he walked the Meridian mall, being invited to join the most expensive hunting club on the Alabama line and having a building downtown named for him. He would have been overwhelmed by the seven story high-rises in Jackson and The Stack.

Kingfish said...

OK, issues? Try the fact these pronouncements this will boost the state's economy are based on so-called multipliers that never seem to work. Remember the 1.57 factor for the stimulus plan? Worked real well.

Anonymous said...

Hospitals wanted to get enough revenue to improve health care delivery, not to increase salaries and build fancier buildings.

You are blind as to what is happening @ UMC.



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