Patterico's Pontifications

8/23/2009

New Mexico Faces Medicaid Cuts

Filed under: Government,Health Care — DRJ @ 6:30 pm



[Guest post by DRJ]

Nearly one-in-four New Mexicans receives health care assistance from the state or federal government, including Medicare that covers older Americans and Medicaid that covers children, poor adults, and the disabled. Medicaid is New Mexico’s largest health care program and it accounts for 11% of state spending. New Mexico’s Medicaid program faces a budget shortfall of up to $300M in the next two years that will result in reductions in coverage, payments to providers, and/or services. The future may be even bleaker due to increases in Medicaid enrollment as unemployment rises, as well as the loss of federal stimulus money in 2012.

There are varied views on how to solve the shortfall but reduced services, limits on payments to health care providers, onerous bureaucracy, and increased taxes … it could be a preview of ObamaCare.

— DRJ

68 Responses to “New Mexico Faces Medicaid Cuts”

  1. Medicaid is New Mexico’s largest health care program

    Fixed.

    Official Internet Data Office (4dd40f)

  2. Huh?

    Leviticus (f565c1)

  3. OIDO, that’s cold!

    AD - RtR/OS! (12f8f2)

  4. If they cut services they’ll save costs, which is what reform is all about, or so Obama tells us. Is this not a good thing according to Obama logic?

    daleyrocks (718861)

  5. “Reduced services, limits on payments to health care providers, onerous bureaucracy, and increased taxes … it could be a preview of ObamaCare.”

    All those people on medicaid can right now go and get the wonderful private market insurance.

    [note: fished from spam filter]

    imdw (308fe3)

  6. imdw,

    It is sad news, not only because the Medicaid patients depend on the government for health care but also because the providers depend on it to be able to pay. That’s why it’s so important for government to budget carefully and not take on more responsibilities than it can pay for.

    DRJ (3f5471)

  7. No, it’s not cold – it’s stupid. New Mexico ranks something like #26 in estimated illegal immigrants – after such reputed havens as Minnesota, Kansas, and Maryland. So, unless I’m mistaking your intended point.. no.

    Leviticus (f565c1)

  8. Hey Leviticus,

    I think it was just a play on words conflating illegal aliens from Mexico with New Mexico, not a claim that New Mexico is overflowing with illegal aliens.

    You seem pretty angry lately my friend and I’m sorry to see it. You know there are dozens of folks here who respect you and would gladly lend a hand (or an ear) if you need, right? If you didn’t, take my word for it.

    Be well.

    Stashiu3 (ed6467)

  9. You wants we should kneecap a few people, man?

    Scott Jacobs (d027b8)

  10. The fiscal house of cards, along with the progressive movement that created it, is collapsing. All over.

    Patricia (29a01d)

  11. Stashiu,

    You’re right, man. I’m sorry, OIDO. Major overreaction.

    Nothing’s wrong; I’m just a little frustrated with the general drift of things on this blog of late. Too much sniping, not enough productive discussion (not that I’m in any position to talk given the current circumstances). Everyone’s so busy declaring that Obama’s going to bring about the end of America as we know it that they’re forgetting to propose what exactly we’re supposed to do about it (which is the part I find enlightening).

    Leviticus (f565c1)

  12. Plus, us New Mexico boys are quick to answer any perceived slight to our state (which we love dearly).

    Leviticus (f565c1)

  13. Plus, us New Mexico boys are quick to answer any perceived slight to our state (which we love dearly).
    Comment by Leviticus — 8/23/2009 @ 8:27 pm

    You really shouldn’t give me ammo like that. I might know one or two (dozen) jokes about New Mexico. 😉

    (Most of them really started as jokes about other states but can be easily modified because people are stupid everywhere. It’s true, Google it!)

    Stashiu3 (ed6467)

  14. As far as the general drift of the blog, try not to be influenced by the reaction to left-wing trolls, nor the idiocy of right-wing trolls who think they’ve found like-minded folks *cough* *TJ* *cough*

    Sorry, high pollen count here. 😉

    Stashiu3 (ed6467)

  15. You really shouldn’t give me ammo like that.

    Seriously… Have you not noticed what we do around here?

    :)

    Scott Jacobs (d027b8)

  16. I never understood why we wanted to take New Mexico from Mexico in the first place. What does it have that we need? California had gold, Nevada silver, Texas oil and pasture, Utah some place to put the Mormons. New Mexico for nuclear tests? But how could we have foreseen that in 1849?

    nk (c004f4)

  17. Maybe DRJ will do a “New Mexico’s Momma Is So…” post if enough of us ask.

    Or a caption contest or something.

    I know, let’s speculate on what possible reason anyone could have to spell a city A-L-B-U-Q-U-E-R-Q-U-E. Really, are there that many drugs in the desert?

    😉

    Stashiu3 (ed6467)

  18. But how could we have foreseen that in 1849?
    Comment by nk — 8/23/2009 @ 8:49 pm

    I work here is done.

    Stashiu3 (ed6467)

  19. nk:

    Green chile.

    Plus, you don’t live in a high desert. You don’t know what you’re missing.

    Newtons.Bit (f56ada)

  20. “That’s why it’s so important for government to budget carefully and not take on more responsibilities than it can pay for.”

    If it hadn’t taken on more responsibilities, then those poor people wouldn’t have been covered to begin with.

    It’s a wonderful feature of this healthcare debate. We’ve gotten the right wing opposing and denouncing cuts in social spending for the poor (medicaid) and the old (medicare). Good show!

    [note: fished from spam filter]

    imdw (034b9e)

  21. Stashiu,

    Well… Albuquerque (where I live) was the nation’s number one city for fitness fanatics a few years ago. But don’t hold that against us – we’re also one of the top cities in the nation for ugly lesbians. I went to an Indigo Girls concert a few years back… yikes, I say.

    nk –

    From the look of things, New Mexico had space to put Californians after they ran their own state into the ground. Plus sanitarium real estate – and Great Views! Seriously, though Newton’s.Bit is right about high desert living – I never want to live outside the Southwest, if I can help it.

    I mean, you’re from Illinois, right? How many people do see walking around with a bitey eagle tattooed on their bodies? Because we’ve got plenty of Zias to go around…

    Leviticus (f565c1)

  22. “Options range from reducing or eliminating benefits, such as dental care for poor adults, to lowering the reimbursement rates for doctors and other providers, according to New Mexico Human Services Secretary Pam Hyde.

    If drastic cost-cutting becomes necessary, she said, the state might need to scrap entire portions of Medicaid, such as a program to help low-income workers with insurance coverage, or revamp Medicaid to provide a minimum amount of services.

    “We know there is going to be some cost containment. The only question is how much,” Hyde said in an interview last week.”

    And we look in vain for the words “cut back on the Medicaid staff so that more money goes to program services.

    Kevin Murphy (3c3db0)

  23. The surface of Lake Michigan is about 600 ft. above sea level. That’s high enough for me. And I thought Arizona was the place for sanitoriums. And it had silver, too. And we have antibiotics for tuberculosis, these days, anyway.

    Los Alamos is the best excuse for New Mexico being in the Union, I think.

    nk (c004f4)

  24. imdw:

    If it hadn’t taken on more responsibilities, then those poor people wouldn’t have been covered to begin with.

    Every person can get emergent care at a public hospital, regardless of whether they are legal or illegal, rich or poor, insured or uninsured. As for non-emergent care, when your default setting is to push whole groups of people into Medicaid then you foreclose other options that might be more economical (e.g., charities and communities that establish low-cost/free clinics for routine healthcare).

    Why do you believe the only choices are no health care vs. government health care? There are a range of choices in between that might be more practical, efficient and cost effective. In addition, different choices may work better in different places.

    DRJ (3f5471)

  25. I think the point OIDO was trying to make was that there are a large number of illegal aliens on the Medicaid roles from sea to shining sea, not just in New Mexico.
    And, this IS an allegedly conservative blog,
    so why wouldn’t we be sniping at Democrats/Leftists?
    The Congressional Dems have pushed the GOP away from the table, so I think they are getting all of the criticism they deserve, in spades!
    Speaking of NM, I see that the ex-Sec State is being looked at for some serious corruption by the NM-AG – would this be one of the voter corruption cases that Iglesias didn’t want to pursue, and he got canned for?
    It seems only a matter of time before they start parking the news vans at the end of the Gov’s driveway.

    AD - RtR/OS! (12f8f2)

  26. Why do you believe the only choices are no health care vs. government health care?

    They really do not have a position beyond that standard false choice.

    JD (927cb2)

  27. Leviticus,

    New Mexico has never gotten the respect it deserves. My favorite column in the New Mexico Magazine was always “One of Our 50 is Missing,” a column that jokes about how little respect New Mexico gets. But I’ve lived and worked in New Mexico and, like you, I know it’s a beautiful state with terrific people.

    DRJ (3f5471)

  28. So, solutions?

    I don’t know how Medicaid works (or doesn’t) in New Mexico, but I can tell you what’s wrong with it in my state (somewhere in the Midwest):

    Onerous regulations for anyone providing care to get paid. The paperwork is idiotic, lots of bureaucracy for the pay.
    Medicaid involves ZERO responsibility, meaning if you want to show up in the ER for a pregnancy test, along with your friends in tow, all to be there for the same, Medicaid pays for it. And yes, THIS REALLY HAPPENS. Oh, the girls say they have belly pain so they will be seen.
    Tons of Medicaid folks coming to the ER for sexually-transmitted disease care. Pay not one thin dime, but there is a whole Public Health apparatus to track down the contacts of those with positive test results…like any of it is going to cut down on STD. If anything, it’s growing, just like teen pregnancies, at least where I”m at.
    Oh yeah, numerous visits for pregnancy-related things, after they are found to BE pregnant. And grandma-to-be, all of 30, is happy for their 15 year old daughter. No, it’s not hyperbole, we have 20 year olds with 3 kids. Medicaid pays for it all, while couples who are not on Medicaid agonize whether they can afford the first child.
    Did I mention that cellphones are a Constitutionally-protected right? Because most of the same people coming in for their STD and pregnancy visits have cellphones, but can’t afford any paid medical visits. And then forget to take the STD meds, and have to come back to get another prescription.

    This is all the truth. However, does it mean that everyone on Medicaid is a pain-in-the-ass? No. I do NOT say that, and many are good moms, good people (and are white and black so let’s keep the racist stuff out of here, thank you), do need help. And, it’s NOT only Medicaid patients that abuse the ER, to say the least. (I did forget to mention the repeat drunks, druggies, drug seekers etc. Not limited to Medicaid, but certainly, a higher percentage of these ARE on Medicaid, or even Disability-SSI for…who knows? Drug addiction? Stress? Who has stress?

    Do I want rationing? No, and I don’t know THE answer to what to do, in truth, but I do know there is tremendous abuse and waste in the ‘system’, and it needs to be dealt with. I DO know if they can afford 1) illegal drugs or alcohol or 2) cellphones for every single family member, then they can probably afford small copays to help with their care for their STD’s and pregnancy testing.

    The real culprits here are “free” care. Anytime you make anything “free”, it’s abused. On the other side, the bureaucracy of Medicaid is insane. Few doctors want to take it, because as bad as the insurance companies are, they are a lot better to deal with than the Medicaid commisars.

    Maurice (dc7baa)

  29. a column that jokes about how little respect New Mexico gets. But I’ve lived and worked in New Mexico and, like you, I know it’s a beautiful state with terrific people.

    Please. My native state got mocked in a freaking BOND movie…

    Scott Jacobs (d027b8)

  30. Comment by Scott Jacobs — 8/23/2009 @ 10:03 pm

    And JD is always wanting to give mine away to Canada.

    Paul (creator of "Staunch Brayer") (3b3b67)

  31. I didn’t know you were from Southern Quebecistan, Paul.

    JD (927cb2)

  32. My tiny rural church runs a food bank. Staff is unpaid, 100% labor is free, 100% of donations go to food. The staff is church members, mostly elderly and certainly not rich themselves. They work very hard to have food, clothing, and toys for Christmas. I help out as I can.

    It is amazing how often the recipients complain about the selection, complain about the hours, complain about the Christmas toys, etc. It is all free for them. Many are addicts/alcoholics. Many are frequently found at the local community college, where they can attend classes to qualify for welfare without having to search for a job.

    Many of the food bank staff are very disillusioned, but feel at least the children of these people won’t go hungry. The flip side is that the food frees up more income to blow on drugs or whatever.

    My spouse works in corrections, and inmates receive more medical care than most of us law-abiding types, and again, are continually dissatisfied and complaining.

    The point is that free stuff is not really helping these hapless people, and taxing the rest of us more won’t help them either. Some stuff is just not fixable, at least by us mortals. The net result of all these freebies is negative for all.

    jodetoad (059c35)

  33. I’m just worried that the greedy doctors under a government option will be hacking off more body parts to make up for the cut rate reimbursement levels Obama has been bandying about and this post discusses relative to private care.

    I’ll have to ask Mike K about that.

    /sarc/

    daleyrocks who wants to keep his tonsils and feet (718861)

  34. jodetoad – inmates receive more medical care than most of us law-abiding types

    And friends of mine are physicians, and to a person all relate that their best pay rates come from treating prisoners.

    That’s because the state won’t bother to negotiate with them, and just pays full price. I ask them if they would still treat prisoner patients if the state negotiated and they confirm that yes, they would.

    The state doesn’t bother to negotiate because the state doesn’t need to turn a profit.

    Apogee (e2dc9b)

  35. New Mexico ranks something like #26 in estimated illegal immigrants

    So what?! It’s a small state, so context is everything.

    fairus.org:

    New Mexico’s population increased by 20.2 percent between 1990 and 2000, and by 7.3 percent between 2000 and 2006, bringing New Mexico’s total population to approximately 1.9 million. Approximately 20 percent of the total population increase between 2000 and 2006 in New Mexico was directly attributable to immigrants.

    FAIR estimates the illegal alien population in 2005 at 73,000. This number is 87.1% above the U.S. government estimate of 39,000 in 2000, and 265% above the 1990 estimate of 20,000.

    According to an estimate of the Pew Hispanic Center, in 2005 there were an estimated 50,000 to 75,000 illegal aliens living in New Mexico

    FAIR estimates in 2004 that the taxpayers of New Mexico spent $153.1 million per year on illegal aliens and their children in public schools.



    CNN.com, August 2005:

    New Mexico Gov. Bill Richardson declared a state of emergency Friday in four counties along the Mexican border that he said have been “devastated” by crimes such as the smuggling of drugs and illegal immigrants.

    The declaration said the region “has been devastated by the ravages and terror of human smuggling, drug smuggling, kidnapping, murder, destruction of property and the death of livestock. …

    “[It] is in an extreme state of disrepair and is inadequately funded or safeguarded to protect the lives and property of New Mexican citizens.”

    New Mexico shares 180 miles of border with the Mexican state of Chihuahua.

    “The situation is out of hand,” Richardson said Friday night on CNN’s “Lou Dobbs Tonight,” noting that one 54-mile stretch is particularly bad.

    He noted he is the nation’s only Hispanic governor, and “we’re a state that’s been very good to legal migrants. … This action, I believe, had to be taken.”

    No, it’s not cold – it’s stupid.

    Stupid are all the people of a nation like Mexico who continuously, consistently vote like simpleminded residents of inner-city America — in which liberal politicians and policies can do no wrong — make a socio-economic mess of their environment and then expect others to clean it up. Either that or they feel they have no choice but to pick up and move to another community (or country) and then repeat the cycle of dysfunction all over again.

    Mark (411533)

  36. ___________________________________

    It is amazing how often the recipients complain about the selection, complain about the hours, complain about the Christmas toys, etc. It is all free for them. Many are addicts/alcoholics

    Well, what more is there to say?

    Even the dysfunctional who probably are made up largely of those loyal to the Democrat Party (assuming such people do, or were to, vote) and who the left loves to get all weepy over sound like limousine liberals.

    Mark (411533)

  37. If we peer into the numbers a little bit, the first item is this “Nearly one-in-four New Mexicans receives health care assistance from the state or federal government, including Medicare that covers older Americans and Medicaid that covers children, poor adults, and the disabled.”

    According to the New Mexico government [at http://www.health.state.nm.us/TitleV/pdf/Overview.pdf the 65 and over population comes in at 12% of the state’s total population. So, of that 1 in 4 [25%], 12% is Medicare and 13% should be Medicaid.

    Further down in the article we find this: ““Medicaid is a huge part of our economy,” said Hyde. “Medicaid represents a third or better of the health care industry.”

    So if my math is right, 13% of the state’s population is spending 33% of the state’s health care dollars. Not paying mind you, spending.

    Does this seem out of whack to anyone else? Is everyone in the system using those expensive ERs for primary care?

    kaz (e7a67c)

  38. Southern Quebecistan

    Now that’s funny, JD.

    Paul (creator of "Staunch Brayer") (3b3b67)

  39. “Every person can get emergent care at a public hospital, regardless of whether they are legal or illegal, rich or poor, insured or uninsured.”

    But they also have to pay for it. Rich or poor, insured or not. I really can’t believe people still bring this up when we’re talking health reform, as if it has much relevance to the debate.

    “As for non-emergent care, when your default setting is to push whole groups of people into Medicaid then you foreclose other options that might be more economical (e.g., charities and communities that establish low-cost/free clinics for routine healthcare).”

    I’m sure free clinics still get quite a bit of attendance.

    “Why do you believe the only choices are no health care vs. government health care? ”

    Because a poor person with a pre-existing condition is going to find some really awesome options on the private market.

    imdw (0172f3)

  40. But they also have to pay for it.

    No, they don’t. The poor 99% of the time don’t even GET a bill because the Hosp isn’t going to waste it’s time, and those who aren’t poor could have had Insurance, but likely chose not to pay for it, and got bit in the ass by that decision.

    Scott Jacobs (d027b8)

  41. “Every person can get emergent care at a public hospital, regardless of whether they are legal or illegal, rich or poor, insured or uninsured.”

    But they also have to pay for it

    Oh, the horror. Imagine being expected to actually pay for goods and services. Imagine having to pay for utilizing someone else’s labor.

    JD (1255f0)

  42. “No, they don’t. The poor 99% of the time don’t even GET a bill because the Hosp isn’t going to waste it’s time,”

    Two of my poor friends did this. They got bills. They got this bill on their credit. Must be some other 99% not getting bills. But really you don’t think the hospital even generates a bill and calculates the loss? How do they know ahead of time who is poor and who is not?

    “Oh, the horror. Imagine being expected to actually pay for goods and services. Imagine having to pay for utilizing someone else’s labor.”

    This is what’s amazing. We’re talking about medicaid: care for people who can’t afford it. Now you know how inadequate it is to answer that they can walk into emergency rooms and not be denied care.

    [note: fished from spam filter]

    imdw (085706)

  43. Medicaid is running out of funds? Is this in any way related to the critically urgent ObamaCare?

    During the final days of Bernie Madoff’s scheming, he aggressively recruited new investment members, offering even more enticing promises of higher interest rates due to “discoveries of new higher profit opportunities.” Ponzi scheme artists will usually advance either higher profit or lower cost promises as a ploy to entice the target to believe the unbelievable. As the game exhausts its funding, many artists will seek to architect a radical change event — e.g. an acquisition, a take-over of another fund, or some other fresh pool of opportunity to muddy up the waters and transfer the looming debt to a new chart of accounts where it won’t be seen for another decade or so.

    Imploding PonziCaid and PonziCare? PonziSecurity? Of course, this is the impetus for OponziCare.

    Even the AARP admits it, as my mother discovered last week when she canceled her membership and joined the conservative ASA. In addition to their other political association crimes that go against the values of their membership, she explained that she was increasingly pressured to join Medicare and leave her husband’s university medical insurance program that provided many times the benefit. Indeed, her joining Medicare is important, said the AARP representative, for we need more people in the system (more cash in the system to muddy up the Ponzi waters and buy the political elites a few more years before it all crashes).

    And speaking of that inevitable collapse of the USFG Ponzi scheme, you can expect that the elites are both aware of its inevitability, and do not wish to lose power when it does arrive. The more they can tighten that yoke around the middle class’s neck (the lower class is already controlled and dependent), the more this ensures the preservation of their power when the end of the scheme arrives. That’s when soft tyranny goes hard.

    HatlessHessian (cca288)

  44. But they also have to pay for it. Rich or poor, insured or not

    This is flatly wrong, period. Go into any County Hospital and ask them if they’ll expect you to pay anything if you’re indigent or poor, and they’ll tell you in no uncertain terms…NO. Here in Cook County, one of the reasons for our budget crisis is the huge backlog of past due invoices for services rendered, and yet these invoices are for those who could have afforded to pay for their insurance, but chose not to, and so then decided to try to screw the publicy – funded hospital instead. This is the widespread canard that the Dems have been proven demonstrably false in stating.

    Dmac (e6d1c2)

  45. I once drove from Albuquerque to I-10, on my way to Tucson. Lots of nothing except sunshine.

    PatAZ (9d1bb3)

  46. Comment by PatAZ — 8/24/2009 @ 8:59 am

    If you really want to see (beautiful) nothing, take US-60 west from Socorro over the mountains to AZ – you will get to see the Very Large Array Radio-Telescope on the way.

    AD - RtR/OS! (cbe8a1)

  47. The Nothing is the draw of the place.

    Leviticus (f565c1)

  48. Plus, us New Mexico boys are quick to answer any perceived slight to our state (which we love dearly).

    Comment by Leviticus

    Geez! You are a New Mexican too? This state may well be doomed.

    I agree that there is a lot to love about this state but the corruptocrats (Dems) are taking it the wrong way. And, yes, there are too many illegals taking up tax dollars.

    PatriotRider (648d0f)

  49. AD … I remember being in Socorro once, in another life, but don’t remember much about the trip. Great Mexican food tho.

    PatAZ (9d1bb3)

  50. imdw,

    People can get medical care in America but it may not be free, and it’s clear your concern is not medical care but free medical care. You obviously believe health care should be an entitlement. I disagree, primarily because we can’t afford it but also because making health care free will encourage people to use it beyond our capacity to provide services or pay for them.

    There are many things people need that they still have to pay for. As America has grown more wealthy, government has taken on obligations to help people pay for food, shelter, and utilities. We haven’t done that because people have a right to those things for free. We’ve done it because we want to and can afford it.

    The reality is we can’t afford to give people free health care beyond what we’ve already obligated society to provide, and frankly we can’t afford to meet those obligations given the bankrupt status of Medicare, Medicaid, and other government health plans. However, people who have onerous medical debts they can’t pay can discharge those debts in bankruptcy. There’s a reason why we need to have procedures like bankruptcy — because we don’t want people to avoid paying debts they can afford to pay. If we were a hard-hearted society, we would refuse any health care to people that couldn’t afford to pay for it, or we would deny people the right to file bankruptcy.

    DRJ (3f5471)

  51. DRJ – We cannot meet our current obligations, yet to save the system, folks like imdw would have us simply take on even more obligations. I do not know in what world that makes any sense at all.

    JD (d3f3ab)

  52. Scott, you should be thanking the People of New Mexico for building the University that Brian Urlacher graduated from.

    PCD (02f8c1)

  53. Comment by PatAZ — 8/24/2009 @ 11:53 am

    Didn’t stop there. We were pulling a large race trailer with an even larger motor home, and maneuvering in cities is tough. So, we stopped and made lunch at a rest stop up near the Divide. It was painfully peaceful. We like to go cross-country off of the Interstates – on that trip we saw two full days of corn (WI-NM) with some interesting historical stops thrown-in for good measure.

    AD - RtR/OS! (cbe8a1)

  54. “Every person can get emergent care at a public hospital, regardless of whether they are legal or illegal, rich or poor, insured or uninsured.”

    But they also have to pay for it. Rich or poor, insured or not. I really can’t believe people still bring this up when we’re talking health reform, as if it has much relevance to the debate.

    It is the essence of the debate except for people who think money grows on trees. For years, I was on the board of CMRI, the Medicare peer review organization. One year, we were looking for new revenue sources since having a business with one client is not good for your health. Since the company was heavily involved in managing Medicare in California, the staff felt a good possibility was MediCal, the California version of Medicaid. I think Pete Wilson was governor so there was some optimism that a privatization proposal had a slight chance.

    CMRI did a study of the CA DHS which ran MediCal. They had 5,000 state employees, about the same number as ran HCFA, then the Medicare administration for the entire USA. We were told, NO THANKS ! They were not interested in considering a bid for outsourcing the administration.

    The best way to care for the poor is with county hospitals and clinics. The doctors are on salary and the system can be run quite efficiently. When Medicaid tries to run the system with private docs, they pay so poorly that only crooks and a few saints (very few) will participate. As far as charging the patients is concerned, LA County used to have a system in which each patient got an ID card with a payment code. The code was a G plus a number from 9 to zero. If you were a G9, you paid or your insurance did. There were a few private patients, either trauma or to some specialty services. If you had a G0 (We called it a “Go card”), you paid nothing.

    Once in a while someone who could pay would come in with grandpa thinking it was free for everyone. That was wrong but 95% of inpatients were G0. Clinic patients were probably 99% G0.

    Mike K (2cf494)

  55. The value attached to a good or service is in direct relationship to the out-of-pocket cost of same.

    AD - RtR/OS! (cbe8a1)

  56. “The reality is we can’t afford to give people free health care beyond what we’ve already obligated society to provide, and frankly we can’t afford to meet those obligations given the bankrupt status of Medicare, Medicaid, and other government health plans.”

    The reality is we spend more government money per capita as most other countries. I do agree that we can’t afford to spend more money, public or not, on health care. If anything the goal of reform should be to spend less.

    “However, people who have onerous medical debts they can’t pay can discharge those debts in bankruptcy. There’s a reason why we need to have procedures like bankruptcy — because we don’t want people to avoid paying debts they can afford to pay. If we were a hard-hearted society, we would refuse any health care to people that couldn’t afford to pay for it, or we would deny people the right to file bankruptcy.”

    I think another goal should be to create a system where someone would not be driven into bankruptcy by a medical ailment.

    “The value attached to a good or service is in direct relationship to the out-of-pocket cost of same.”

    Propose cutting medicare — like the GOP used to do — and you’ll see how much value people attach to this.

    imdw (017d51)

  57. […] used to live in New Mexico. It is with great sadness that I found out that their Medicaid program is facing massive budget cuts. Cuts to payments, services and rationing. This from a program that was set up to counter those […]

    Horrors « Chockblock’s blog (ea1fd5)

  58. If your goal to reduce costs is actually a goal, you should be able to easily demonstrate the aspects of your plan that would actually reduce costs.

    JD (c3a7b7)

  59. Obama is already proposing cuts to Medicare, under the guise of “increased efficiency”.

    JD (c3a7b7)

  60. imdw, the number of bankruptcies related to health costs has been grossly exaggerated. It is a favorite tactic of young adults who lose their gamble with health insurance and the odds. Beyond that, it is a rare cause of personal bankruptcies. It is not necessary to destroy a system that is working well for 80% of the population to solve the problems of a small minority.

    MIke K (2cf494)

  61. “The reality is we spend more government money per capita as most other countries. I do agree that we can’t afford to spend more money, public or not, on health care. If anything the goal of reform should be to spend less.”

    imdw – But Obama says we will cover more people, regardless of age, with no restrictions on preexisting conditions, provide extensive preventive care and yet promises no reductions in quality or choice all while promising cost savings. How? He doesn’t provide details, but it sure sounds counterintuitive to anybody familiar with health care or insurance.

    He’s got a big credibility problem going.

    daleyrocks (718861)

  62. “imdw, the number of bankruptcies related to health costs has been grossly exaggerated”

    Caused by probably. “related to” is a low standard. I’m addressing DRJ’s bankruptcy solution. I don’t think medical ailments should destroy a family’s equity, for instance.

    “imdw – But Obama says we will cover more people, regardless of age, with no restrictions on preexisting conditions, provide extensive preventive care and yet promises no reductions in quality or choice all while promising cost savings. How? He doesn’t provide details, but it sure sounds counterintuitive to anybody familiar with health care or insurance.”

    He’ll start with castration panels.

    imdw (06d366)

  63. imdw,

    I’d also like a world in which people don’t have to file bankruptcy for a serious illness. For that matter, I’d like a world where people don’t get serious illnesses. But these things happen and we can’t bankrupt society just because we don’t want some people to have to file bankruptcy.

    DRJ (3f5471)

  64. “He’ll start with castration panels.”

    imdw – That’s different than circumcision, but whatever.

    daleyrocks (718861)

  65. DRJ: Please remove this extraneous material after you read this but I was very pleasantly surprised to see you posting here again last week when I wandered over here. I’m sure you’ve already heard plenty but I am very glad you have shown up here to add your strength of character and well-researched opinion once again.

    It was a loss for all readers to have a DRJ-shaped void on this site, but the reason was well-understood.

    Again, welcome back (although I am now far too sporadic a reader now).

    John Hitchcock (3fd153)

  66. “That’s different than circumcision, ”

    And they’re not “death panels” either.

    “But these things happen and we can’t bankrupt society just because we don’t want some people to have to file bankruptcy.”

    Obviously we don’t have to bankrupt society if the goal is to just avoid some people’s bankruptcy. The idea that “these things happen” is precisely what insurance and risk spreading is for — minimizing the catastrophic impact on an individual when “these things happen.”

    [note: fished from spam filter]

    imdw (e6c812)

  67. Thank you for your comment and I wouldn’t dream of removing it. Kind thoughts like this make my day.

    DRJ (3f5471)

  68. New Mexico is a the nations future. Heavily hispanic and a basket case.

    hortense (aka horace) (235454)


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