Reply
 
Thread Tools Display Modes
  #1  
Old 01-30-2020, 07:38 PM
survinga is offline
Guest
 
Join Date: Sep 2017
Location: In the Deep South
Posts: 559

Medicaid Block Granting will drive up the uninsured. Agree or disagree?


https://www.nytimes.com/2020/01/30/h...ant-trump.html

I was afraid this would happen. I predict most blue states will not take this. But red states will pursue block grants, and the result will be a greatly diminished Medicaid in those states, as it will result in underfunding and people will be kicked off the Medicaid rolls.

This reminds me of welfare reform, where block grants didn't keep up with necessary costs, and now TANF is hugely diminished as a program, because it's incredibly underfunded.
  #2  
Old 01-30-2020, 10:07 PM
Wesley Clark is offline
Guest
 
Join Date: Aug 2003
Posts: 23,119
Thats the goal, to drive down medicaid usage. So yeah the uninsurance rate will go up.

Which sucks because medicaid is the most cost effective insurance program in America.

At least it isn't mandatory. But yeah sadly red states will jump at it, people will get kicked off the rolls and many of the people who get kicked off either won't vote or they'll find a way to blame democrats.
__________________
Sometimes I doubt your commitment to sparkle motion
  #3  
Old 01-31-2020, 09:32 AM
survinga is offline
Guest
 
Join Date: Sep 2017
Location: In the Deep South
Posts: 559
Quote:
Originally Posted by Wesley Clark View Post
Thats the goal, to drive down medicaid usage. So yeah the uninsurance rate will go up.

Which sucks because medicaid is the most cost effective insurance program in America.

At least it isn't mandatory. But yeah sadly red states will jump at it, people will get kicked off the rolls and many of the people who get kicked off either won't vote or they'll find a way to blame democrats.
If anything, I wish Medicaid paid more than it did. Its reimbursement rates are so low, that many doctors don't take it. The idea that it needs to be block-granted is nonsense from a money standpoint, as it's already very efficient.

The only way to stop this will be at the ballot box in 2020. We have to vote Trump out, and only then is it possible to roll back - or stop before they get rolling - his healthcare policies, and pass a bill that brings the ACA closer to what is possible if properly implemented.

It's strange that Trump made a promise during 2015-2016 to not cut SS, Medicare, and Medicaid. This will be a Medicaid cut. But his base won't care, as he doesn't get held accountable - seemingly ever - for his lies.
  #4  
Old 01-31-2020, 09:48 AM
Shodan is offline
Charter Member
 
Join Date: Jul 2000
Location: Milky Way Galaxy
Posts: 40,559
If we want to cut spending on health care, then we need to cut spending on health care. If we don't cut spending on health care somewhere, we won't cut spending on health care anywhere. And we need to cut spending on health care.
Quote:
I wish Medicaid paid more than it did.
Raising Medicaid rates means raising health care spending.

Regards,
Shodan
  #5  
Old 01-31-2020, 11:14 AM
Wesley Clark is offline
Guest
 
Join Date: Aug 2003
Posts: 23,119
Quote:
Originally Posted by Shodan View Post
If we want to cut spending on health care, then we need to cut spending on health care. If we don't cut spending on health care somewhere, we won't cut spending on health care anywhere. And we need to cut spending on health care. Raising Medicaid rates means raising health care spending.

Regards,
Shodan
Making health care more cost efficient is a better method than cutting people from the most cost efficient program we have.

Allow importation of Rx and medical devices from overseas
make it easier to go overseas for surgery and long term care
streamline administration (all payer or single payer)
let the public sector negotiate prices
make all prices transparent
Create a strong public option tied to medicare to compete with private insurance

etc etc will cut medical costs far more than kicking people off medicaid. The problem is that the health industry doesn't want these reforms since they cut into their profits and business model.
__________________
Sometimes I doubt your commitment to sparkle motion

Last edited by Wesley Clark; 01-31-2020 at 11:14 AM.
  #6  
Old 01-31-2020, 11:19 AM
RitterSport's Avatar
RitterSport is offline
Guest
 
Join Date: Mar 2002
Posts: 3,756
Quote:
Originally Posted by Shodan View Post
... And we need to cut spending on health care. ...

Regards,
Shodan
Please provide a cite for this claim. Thanks!
  #7  
Old 01-31-2020, 11:23 AM
Shodan is offline
Charter Member
 
Join Date: Jul 2000
Location: Milky Way Galaxy
Posts: 40,559
Medicaid rates are already so low that many doctors will not accept those patients because they tend to lose money treating them. Do you support
  1. Raising those rates so more doctors will accept them, thereby increasing spending and reducing "efficiency", or
  2. Compelling doctors to accept patients and be reimbursed at the lower rates?
Regards,
Shodan
  #8  
Old 01-31-2020, 12:00 PM
asahi's Avatar
asahi is offline
Guest
 
Join Date: Aug 2015
Location: On your computer screen
Posts: 12,007
Quote:
Originally Posted by Shodan View Post
If we want to cut spending on health care, then we need to cut spending on health care. If we don't cut spending on health care somewhere, we won't cut spending on health care anywhere. And we need to cut spending on health care. Raising Medicaid rates means raising health care spending.

Regards,
Shodan
Cutting spending on healthcare might save money on healthcare but it won't necessarily lead to better overall economic outcomes. You don't save money when your population is less healthy and less productive.

Last edited by asahi; 01-31-2020 at 12:01 PM.
  #9  
Old 01-31-2020, 02:37 PM
slash2k is offline
Guest
 
Join Date: Feb 2014
Posts: 2,690
Quote:
Originally Posted by Shodan View Post
If we want to cut spending on health care, then we need to cut spending on health care. If we don't cut spending on health care somewhere, we won't cut spending on health care anywhere. And we need to cut spending on health care. Raising Medicaid rates means raising health care spending.

Regards,
Shodan
Spending less on Medicaid doesn't mean we're spending less overall, however. If somebody with untreated medical conditions ends up in the ER or on disability, for example, where do you think the money for those comes from?

For example, I have an acquaintance who has a long history of mental health issues. He got caught up in the botched roll-out of "KanCare" (Medicaid managed care in Kansas), and was off his meds for awhile. In the meantime, he ended up spending time both in the local jail and in a mental hospital. I'm not convinced that transferring the cost of his care from the Medicaid budget to the Dept of Corrections budget and then to whatever line item funds the psych ward was a net benefit to the taxpayer, but hey, it made the Medicaid budget look better, and that's the important part, right?
  #10  
Old 01-31-2020, 03:24 PM
glee is offline
Guest
 
Join Date: Aug 1999
Location: Obama country
Posts: 15,843
Quote:
Originally Posted by Shodan View Post
If we don't cut spending on health care somewhere, we won't cut spending on health care anywhere. And we need to cut spending on health care.
Regards,
Shodan
The Republican position:

We need to cut spending on health care ... and give that money to insurance companies!
  #11  
Old 01-31-2020, 04:43 PM
Shodan is offline
Charter Member
 
Join Date: Jul 2000
Location: Milky Way Galaxy
Posts: 40,559
The Democratic position:

We need to cut spending on health care...OK, not that spending!

Regards,
Shodan
  #12  
Old 01-31-2020, 09:30 PM
RitterSport's Avatar
RitterSport is offline
Guest
 
Join Date: Mar 2002
Posts: 3,756
Quote:
Originally Posted by Shodan View Post
The Democratic position:

We need to cut spending on health care...OK, not that spending!

Regards,
Shodan
Please provide a cite for this claim.

My understanding is that Democrats think that by covering everyone that overall costs will go down, because there will be more preventive care and fewer ER visits. They think that we should be able to get similar results as other first world country in terms of cost per patient. So, they think spending will come down naturally once we have a more reasonable healthcare system.

They may be wrong. However, I don't see Democrats saying "we need to cut spending", so please provide a recent cite that a prominent Democrat is saying such. Thanks.

And, I'm still looking for a cite that we "need to cut spending on healthcare" from your earlier contribution. We may need to cut spending in general (do we?), or lower our deficit (do we?), but that can be done through spending cuts to the military, through various tax increases, or through other spending cuts (farm bill, corporate subsidies, social security, tax shelters, etc.). I'm looking for a cite that we need to cut healthcare spending. Thanks!
  #13  
Old 02-01-2020, 11:15 AM
survinga is offline
Guest
 
Join Date: Sep 2017
Location: In the Deep South
Posts: 559
Quote:
Originally Posted by Shodan View Post
If we want to cut spending on health care, then we need to cut spending on health care. If we don't cut spending on health care somewhere, we won't cut spending on health care anywhere. And we need to cut spending on health care. Raising Medicaid rates means raising health care spending.

Regards,
Shodan
But why would you cut it in the area that's the lowest cost already, so low that some people with medicaid have trouble finding a doctor? I don't buy into the idea that all healthcare spending is equal, which is the implication of your post. If we want to cut spending, we should cut it where we're overpaying, not where we're underpaying.
  #14  
Old 02-01-2020, 09:28 PM
glee is offline
Guest
 
Join Date: Aug 1999
Location: Obama country
Posts: 15,843
Quote:
Originally Posted by Shodan View Post
The Democratic position:

We need to cut spending on health care...OK, not that spending!

Regards,
Shodan
The Democratic position:

Look at how successful and cost-effective health-care is in other countries. We can cut costs and provide a better system for everybody.
__________________
Arnold Winkelried:
'glee, I take my hat off to you.... at first I thought you were kidding with your cite but I looked it up and it was indeed accurate. (Still in awe at the magnificent answer)'
  #15  
Old 02-01-2020, 10:40 PM
Wesley Clark is offline
Guest
 
Join Date: Aug 2003
Posts: 23,119
Quote:
Originally Posted by glee View Post
The Democratic position:

Look at how successful and cost-effective health-care is in other countries. We can cut costs and provide a better system for everybody.
Thats the honest position of many democrats. But Shodan is arguing with a strawman.

I outlined a variety of ways we could cut costs and improve efficiency without reducing insurance coverage rates in post 5.

Breaking up hospital monopolies should be added to that list. There are even some bills supported by republicans to break up hospital monopolies.

https://www.modernhealthcare.com/art...-consolidation

It would be nice if introducing more competition to drive up quality and drive down prices in the US health care system was something we could pass through congress, but I honestly doubt even that is something that'll happen.
__________________
Sometimes I doubt your commitment to sparkle motion

Last edited by Wesley Clark; 02-01-2020 at 10:40 PM.
  #16  
Old 02-03-2020, 08:40 AM
Shodan is offline
Charter Member
 
Join Date: Jul 2000
Location: Milky Way Galaxy
Posts: 40,559
Quote:
Originally Posted by slash2k View Post
Spending less on Medicaid doesn't mean we're spending less overall, however. If somebody with untreated medical conditions ends up in the ER or on disability, for example, where do you think the money for those comes from?
  • Overall, preventative care does not save money (cite, cite, etc.)
  • One of the ideas behind Obamacare was to get people covered so they would get treatment from their PHPs and that was supposed to reduce emergency room visits. Emergency room visits and visits to PHPs went up under Obamacare, not down (cite, cite, etc.)
Quote:
Originally Posted by survinga
But why would you cut it in the area that's the lowest cost already, so low that some people with medicaid have trouble finding a doctor?
Quote:
We need to cut spending on health care...OK, not that spending!
Regards,
Shodan
  #17  
Old 02-03-2020, 09:04 AM
Ravenman is offline
Charter Member
 
Join Date: Jan 2003
Location: Washington, DC
Posts: 27,683
Can you acknowledge the basic point that "cutting spending" and "cutting costs" are not the same thing?
  #18  
Old 02-03-2020, 05:25 PM
RioRico is offline
Guest
 
Join Date: Sep 2019
Location: beyond cell service
Posts: 1,664
A reminder: Otto von Bismarck didn't establish the first government safety net because he loved stinking peasants and proles, but to 1) have a healthier, more productive nation that paid the Kaiser more taxes, 2) steal political points from socialists, and 3) dissuade the underclass from rising up and slaughtering the aristos. GOP strategy is to hate #1, ignore #2, and to rely on private security to handle #3.

Americans wanting a sicker nation are IMHO enemy assets working against US interests. Remember them.
Reply

Bookmarks

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off

Forum Jump


All times are GMT -5. The time now is 04:35 AM.

Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2020, vBulletin Solutions, Inc.

Send questions for Cecil Adams to: cecil@straightdope.com

Send comments about this website to: webmaster@straightdope.com

Terms of Use / Privacy Policy

Advertise on the Straight Dope!
(Your direct line to thousands of the smartest, hippest people on the planet, plus a few total dipsticks.)

Copyright 2019 STM Reader, LLC.

 
Copyright © 2017