Bob's Words of Wisdom News

Don’t make another dumb decision on Medicaid Expansion

While our Legislators explore a case for Medicaid Expansion with bills 1204 and 1205 the Idaho Freedom Foundation appears to be the lone white knight in this battle to keep Medicaid costs at bay in our state. Once again our so called conservative legislators have two bills before them that in essence could at some point bankrupt our state if there are any changes that lower Federal payouts to the states. This is not the only problem with Medicaid Expansion, as we have written about this subject many times in the past. It seems we must once again rehash the fact that of the more than one dozen states that opted to expand Medicaid under the ACA enrollments have poured in at many times the original, projections. This is causing concern about the strain it will eventually put on their budgets when there is a scaling back of aid in two years. Let me quote from a story by (AP) “In Kentucky, for example enrollments during the 2014 fiscal year were more than double the number projected, with almost 311,000 newly eligible residents signing up.” “As a result the state revised its Medicaid cost estimate from $33 million to $74 million for the 2017 fiscal year. By 2021, those costs could climb to a projected $363 million.” IACI has been pushing for Medicaid Expansion for the past 3 years, and we all know why. If it passes, there are many employers in our state who have employees that will qualify for Medicaid so that the companies can cut their health insurance and increase their profits while the taxpayer picks up the bill.

Why would anyone think that these numbers would not be similar in Idaho? We have 78,000 who would qualify for Medicaid, but what if we had 150,000 sign up. Do any of our legislators understand the consequences of bearing the cost of that many additional sign ups? Not only that, but have any of our legislators, including Dr. Wood, thought how an influx of 150,000 more patients would be handled with the current amount of primary care physicians we have in our state? Where will the money come from if the federal payout is dropped to a lower level like 70% which has already been proposed? What part of the state’s budget will suffer cuts should we have to come up with extra money, “Education”? All unanswered questions and no one is thinking out of the box.

Kudos to the Governor for not wanting to expand Medicaid but if he thinks this will fix this Medicaid problem with Otter care he is somewhat delusional and doesn’t have a real grasp of the problem and lord only know where he came up with a number of $32 per person per. month. Maybe our Governor has a cadre of unemployed physicians who are willing to work for practically nothing to take care of these 78,000 new patients. Spending $20 million in 2017 and $30 million in 2018 in another giveaway program is only going to make things worse as doctors will have an influx of patients they were not planning on. We already have a shortage of doctors in our state and adding 78,000 more patients is not going to help with this problem. This is nothing more than another government entitlement program which will grow exponentially each and every year as medical costs continue to climb.

We already have 36% of our state budget coming from the federal government. Is our state going to become a total ward of the Feds? The simpler answer is to set up free clinics for those in need and make sure they have access to medical care rather than jamming them into our emergency rooms which are already overcrowded. When will the legislature look into opening a medical program in Idaho which can be used to train our doctors and nurses rather than having them go to other states where many of them wind up residing? This would give us an opportunity to train our own medical personal and offer them reduced tuition for working at the free clinics during their training period. We elect our legislators because they are supposed to solve problems for us, not dump our problems in the laps of the federal government so we are all the more beholden to Washington politics.

Just a few quick words for our illustrious Dr. Kenneth Krell who testified that it was the legislators who were responsible for 1,000 Idahoans deaths. I would tell the good Doctor Krell that “people who live in glass houses shouldn’t throw stones. Medical errors are the third leading cause of death in the United States with estimates as high as 440,000 according to 2013 numbers, and most of these patients are covered by some kind of health insurance. These are only the ones reported as many are not. The Dept. of Health and Human Services has documented that 180,000 Medicare patients die each year from preventable adverse events in the Hospital. Furthermore the CDC has said that 1 in 25 hospital patients get an infection from being in the hospital; 700,000 of them get sick as a result and 75,000 die. Maybe free clinics would be a lot better than hospitals for those on Medicaid when you look at these numbers of those getting sick and dying.

There is no simple solution to this problem, but allowing further involvement of the federal government in our medical care is sure to lead to eventual disaster financially. Direct Private Care should be playing a part in solving this problem along with medical savings accounts and having Medicaid patients put some money up front so they have some skin in the game. People are less likely to run to an emergency room because of a splinter or a sprained wrist if they know they will have to put some money on the line.

Maybe it’s time to send some of our legislators out to pasture if they are not capable of coming up with innovative solutions to the state’s problems and bring in some fresh blood. Sometimes what is needed is a transfusion.