• Don’t cut Medicaid, fund it better

    With all our recent posts on Medicaid, I thought it might make sense to write something summing up my feelings on the subject. CNN.com was kind enough to publish it.

    I hope you’ll go read it.

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    • It’s amazing how liberals always tie everything to ‘the children’.

      So, what about the rest of America’s childen – the one’s who represent 67% of our youth population? What happens to them when Uncle Sam either taps out – when tax rates go up to 98%?

      Bottom line, if parents can’t afford to provide health care for their kids, then the kids need to be removed from the home and the parents imprisoned or deported to Cuba where I’m sure they’ll love the safety net that big gov’t can provide.

    • Too many hospitals that are not full.
      Too much staff that is not needed.
      Too many tests that are not required.
      Too much greed and fraud and cloak and dagger.
      Rabbit trail research in the Universities.
      “dealing drugs that will never cure your ills.
      When you gonna wake up?”

    • The Canadian Government has the best healthcare in the world and America should take a leaf out of our books. We pay for it through our taxes, which is quite high but so worth it to get great heath care.

    • Thanks for this good summary. This whole discussion of “Medicaid is bad for you” is something that is so transparently false that I couldn’t believe that we were even discussing it. However, I guess it is just a reflection on the poor state of public discourse that the issue needed to be addressed rigorously and you have done that well.
      Hopefully we can now move on to some more productive discussions such as how to eliminate overcharging, waste, fraud and abuse in medical care.

    • Medicaid covers one in three children in the United States, making it the largest insurer of children. It also covers one in three births, 8 million people with disabilities, and 9 million low-income Medicare beneficiaries.

      This would imply some market power .

      At a cost of $366 billion to cover about 49 million people in 2009, Medicaid is one of the cheapest ways to cover people, especially a high-risk population.

      I think that that is still above what Canada would spend on health care for a similar population so why is this not a supply problem. Could we address this by making it much easier to become a Doctor, NP or PA. Could we address this by making it much easier for doctors to use staff trained on the job to do certain tasks? There is a 9% unemployment rate right now. (Also more evidence based medicine might help.)

      Being on Medicaid is associated with being unhealthy, because being poor is associated with worse health and with being on Medicaid. This is a far cry from finding that Medicaid caused poor health outcomes. Unfortunately, that’s often lost in all the noise.

      “Associated” is a good word to use because there is evidence that poverty and poor health are caused by a lack of certain abilities more than poverty itself. (The old saying “We are not poor we just don’t have any money” might be more relevant than we think.)

      They claim that Medicaid is worse than being uninsured. This just isn’t so. To begin with, it’s hard to imagine how this could be possible, since no one is forced to be on Medicaid.

      I am not saying that it is so but when one considers that the death rate fell during the Saskatchewan Doctors’ Strike it is not so hard to think a way that Medicaid could harm health. The data should give us some doubts about the efficacy of medical beyond vaccinations, antibiotics and trauma care (all of which we have excellent evidence for) for the poor who are generally lass capable of following medical instructions than the average citizen. We should not be too confident. Poor care for less capable people could possibly be worse than no care. Consider that outcomes for poor people in Canada and UK are similarly bad and they all have the same access to care as their fellow citizens.

    • Dr. Carroll,
      From your numbers, I figure the average cost for a Medicaid patient is around $7600. This is close to twice as much as the average cost for the remainder of the industrialized world. I understand that the Medicaid population is generally younger or older and/or sicker than the general population, but this differential seems quite large. Any thoughts?