Friday, November 29, 2019

Medicaid Mauls New York

Medicaid is busting New York's budget.  The New York Daily News reported a week ago:

Budget officials estimate that the state’s share of Medicaid spending is $4 billion over budget this fiscal year. That figure includes $1.7 billion in Medicaid costs held over from the previous fiscal year’s budget.

Cuomo’s plan for dealing with the gap includes pushing $2.2 billion worth of Medicaid costs into the future. He’d also impose a “savings plan” that reduces current-year Medicaid spending by $1.8 billion.

Details of the savings plan won’t be available until Cuomo makes his annual budget proposal in January.

Cuomo is already late with the news of the deficit — he disclosed the magnitude of the problem in a mid-year budget update Friday that was three weeks late...

But spending has soared since 2016, something the governor has chalked up to minimum wage increases, the rising costs of long-term care and other factors. There was also the matter of a $140 million increase in reimbursement rates approved last year shortly after a hospital association donated $1 million to the state Democratic Party. ... Rest of article.
The New York Post slammed the Governor for kicking the Medicaid can down the road:



34 comments:

Anonymous said...

A democrat with a "savings plan" ..... smells a lot like a tax increase to me, and deferring costs, typical democrat move. All you need to know about the economic ramifications of medicare for all is being revealed in real time in NY. Pay attention people - the "free stuff" economic model just doesn't work.

Anonymous said...

How much does it cost in human lives to not have access to medical care?

🧐

Cynical Sam said...

"...pushing $2.2 billion worth of Medicaid costs into the future."

Translation: Libtards kicking the can down the road.

Notice that Cuomo made the announcement on a Friday - typical libtard move so that there isn't much media coverage.

What Americans need is the dem's "Medicare for all." Yea, that's the ticket. //sarcasm mode off//

Solomn said...

There are no easy answers

Anonymous said...

Medical costs (including pharma) are exploding everywhere. This is not just New York and it is not sustainable. For anyone, anywhere. It is solidly estimated that the costs of commerical insurance for a typical teacher (in the USA) will exceed their total annual salary by 2024.

This is, of course, insane.

We need to be the last civilized nation to have universal insurance, paid by the government.

I am a Republican and a physician and I am very much for Medicare-for-all. Everyone deserves access to care.

The dumbest right wing argument against it (I heard it yesterday) was that it would lay off 200,000 current employees who work in the insurance industry. A bit like arguing against cars because they would lay off all the horse and buggy drivers.

Anonymous said...

This is what Wallet and Hood wanted to do to us

Anonymous said...

And Elizabeth Warren's "Medicare for all" will ONLY cost $52 trillion? What multiple would make an accurate figure? It would likely 10x the current 20+ trillion national debt.

But a $200 trillion debt would be worth it just so Trump isn't re-elected.

We will be a totalitarian state within 50 years, but at least it will be a "compassionate totalitarian state."

Anonymous said...

2:45 - take that red herring and drag it across another road. Where does it say that the folks in NY don't have 'access to medical care'?

Just as in Mississippi, the expansion of Medicare via ACA (aka Obamacare) did not change the 'access to medical care', it just moved many people from private insurance to government insurance.

You might note the $1 million donated by the Hospital Association to the Democrat party - as they have done here in MS except it was to the Democrat candidates, not to the party, in an effort to get their higher payments covered by Medicaid.

Please give us some kind of statistical statement about "cost of human lives lost" because of not having access in New York prior to their expansion and overspending.

Anonymous said...

This is where the bleeding hearts, like 2:45, start whining about babies dying in the streets and Old Men getting their legs amputated down to the VFW with no anesthesia.

Anonymous said...

The world's largest concentration of billionaire hedge fund managers is in Manhattan, NY.

They should never be asked to spend a single shiny shekel on a sick human.

Anonymous said...

The state's overall budget is over $150 billion, so all you country bumpkins need to take a deep breath.

Anonymous said...

I am a Republican and a physician and I am very much for Medicare-for-all.

Anonymous appeal to (an) authority that does not exist.

Anonymous said...

People here like to pretend the Republicans are better with the budget and will blindly ignore the Trillions added to the deficit under complete Republican control. It turns out that you can’t cut everyone’s taxes and spend way more money like they thought. At least if we spend the money on health are, we would get some real and tangible benefit.

Anonymous said...

6:20 - nice to know anti-semitism is alive and well in 2019.

Anonymous said...

@5:02- As a physician, do you acknowledge that while Medicare-for-all may provide “access to care”, it will NOT cover many services and procedures? I think people get caught up with the “access” without realizing services and procedures will be cut to “fit” everyone under the financial umbrella. What will you then be able to recommend for your patients with non-covered illnesses and conditions?

Also, with the government controlling the procedures and reimbursement rates (you KNOW these WILL continue to fall over time), how will hospitals and clinics maintain/operate at quality levels?

I’m left to assume you will be quiet comfortable only being able to treat covered conditions and illnesses. After all, you’ll be able to blame the government for your inability to help all patients.

To those asking how many are at risk of dying due to no access to healthcare with our present system, just wait until you see how many die on Medicare-for-all due to non-covered conditions and illnesses. Better yet, I can’t WAIT to hear you complain about wait times for care and procedures.

Medicare-for-all is a financial nightmare, a benefit nightmare, and a competitive nightmare. The money WILL run out. Care WILL decline. Options WILL be eliminated. Those wealthy folks you think are going to fund this nightmare WILL move on, because they have the resources to do so.

Bagel and a Shmere said...

@7:35
Antisemtic? It was literally another Shoah!

Anonymous said...

It's the Daily, might as well be FOX.

Anonymous said...

"Medicare for all" - Bring on the government death panels. Obama is smiling.

Of cour$e the alleged phy$ician above like$ "Medicare for all." It'$ his rice bowl.

Anonymous said...

@8:00. I am happy to continue the conversation. You mention a lack of coverage by Medicare for many procedures and services. What procedures and services are you referring to? Although I am working full time, I am on Medicare and it is just about the best insurance I have ever had.

The greatest threat to your continuing "health insurance" (non-Medicare) is exactly what you are accusing Medicare of: denied, medically necessary services. All private and commercial insurers are now using "benefit management" firms to make it very hard for you to get necessary services. They do this (and it is growing by the day) by requiring your doctor to get a prior authorization before you can get a given service or item. And the prior authorization (this is not Medicare) or "PA" is driving physicians into retirement because of the administrative burden.

One added tidbit for the anti-Medicaid crowd who read this blog: The majority (as in over 50%) of mothers who have babies born in Mississippi are on Medicaid. The majority.

Anonymous said...

People who gripe “Medicare won’t cover everything” obviously haven’t been seriously ill with Blue Cross.

Anonymous said...

When will we get credited with doing something right? Why drop a benevolent contributorS name from a building? Why take down the monuments of (un)civil war hero’s who gave their lives for their country? Why do we still have a coach who obviously condones this repeated crass behavior on the football field? Why not get a permanent mascot? We have a few rich liberal contributors who apparently run the school. Ticket sales are dismal. Enrollment is dropping like crazy. Even the Texas students who don’t qualify for entrance in Texas colleges are starting to dry up. We can’t even fill the law school after dumbing it down.

Anonymous said...

Why is it that universal health care can work in Japan but not in America?

I'm currently watching a Japanese medical drama on Rakuten streaming service. Japanese doctors and nurses aren't underpaid. They are young and energetic. They operate in rural farms and fishing islands as well as mega cities like Tokyo.

Hell, you can't even use the excuse that half the population doesn't work in the USA. Half of Japan's population is retired. I think America's problem is racism and greed. That is the only answer. In Japan they are taking care of their own.

The tax paying majority in America just sees a different race.

Friend of a Madison doctor said...

I have heard that the doctors in Mississippi are paid higher than doctors nationally. Is this true? Asking for a doctor friend.....

Anonymous said...

Not sure about salaries but the cost of living bump for doctors makes a big difference.

Anonymous said...

8:13 - neat trick you have learned - exchange your comments back and forth between Medicare (which you are on) and Medicaid (which is a different program, and has different standards).

Yes, Medicare does cover most things quite well. I too am on Medicare and can't complain about the lack of coverage. However, my providers probably do care since the reimbursement rate for those services amount to much less than they receive from a private insured plan, and almost 80% less than a cash pay client, if such still exists in this world.

But Medicaid is a different animal. And its reimbursement rates closely match the Medicare rates, but the coverage has several differences.

The main result, though, from 'universal coverage' -- be it copying Medicare or Medicaid is that the services provided will be rationed as they are in other countries that have 'universal coverage'. Those services will not match the current Medicare (which we have paid for over the years for the coverage) in that once it is not worth the money to treat a patient, they are denied the service. Check out our neighbor to the north where folks with dual citizenship (Canadian and American) leave and come south of the border to receive treatment that they are required to wait six, eight or more months ------ if they are approved to have the treatment.

Once those realities set in, your (and my) Medicare or the poor's Medicaid coverage won't matter because at our age we will not be shortlisted for many procedures that we receive routinely today. A heart surgery after 70? Doesn't happen in Canada. Don't even think about serious cancer treatments when you pass the magic ages. And for those younger, hope your treatment isn't one that is time sensitive, because that is not how it works. And really don't plan on needing to go to a specialty treatment center like MD Anderson, Sloan Kettering, Mayo, John Hopkins, etc. Those needed treatments will only be available to folks with deep pocketbooks, or with private insurance if such is allowed to survive as a business.

Anonymous said...

@8:16 bullshit detected
You don't have a shred of evidence regarding long wait times in Canada. You are also totally dishonest about coming south of the border for treatments. Back up your ignorant claims with sources. Don't bother with American Pravda like breitbart.

Anonymous said...

Don't bother with American Pravda like breitbart.

Don't bother waiting for any answer when you automatically assume you get to call the shots relative to sourcing.

No bullshit, you're an idiot.

Kingfish said...

It's the Daily? Google new York and Medicaid deficit. This story is reported by several media outlets, not just one.

Anonymous said...

8:16 pm

Maybe at a certain age you don’t need expensive surgeries?

Most of the money we spend is on end of life care.

I agree you’ve paid into a system and have expectations for care but maybe going forward we stop providing expensive treatments to 90 year olds?

I do think technology will eventually aid us in making these decisions.

And debt will force us to make harder ones.

Anonymous said...

The biggest free medical users I have seen are trash with self induced health problems. Soft drinks, no water, no good teeth cleaning habits, shit food eating, low class living, alcohol, tobacco of all sorts, whacky weed and other crap, no money havin, no kid supportin, no good earning, not a good word to anyone else--just shit headed mooches. Could stand to learn anything worth knowing type of people.

Anonymous said...

9:36 am

So Americans?

Anonymous said...

Oh my! The sky is falling! Armageddon in the form of a 1.25% shortfall of NY's Medicaid budget!

But then NY's 3 year gdp growth is 3.8% and Mississippi's -.19%. I'd ask, whose sky?

Anonymous said...

The more the government pays for folks being sick, the more people will be sick.

"From each according to his ability; to each according to his needs."

And the government will decide what your ability and your needs are.

Anonymous said...

Meanwhile, in Kentucky and Arkansas, two states much more similar to MS, Medicaid expansion has been a huge success. Hospitals thriving, not closing. NY has nothing in common with MS.



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