Chronic Rants

Medicaid makes me so damn mad!

Our entire healthcare system in this country is so incredibly broken.  Now, I’ve heard mixed things about healthcare in other countries, but since I’ve never lived in those countries I can’t comment on their healthcare.  My guess is that in most industrialized countries the healthcare is better than what we have here but it still needs improvement, but that’s just a guess.  What I do know about is the broken system in the United States.

I could rant about many different aspects of healthcare, and I have, again and again, but right now I’m thinking about Medicaid.

First, there was a posting in the forum of a personal finance web site.  Personal finance is a hobby of mine, and it often intersects with the health stuff (like in reducing expenses and paying for medical care, etc.)  This particular posting was from someone with a very low income who was wondering how she could possibly afford health insurance.  Several people suggested that she apply for Medicaid and they didn’t realize that in many states, including hers, she isn’t eligible for it.  In some states, people without children simply aren’t eligible, regardless of their financial or medical status.  This is absurd.  Why on earth is this being handled on a state-by-state basis?  When people assume that eligibility requirements are looser than they are, it skews their political beliefs, not to mention their view of their own safety net.  The American public needs a lot of education about this.

Then I applied for Medicaid in my own state.  Thankfully, in Massachusetts a single person can be eligible for Medicaid.  Of course, just because I can and should be eligible doesn’t mean I’ll get it, and if I do get it, I have no idea which of the many plans I would be offered.  This means that I don’t know if I’ll lose my PCP or not.  If I lose my PCP, then I won’t be able to get referrals to my specialists.  That means I would not be able to get my prescriptions.  Then I’d be screwed.  Shit.

I follow politics closely and so I am very aware of the current healthcare debates.  The Republicans were all for healthcare reform until the Democrats enacted it.  Now the Republicans want to repeal it simply because they want to hurt the Democrats.  WTF?!?!?!?!  Since they can’t repeal healthcare reform right now they are doing what they can: many Republican governors are refusing to expand Medicaid, even though they would get complete federal funding at the beginning and quite a large federal subsidy thereafter.  In looking to hurt the Democrats, they are hurting their own citizens.

And then there was this article.  Who on earth thinks that the yearly income limit for Medicaid should be less than the yearly premiums for health insurance?!?  Whether or not you believe that Medicaid should exist, can anyone really argue that as long as it does exist, it should be available for those who need it?  What’s the point in having a system that the people who it was designed to help can’t access?

This is madness, I tell you, madness!!!

I admit that I don’t have all the answers, but I would like to suggest a few anyway.  Please bear with me.  First, Medicaid, like Medicare, needs to be offered on a federal level, or at least it must be subject to federally-mandated minimums.  Clearly states can not be trusted to handle it.  Anyone who thinks that non-parents do not “deserve” healthcare as much as parents needs some serious help.  Also, Medicaid should be used to fill in the gap of people who want health insurance and who truly can not afford it.  If you don’t earn enough to cover basics like rent/mortgage, food, and health insurance, then you should be covered.  Finally, Medicaid reimbursement rates need to be increased.  I’m not suggesting that every medical visit warrants a four-figure reimbursement, but medical facilities must receive reimbursement that at least covers their costs so that they will continue to take on Medicaid patients.  The system doesn’t do the patients any good if reimbursement rates are so low that all doctors refuse them, and that’s what’s happening now (which is why I may lose my PCP.)

Like I said, I don’t have all the answers, but I think this would be a good start.  I’m sure you’re wondering how we’d pay for this.  Well, I don’t know, but let me ask, how are we paying for Medicare?  How much are we spending on graft and fraud?  Isn’t it worth keeping our citizenry healthy so that they can continue to work and thereby pay more in income tax (and probably sales tax too, since they’d be able to spend more?)  Personally, I need health insurance and social security so that I can focus on getting healthy.  Yes, some people may never recover, but there are others (and I sincerely hope that I’m one of them) who can, and who will gladly return to the workplace and to paying their fair share of taxes so that others can enjoy the support of the same system that helped them to recover.  Now that’s a system I’d like to see.