Tag Archives: ACA

Plunkett: DSH payments will never be cut. Dems should vote to reauthorize Medicaid now. | Mississippi PEP

 

Plunkett: DSH payments will never be cut. Dems should vote to reauthorize Medicaid now. | Mississippi PEP

Republicans keep projecting their wishes on the future, forecasting that the things for which they long are “inevitable.” They say things like “With one single decision President Barack Obama pulled the rug out from under any moves by Mississippi Democrats to expand Medicaid in Mississippi.” And that undoing his “signature achievement as President” was “inevitable.” Now this bit of prognostication was a conservative Mississippian’s response to the Obama administration’s decision several months ago to delay “cuts to DSH payments” (“Disproportionate Share Hospital (DSH) payments are given to hospitals by the federal government to states through Medicaid for caring for the uninsured”).

Conservatives say this because they see a delay in implementing a shift in payment for indigent care (which they have been successful in labeling a penalty for the states) as a fatal flaw, even getting liberals to adopt the “Luntz” framing. And, although many of the people they, the Crpto-Fascists, count as supporters would die without expansion, they, in clear Atwater fashion, seem perfectly content with repealing:

Coverage which

And the pseudo-anti-judicial activists rejoiced in hearing an activist court legislate with under cover of a flimsy explanation like:

“What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding”

effectively revitalizing the old states-rights ideology almost a century and a half after the Civil War settled the issue and challenging Congress’ authority to determine how indigent care will be compensated. In one of the most striking examples of the effect of poor history education in America, the American public voted for people who are actually states-rights proponents as if they, “the people,” have no idea that this was the position of staunch white supremacists who sought to rend the Union asunder. How is Medicaid a new program? How does the Court tell Congress how to aid the indigent?

It is, indeed, amazing that somehow shifting the funding to compensate providers for indigent care from disproportionate care payments to Medicaid payments can be viewed as a penalty when:

“Congress had amended Medicaid more than 50 times since its enactment, with a trend of enlarging the population and services covered by the program”

And none of these expansions were considered penalties? As I said, the Supreme Court conservatives, who acted as neo-confederates, used a flimsy excuse to indulge in some conservative-orchestrated judicial activism.

Conservatives say that the

Supreme Court of the United States ruled that states had the legal authority to reject expansion and the federal government could do nothing to penalize states for it.” Of course this was the courts response to “all or nothing.”

But there is nothing to stop congress from reducing the payments over time regardless of whether a state expands Medicaid or not Mr. State’s Rights, as in “ignoring states’ decisions to expand Medicaid when calculating the DSH reductions, meaning states won’t face a financial penalty for refusing the Medicaid expansion as the reductions could be made without any regard to whether a state expands Medicaid or not. Wishing that the law will go away and funneling your attacks to a hypocrite-judicial-activist, states-rights Chief Justice (whose states-rights ideology lines up with even Mississippi neo-confederates) doesn’t mean that the American people will get rid of a law which addresses

Costs

And

Care

But back to that wishful thinking about the delay being the unraveling of the Affordable Care Act. The conservative’s argument goes:

“DSH payments were never going to be cut. One only need to look at the SGR and the annual “Doc Fix” under Medicare to see a perfect example of why,”

comparing Medicare advocacy to Medicaid advocacy. This is delusional, as the Medicare constituents are not the same as a substantial number of the Medicaid constituents. In their delusions about ObamaCare and their fixation with repealing it, conservative pundits have conflated the two. Medicaid constituents, by and large, are not appearing at Tea Party rallies, trying, asininely, to wreck the people’s government. Wish as the neo-confederates will, the people targeted in “their home districts for voting against providing health care to the most needy” won’t be the people who are vigorously advocating Medicaid expansion. It won’t be the people who know the 7 things Republicans don’t want their working class constituents to know who will be confused about who’s responsible for service reductions to the needy. The non-Republican Medicaid recipients already know who is trying to cut SNAP and WIC benefits, in short assistance to the most vulnerable. They know that wishing that Republicans would actually favor social programs won’t make it happen; they know that wishing won’t make it so.

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▶ The Nine Most Terrifying Words – YouTube

 

Funny, how you only hear this when the group that they’re against is getting assistance. 

Nine most terrifying words?  Well, not so much in Mississippi these days.  Just look at the insurer-provider dispute in Mississippi. 

In the dispute between a big insurer and a hospital group in Mississippi how can you possibly be concerned with “the patients that Blue Cross insures and these hospitals serve” and refuse Medicaid expansion? How can you not see the connection? Absence of Medicaid expansion in Mississippi will drive up medical costs to Mississippians relative to other states. The cost of not getting preventative treatment and health maintenance drives the cost up for everyone by channeling impoverished people into the emergency rooms for more expensive care. That cost doesn’t just disappear but is passed on to other consumers through higher costs which they pay via higher premiums and higher co-pays and deductibles. Of course the insurance industry operating in Mississippi would move to cut out the more expensive hospitals; they have stock prices and shareholders to worry about. Conspicuous by their absence once again is the Mississippi Heritage Foundation doppelganger, the Mississippi Center for Public Policy. Where were the faux-limited government proponents advocating unfettered markets? It’s funny how you didn’t hear them complain about the governor issuing an order which “would have required Blue Cross Blue Shield of Mississippi [a private entity] to resume paying in-network rates at Mississippi hospitals.” Not really when you realize that, despite what the Tea Party-types profess, they are in favor of limited government only if it doesn’t affect their comrades or people who lobby for laws that increase the corporate profits out of which their financial support comes. If Mississippi politicians can spend so much time and effort trying to make sure that the federal government keeps maintaining military installations and spending that produce a net inflow of federal dollars to Mississippi then it doesn’t make any sense to try and stop the federal government from helping Mississippi defray the state’s overall healthcare costs on the grounds that you don’t believe in government involvement in the free market. Channeling government spending into arguably unnecessary military spending or at best spending that is not efficient because of the economic impact to a given state, say Mississippi, is an admission that the government does create jobs and that it is desirable for the government to do so. Even Ronald Reagan acknowledged the military as an employment source and favored including the military in employment figures. And from a fiscal standpoint, pretending that expansion of Medicaid is detrimental to Mississippi’s budget is to bury one’s head in the sand.

The cost of medical care in Mississippi will not decrease because Medicaid is not expanded, the costs will actually rise faster because of the absence of the benefits of expansion. The truth is Mississippians’ insurance premiums will be higher than they would have been under expansion and the medical infrastructure will be more overwhelmed because Mississippi is refusing federal aid, in a move that befits a continuation of the secessionist impulse, an impulse which operates to the creation and maintenance of huge wealth gaps. And the crack, about Mississippians not looking for work because the government is providing healthcare, is a reflection of the neo-feudalist nature of some Mississippi politicians. They would rather have citizens tied to employers because of healthcare than to have them be truly free to start their own businesses, then to see a “thousand flowers bloom.” There is one report which “finds that up to nearly 1 million workers may voluntarily leave their jobs because of the new health care law.”

They, the Crypto-Fascists, would rather the average citizen be constrained in such a way that they, average Mississippians, have to look up to and be beholding to corporate interest in a way that lets corporations place greater and greater controls on citizens. You see this manifested in things like Mississippi politicians’ (Crypto-Fascists’) participation in and defense of organizations like ALEC which brought Mississippi, through Joey Filingane, the photo ID law, which constricts democratic participation. The less-government, less-regulation crowd is actually an anti-democratic cabal which orchestrates the development and maintenance of monopolies. Anti-democratic forces don’t really believe that “[t]he antitrust laws reflect our society’s belief that competition enhances consumer welfare and promotes our economic and political freedoms.” They actually believe in tying people to employers in a slave or share-cropper fashion. With people so tied to an employer, how likely are they to vote in a way with which their employers disagree? This is a very real way in which something as simple as the denial of healthcare access UNDERMINES DEMOCRACY!!! Mississippi where sine qui non for political success is a simple as opposing anything related to Obama, it’s relatively easy, also given Mississippi’s neo-feudal, plantation-heritage (see flag vote)-loving past, to propose things which support plutocracy or oligarchy.

Additionally, on the subject of the rejection of democracy, widely-dispersed opportunity and equality, no one ever seems to even consider how the linkage of healthcare to existing businesses (getting insurance through your employer) may stifle competition by reducing the number of entrepreneurs thereby driving up consumer costs because of lack of competitors or of alternative products related to the inhibition of innovation. It is an intuitive design, this strategy of opposing the Affordable Care Act; forcing labor into existing businesses to obtain healthcare dovetails so nicely with right-to-work-for-less laws. Employers can reduce pay by offering insurance and reduce the number of competitors simultaneously. This is something which may be good for the existing employers but can’t be good for consumers or labor in the long run. The first order of business for CONservatives is to make certain that challenges to the existing economic kingpins are few or non-existent. Anything from unions to healthcare which threatens that imperative must be utterly crushed. When people like Dwayne Blaylock, president and CEO of River Oaks says “communities need protection and patients need access to the health care professionals of their choice,“ you have to wonder if they ever think about what repeal of the McCarran-Ferguson Act would mean for patient choice and for costs and consider that “[tlo the extent that insurance companies engage in anticompetitive collusion . . . then they appropriately [should] be subject to antitrust liability.]” But something tells me that being the CEO of a hospital means that his imperative, like the big insurers, is also something other than patient protection and universal access to any health care professionals much less the “professionals of their choice.” In this system patient choice is a sales tool which like patient protection is a means to an end. And in Mississippi because of resistance to things like Medicaid expansion, a physician, in many cases, doesn’t have to be concerned with first, doing no harm; sick people without access means that first, they do nothing at all.

Sebelius deflects criticism on ObamaCare-tied cancellation notices | Fox News (and another thing)

“Hold me accountable for the debacle I’m responsible.”

 

Words from a Fox (pronounced Faux) news story titled: “Sebelius deflects criticism on ObamaCare-tied cancellation notices.” Only Faux News would headline a story in which Secretary of Health and Human Services, Kathleen Sebelius, is quoted as saying “Hold me accountable” with the title “Sebelius deflects”

Gota love a news organization which was for the eight years of the Bush Administration, the equivalent of the cold war’s Pravda. And those words: “Hold me accountable for the debacle, I’m responsible” are words you would never hear from one of the Soviets. Nor are they words that you would hear from Dick-5-deferments-Cheney after he assured Americans that “We will be greeted as liberators,” in Iraq or providing the atmosphere for the Scooter Libby affair. And liberals must always remember that this is the dividing line between them and conservatives. Conservatives, not unlike true sociopaths, never have anything for which they are sorry because they are always right. Just look at Condeleeza–smoking-gun-mushroom-cloud Rice. You see, at heart, conservatives are neo-feudalists and express the proclivity to advocate a kind of executive sovereignty, an imperial presidency. Former VP Cheney was so brazenly imperialistic that he at one point stated that

the office of the Vice President was not an “entity within the executive branch” (see ThinkProgress article)

No Tea Party rallies to get “their” country back were held by those great interpreters of the constitution, those who call themselves Tea Partiers. There were no complaints of constitutional overreach or extra-constitutional posturing in response to Cheney from the CONservative Teabaggers because the people they liked were in power. The personalities, the men they preferred were in control. There were no Whitewater investigations culminating in Lewinsky probes. No, you didn’t see these things because RepubliCons are hypocrites and bullies, control-freaks with superiority complexes.

You hear this superiority, this proclivity for tyranny, the neo-feudal strain in

Nixon’s “Well, when the president does it, that means it is not illegal.”

You see CONservatives believe in an Imperial Presidency, except of course when they are out of power in which case you have them running around talking about how the other side is doing things that are unconstitutional, like the Tea Party types who are really supporters of a kind of class system in America, a class system in which Republicans or conservatives rule and its perfectly ok for the ruling class to write laws which allow them to hide money off-shore in the Cayman Island and not pay taxes at the rate of bus drivers or teachers. In essence they are declaring their superiority in constitutional interpretation in things like the Affordable Care Act and whether corporations are people among other things. Liberals, Progressives must never, ever cede that ground to them because to do so is to accept a role as their loyal subjects. When Liberals hear a RepubliCon used the terms constitutional government, original intent, or states’ rights, they should immediately remember the activist Supreme Court’s involvement in the 2000 Presidential Election and Dick Cheney and think control freaks and bullies and that they (conservatives) believe when it’s their guy, “Well, when the president does it, that means it is not illegal.”

So when people like Lamar Alexander, many of whom were spending huge chunks of state money saying that the Affordable Care Act was unconstitutional, when people like Senator Alexander, RepubliCon of Tennessee, declare:

“Mr. President, at some point there has to be accountability. Expecting this secretary to be able to fix what she hasn’t been able to fix during the last three-and-a-half years is unrealistic,”

Remember they were not calling for resignations to fix the problems related to the roll-out of Medicare Part D, just as they were silent about the Bush administration’s incompetence, (in the months after the conservative activists Supreme Court halted the counting in Florida), in the Bush Administration’s handling of the Bin Laden PDB. No, they were very silent about those things.

When you hear the now curiously Obamacare loving Lamar Alexander say,

“It’s throwing good money after bad. It’s time for her [Secretary of Health and Human Services, Kathleen Sebelius] to resign — someone else to take charge” 

You would be right to think, competence, competence, are the RepubliCons concerned with competence and resignations after their silence following Bora, Bora and the Curveball-inspired run into Iraq? And Mr. and Mrs. Fiscally Conservative Republican, didn’t we borrow to pay for that war (including all the no-bid contracts) and exactly when did we pay for it? Where were the Taxed-Enough-Already rallies against spending money that don’t have and forcing increases in borrowing (the debt) or taxes?

You must marvel at the RepubliCons’ blatant disingenuousness. You must remember this request for a resignation is coming from someone whose party voted 46 times or more to repeal the very thing he now what, wants to see work properly? You must remember that they (Teabaggers) never said anything about resigning when their representatives used the continuing resolution to fund the government to force a government shutdown costing the country $24 billion in GDP. Thanks fiscal conservatives! You CONservatives are so concerned about the debt and the deficit, right? What’s $24 billion dollars anyway? What’s a little lost revenue in a place like say, Tea Party Senator’s Mike “laughing stock” Lee’s Utah? Only CONservatives would still be selling a faux concern for deficits and debts after costing this much GDP and wasting time and money by passing bills to repeal the Affordable Care Act instead passing the President’s infrastructure bills. Could you imagine what it would have been like to have this crowd around when the country was contemplating the TVA? And only masochists would still be voting for Teabaggers like Mike Lee who are perfectly willing to give them (their self-flagellating constituents) as much of a beating as they want. What’s it costing him? I mean Mike “don’t-trend-on-me” Lee was still making his $174,000 a year when many Utahans were wondering how they were going to pay their mortgages, their car notes and yes, kept their health insurance in force. No need to wonder who that rattle snake on that Gadsden flag was striking during the RepubliCon orchestrated shutdown.

Sebelius deflects criticism on ObamaCare-tied cancellation notices | Fox News

Can you really keep your doctors if you like them? | Interviews | Fox News

This is how the Teabagger, RepubliCon, Crypto-Fascist distortion begins:

“ObamaCare requires all plans out there to meet a certain number of minimum requirements including that they provide for example, maternity care.” — MEGYN KELLY, HOST of the Kelly (that’s pronounced Kel-LIE)File

To attack the President using this falsehood, you must ignore the fact that plans sold before the bill (the Affordable Care Act) passed are not required to have the essential provisions that plans sold after passage must contain.

But once you establish the false premise the credibility attack is viable.

Then you can have your accomplice come in and say in response to your question

“So, was the president, you know, is his promise being kept?”

“No, Kelly, it’s not. I mean, President Obama said in 2009 if you want to keep your health insurance plan you can .” — EMILY (pronounced I’m – I – LIE) MILLER, SENIOR OPINION EDITOR, THE WASHINGTON TIMES

So, to the people with the cancellation notices, what was your plan in 2009? Could it have been grandfathered in or did the insurance company change it so that it is no longer your 2009 plan?

Here is a possible answer:

“The main reason insurers offer is that the policies fall short of what the Affordable Care Act requires starting Jan. 1. Most are ending policies sold after the law passed in March 2010. At least a few are cancelling plans sold to people with pre-existing medical conditions.”

But if they fell short but were sold before the passage of the Affordable Care Act, the companies could have kept them in force. The law didn’t tell the insurance companies to cancel them. To the people with the cancellation notices, the government, President Obama, ObamaCare, the law didn’t take your policy away from you. President Obama actually said:

“If you like your plan, and you like your doctor, you won’t have to do a thing,”

And here is the finisher:

“We’re not going to mess with it.” 

The you can-keep-your-doctor- you-can-keep-your-plan assertion was actually and remains a legitimate response to the government takeover lie that the Teabaggers, RepubliCons were throwing up to thwart any effort to break down the monopolistic healthcare industry and bend the cost curve, which shrinks healthcare insurance profits while actually puts more money into the pockets of consumers (see the part about premium returns if a certain percentage isn’t spent on healthcare-$1.5 billion overhead savings and insurance rebates to Americans since its implementation in 2011).

So when KELLY (Kel-LIE) says “If I want to pay less for a less great plan, isn’t that my right? I mean, what we are seeing now is that right has been taken away from hundreds of thousands and perhaps millions of Americans.”

She isn’t talking about herself paying less for a less great plan-a plan that turns out not to cover things that you thought it would(she makes $250,000 per year and is worth $5 million). No, for her and Michelle Bachmann and Michelle’s southern doppelganger Marsha Blackburn (concerned that people who want to buy insurance policies that are the equivalent of Fords are being forced to buy policies that are the equivalent of Ferraris) of Tennessee with their $174,000 per year salaries and government insurance, inadequate insurance is an academic discussion. I am sure there were people like them who lobbied on behalf of people who wanted to buy cars without seatbelts and complained about the cost of cars with seatbelts because, really, how many people are going to have an accident and really need a seatbelt? These people aren’t called CONservatives and RepubliCons for nothing. They know by their elections and campaign contributions that there is a self-flagellating, masochistic element within the American body politic, an element that seems to believe in purification through pain. There has been gold in dem dere hills!!! But if the recent RepubliCon orchestrated shutdown is any indication, even self-flagellation has its limits.  Even Utah which ousted Senator Bennett to elect a clown like Mike Lee may have learned a lesson about attacking a government which is for the people

Can you really keep your doctors if you like them? | Interviews | Fox News

Sebelius deflects criticism on ObamaCare-tied cancellation notices | Fox News

To the American people

“You deserve better. I apologize. I’m accountable to you for fixing these problems”

Those were the remorseful words from our President for not finding weapons of mass destruction in Iraq, right?

No, I don’t remember the President saying that. No, forgive me. Those were the words of Secretary of Health and Human Services, Kathleen Sebelius about computer glitches that have frustrated many Americans as they show their interest in affordable healthcare. What if, in this instance, in responding to the opponents of healthcare reform, the progressive part of the country did as Mitt Romney suggested in the title to his book and remembered No Apology is necessary when you’re doing the right thing. Conservatives held to this principle and didn’t apologize, even when what they did was the wrong thing like suggesting that Saddam and Bin Laden were somehow aligned and Saddam had WMD that he could give to terrorists. Not only didn’t the Bush administration apologize for misleading the country into an unnecessary war, none of the RepubliCons, who have attempted to block implementation of Obamacare at every turn and now are complaining that Americans don’t have access to the very thing to which they don’t want them to have access, none of these Crypto-fascists demanded any resignations related to the great, as Thomas Ricks described it, Fiasco, the Iraq War.

What, however, is ingenious is the RepubliCons’ ability to make a charge, as in the case of Shirley Sherrod, or a demand, like the individual mandate, and watch liberals, apparently acting out of some self-imagined superiority, go into overdrive to prove how compromising and pure, they are by forcing resignations or implementing proposals. Sometimes a little Bush-Cheney cowboy attitude may be good. It seems to be the only thing Teabaggers can recognize as American. Perhaps Liberals should meet them, the conservative, Teabagger fringe, half-way and speak a little of their lingo say to the RepubliCons: Sebelius ain’t going nowhere and we’re going to mend not end it, the Affordable Care Act.

And when you hear things like

“Some people like to drive a Ford, not a Ferrari,” Rep. Marsha Blackburn, R-Tenn., said. “You’re taking away their choice.” 

Perhaps you should respond: Yes, Rep. Marsha “Michelle-Bachman-southern-edition” Blackburn, some people may like to drive vehicles that are “Unsafe at any speed” but that doesn’t mean that the government should encourage their production or use by giving anti-trust protection to their manufacturers.

Tell those Cyrpto-Fascists who’ve done everything within their power to protect the insurance equivalent of slum lords that America, via the Affordable Care Act, is getting rid of all that condemned property, junk insurance; we’re moving our people away from pre-existing condition barriers and lifetime caps and doughnut holes. And we need to remove the health insurance anti-trust exemption.

In the process of calling for Secretary Sebelius’ resignation comes “It’s throwing good money after bad. It’s time for her to resign — someone else to take charge,” from Sen. Lamar Alexander, R-Tenn., top Republican on the Senate health panel. Funny, but I never heard him or the other Crypto-Fascists call for resignation after the American people were told that the Iraq war would pay for itself or that we would be greeted as liberators or the Iraq or Afghanistan wars weren’t included in the budget by these all-of-sudden-concerned-with-the-debt-no-bid-contract-giving Crypto-Fascists. Similarly there was no hue and cry when members of his party orchestrated a government shutdown that costs $24 billion in GDP. No, keeping Teabaggers in office is not, in Senator Alexander’s words, “throwing good money after bad.”

Yes, Secretary Sebelius, Americans do deserve better. So, please stay on the job. The Mississippi Yokohama employees deserve healthcare access as good as the Yokohama employees in Japan and the Affordable Care Act is a move in that direction with true out-in-the-open standards. Yes I said Japan, that country where southern governors go to get jobs for their citizens. Japan, where the average Japanese visits a doctor about 14.5 times per year-three times as often as the U.S. average, there is universal coverage, and they spend about 8% of GDP on healthcare, about half as much as the United States and they have a personal mandate with heavy government(Ministry of Health and Welfare) involvement in pricing.* Fortunately, we are taking steps to bend the costs curve because our government is no longer asleep at the wheel. Fortunately we are not yielding to those who did nothing when they had the chance, when they controlled both houses of congress and the presidency to reform healthcare in America. So, no, Dr. Ben “maybe-I-am-the-one-who-needs-brain-surgery” Carson, we are not going to some health savings account where someone can run out of money in the middle of treatment, you neo-feudalist-Heritage-Fund-Koch-Brother-flunky you who calls Obamacare which forces standards on insurance companies,slavery.

The crying over the cancellation of junk plans is reminiscent of domestic abuse cases. If a spouse is deserted by an abuser (like insurance companies changing substandard plans that could have been grandfathered and sending cancellation notices to customers) sometimes the spouse may not realize that that desertion probably just saved their life.

* “The Healing of America” by T.R. Reid.

Sebelius deflects criticism on ObamaCare-tied cancellation notices | Fox News

Jameson Taylor: Demonizing now a common tactic | The Clarion-Ledger | clarionledger.com

This from the birth-certificate-secret-Moslem-against-Obama crowd.  Demonization has been the bread and butter of the Tea-Party, cousins of the Mississippi Center for Public Policy(Jameson Taylor’s) people.  In fact his organization is only a front for the oligarchs.  Consider them the Mississippi branch of the Heritage Foundation, it the creation of the Koch brothers and Paul-shrink-the-electorate Weyrich.  Only in the twisted minds of the conservatives is inequality not tantanmount to bigotry. 

And of course those who oppose the insurance exchanges are protecting the oligarch-centric status quo.  Of course the corporate front groups like the Mississippi Public Policy Center would see Medicaid as a failure and long for a return to the days when doctors accepted chickens for check-ups. 

Chickens for check-ups

And you could never expect these so-called champions of the free-market to lobby for removal of the anti-trust exemption that the insurance industry has because they are fakes and aren’t interested in bettering the condition of the average American.  They are only here to confuse you and muddy the waters to protect the status quo.  You come to expect them to say things like “Never mind that the Bible also teaches we should pay our debts and that expanding government entitlement programs unjustly burdens future generations. “  But they can’t show you where in the bible Jesus dunned a paraplegic for his healing or turned the healed blind man’s bill over to collections subsequently driving him into bankruptcy.  So they have to forgive us, if they can find that concept in their bible, for thinking of them as merciless, even if they feel “demonized.” 

And when this crowd that feels demonized says “Medicaid patients have much higher mortality rates and much poorer health outcomes than people on private insurance.”  Did they ever stop to think that to the extent that that is true, if it is true at all, then the difference might have something to do with income-related environmental factors, i.e. the availability and costs of healthy food, and environmental pollution factors which give health conditions before treatment or diagnosis different starting points.

And then the disingenuous corporate flacks say “As hard as it is to believe, Medicaid patients even fare worse than the uninsured — many of whom are getting health care in some way, but paying out-of-pocket for it.”  If the uninsured are paying “out-of-pocket” we are dealing with quite a different group, from an income level, than those who qualify for Medicaid. So the question is who are you counting as uninsured?  And using the emergency room for primary care is not a serious comparison to having Medicaid. 

 

    The commentators arguing that Medicaid causes poor outcomes anticipate some objections by noting that the cited studies include some variables to address socioeconomic and cultural factors that
    can negatively influence the health of poorer Medicaid patients. Their interpretation of the results, then, must be that Medicaid patients have worse clinical outcomes than uninsured patients with the same socioeconomic and cultural characteristics, including, presumably, health-related behavior before and after a given procedure.

    If so, the problem must lie with the physicians and hospitals (many of them academic medical centers) providing care for Medicaid patients. Are these commentators assuming that poor, uninsured patients, who in principle may qualify for Medicaid, actually have the resources to pay doctors and hospitals more than Medicaid would and that providers therefore give these patients better care and attention, leading to better outcomes? Or is the assumption that only less technically proficient doctors and health care facilities accept Medicaid patients, and the associated lack of skill and resources results in poor clinical outcomes?

It is simply odd, to put it in non-demonizing terms, that these conservative think-tank guys have so much concern for the poor and uninsured now after a Democratic House, Senate, and President started supplying legislation to address pre-existing conditions and life-time caps and money to close the donut hole and money for additional primary care doctors.  And “The ACA authorizes money to increase the primary care workforce by training more doctors, nurses, nurse-practitioners and physician assistants. It includes more graduate medical education training positions, with priorities for primary care and general surgery, and more money for scholarships and loans for all health professionals. The law expands the number of patients seen at community health centers in areas with too few doctors and increases the number of staffers who work in the centers. It also expands nurse-managed clinics at nursing schools where nurses in training see patients who live in the area.”

But the truth is that Medicaid is working and so is Medicare despite efforts by the corporatists to degrade and destroy them at every term and install in their place a greater neo-feudal system.

 

Jameson Taylor: Demonizing now a common tactic | The Clarion-Ledger | clarionledger.com

You can’t have that because it’s good for you.

“Since when did the federal government ever give free money without asking for something in return,” comes the heckling from the Mississippi RepubliCons, in rejecting Medicaid expansion, in a state which receives $2.47(typical of Red states) for every dollar it sends to Washington. All of a sudden when a Democratic Administration passes the ACA, RepubliCons have a problem with receiving federal aid. And Mississippi which hasn’t had a problem with receiving special federal help joins the revolt against helping people in need. This has got to be the Twilight Zone considering Mississippi’s per capita income and poverty level. Even with earmarks, Mississippi (at $147) was one of only seven states which “received more than $100 per person in 2010

Laughably, RepubliCons complain that Mississippi can’t afford the corresponding share of state money it will have to put up to add hundreds of thousands of people to the government health insurance program for the poor.

But Mississippi can afford to have people show up at the emergency room to receive the most expensive care. And there is a strong probability that the reason they waited so long to get medical attention, affordability, inability to pay, will result in the cost being shifted to and shared by premium payers in higher premiums and co-pays. In the Twilight Zone which is Mississippi you began to get the picture why Mississippi ranks near the bottom in so many categories. When your representative government rejects a deal that would see your state get “$9.9 billion in federal money for Medicaid expansion, while the state would pay $429 million, (that’s $1 from the state for every $23 from Uncle Sam)” you may be looking at a situation that can only be described as sadistically neo-feudal. Picture if you will a place where Medicaid expansion increases the number of Americans who are healthy and more productive because they have access to affordable health care. But if you can picture it, you won’t be picturing Mississippi; our representatives have told us that no matter how good for us Medicaid expansion is, we can’t have it.