Month: July 2017

Helping you consider differing viewpoints. Before it’s illegal. 

 

Article 1: Has Medicaid Made the Opioid Epidemic Worse? The National Review, Sam Adolphsen, July 5, 2017

Clay’s summary: Heck yes, it has. Duh.

Key Passage from the Article

In 2015, the seven states with the highest drug-overdose death rates were West Virginia, New Hampshire, Kentucky, Ohio, Rhode Island, Pennsylvania, and Massachusetts. These states all have something else in common: All were among the 31 states (not including D.C.) that expanded Medicaid through Obamacare. Two questions must now be asked: Did expansion actually make the problem worse? And was Medicaid partly responsible for initiating the problem to begin with? Ohio, which has enrolled more than 700,000 adults in its Obamacare Medicaid expansion, is seeing worse problems with opioids than ever before. This year alone, the state is on pace for more overdose deaths than the entire United States had in 1990, according to an Ohio county coroner. It’s important to recognize that the problem ultimately stems from legal prescription drugs, not the illegal drug market — though many prescription-drug addicts do switch to heroin as a cheaper alternative. According to Andrew Kolodny, a Brandeis University senior scientist and the executive director of Physicians Responsible for Opioid Prescribing, “overprescribing of opioids is fueling the epidemic.” CDC data indicate that overdose deaths involving prescription opioids have quadrupled since 1999, and that prescription opioids now account for half of all opioid-overdose deaths.

 

Read it here 

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Article 2: Democrats’ Fearmongering Over Medicaid Ignores Just How Bad the Program Is, The Daily Signal, Betsy McCaughey, July 5, 2017

Clay’s summary: In all the bravado about how Medicaid will be gutted, few are talking about the shame of the inferior nursing home care Medicaid pays for every day and has for decades. If anyone has been in a position to address the issue, Medicaid officials have- and its not enough to just say there’s not enough money.

Key Passage from the Article

Because even rudimentary infection prevention is lacking, one-quarter of residents pick up dangerous, drug-resistant bacteria, according to new research by Columbia University School of Nursing. Columbia’s Carolyn Herzig warns infection rates are increasing across the board and action is urgently needed.

Medicaid recently adopted new standards calling for more infection precautions, but delayed the start date to November 2019. Why delay when hundreds of thousands of elderly residents will die from infection in the meantime?

Don’t count on the media to cover these deaths. The Washington Post is busy claiming repeal “takes a sledgehammer to Medicaid.” The New York Times reports that “steep cuts to Medicaid” will force some seniors out of their nursing homes.

Here’s the truth: There are no “cuts.” Medicaid spending will continue to increase every year, though at a slower rate.

The real threat to seniors isn’t Medicaid funding levels. It’s that Medicaid officials tolerate substandard nursing home care, when they could use the program’s market clout to demand safer care. About 66 percent of long-term residents are paid for by Medicaid.

The federal government rates nursing homes from one to five stars, based on periodic inspections, staffing levels, infection rates, and other quality measures.

But even nursing homes that get the lowest one-star rating year after year—indicating substandard care—are allowed to stay open. They should be shut down.

Read it here

 

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Article 3: How A Bogus Claim About Medicaid Made It Into The Los Angeles Times With No Pushback, The Federalist, Jonathan Ingram, July 5, 2017

Clay’s summary: Expanding Medicaid to more healthy adults came at the cost of reduced coverage for the most vulnerable in multiple states. Also- the MSM hides facts that might tarnish the optics on ACA? No way! Somebody should bodyslam those guys. But not DDT – that’s taking it too far.

Key Passage from the Article

While Ohio eliminated Medicaid eligibility for more than 34,000 seniors and individuals with disabilities, it was busy moving able-bodied adults to the front of the line under Obamacare. The expansion has been particularly tough on Ohio, where the Kasich administration promised the number of able-bodied enrollees would never exceed 447,000. By May 2017, expansion enrollment topped more than 725,000 individuals.

The result? Ohio’s Obamacare expansion has already run nearly $7 billion over budget, costing taxpayers nearly twice what was initially promised. The state’s share of those costs started coming due earlier this year, and those overruns are now crowding out funding for other state priorities like education, public safety, and services for the most vulnerable. In a state where Medicaid already consumes nearly half of the operating budget, cost overruns in the Obamacare expansion can easily lead to devastating cuts to other priorities.

This isn’t an isolated event, either. The enrollment explosion is happening in every state that expanded Medicaid under Obamacare. As a result, states are facing mounting costs far higher than they expected, forcing them to cut funding for other priorities or pass new tax hikes. Domenech was right when he remarked that Obamacare made able-bodied adults a top priority, crowding out funding for the most vulnerable. And he wasn’t lying when he said that more than 34,000 seniors and individuals with disabilities in Ohio were pushed out of Medicaid shortly after the expansion went into effect.

Read it here

 

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Article 4: 

Clay’s summary: It’s getting harder to ignore the fact that organized crime is behind a lot of the bigger Medicaid frauds.

Key Passage from the Article

Fraud tends to cluster in certain areas and in certain treatment categories. The reason for that is that this fraud is not random, not just the result of some yahoo general practitioner in Eucheeanna padding his bills. It’s the work of organized crime. As Sparrow points out, when there is a criminal case filed against one of these fraud artists, then billing in a particular category — some years ago, it was HIV fusion treatments — falls off steeply, by as much as 90 percent. The implication here is that fraudulent billing may make up the majority of Medicaid and Medicare spending in some categories.

 

Read it here

 

 

Helping you consider differing viewpoints. Before it’s illegal. 

 

Article 1: Are Medicaid patients more likely to die than uninsured, as Heritage Action CEO says? Politifact, June 28th, 2017, Amy Sherman

Clay’s summary: I think most “fact-checking” sites (unfortunately including Snopes) have become pretty biased, but this is a decent article. Makes a good case for diving deeper on true impact of Medicaid on health outcomes. Too simple to say “Medicaid makes outcomes worse.” But also too simple to say “Millions will die without Medicaid.”

Key Passage from the Article

 

“This implication that somehow you get worse care with an insurance plan — Medicaid — than you would by not having an insurance plan at all — no coverage, just going to the ER for emergencies — for most reasonable people that doesn’t make any sense,” he said.

PolitiFact has previously found at least seven academic papers that detected a link between securing health insurance and a decline in mortality. In general, these papers present a stronger consensus that having insurance saves lives.

Harvard researchers recently wrote a piece summarizing the evidence on the effect of Medicaid or other insurance on mortality. Their review of the evidence concludes that insurance like Medicaid significantly reduces mortality relative to being uninsured, said Katherine Baicker, one of the authors. The researchers found that “coverage expansions significantly increase patients’ access to care and use of preventive care, primary care, chronic illness treatment, medications, and surgery. These increases appear to produce significant, multifaceted, and nuanced benefits to health.”

Read it here 

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Article 2: Republicans are trying to undo Obama’s Medicaid disaster, NY Post, Besty McCaughey, June 27th, 2017

Clay’s summary: The idea that Medicaid today is not what it was ever intended to be is lost on most. Part of the reason is because we are such a wealthy nation we have lost all concept of what true poverty is. Today’s middle class now thinks of itself as poor.

Key Passage from the Article

Medicaid was created in 1965 as a safety net for the poor. But ObamaCare distorted it, edging the US health-care system closer to a Medicaid-for-all or single-payer system. Swelling the Medicaid rolls — instead of making private insurance affordable — was the main trick ObamaCare used to boost the number of insured.

A whopping 75 million people are now enrolled on Medicaid, 20 million more than in Medicare, the program for the elderly. If the repeal bill doesn’t pass, Medicaid enrollment will soar to 86 million by 2026, according to a Congressional Budget Office analysis released Monday.

Who’s picking up the tab for this vast Medicaid expansion? You. Worse, you pay twice — once as a taxpayer, then again as an insurance consumer.

Families with private insurance pay $1,500 to $2,000 or more in added premiums yearly already to keep Medicaid afloat. The more Medicaid expands, the higher their premiums will go.

That’s because Medicaid shortchanges hospitals and doctors, paying less than the actual cost of care. They make up for it by shifting the costs onto privately insured patients. Ouch.

That cost-shifting only works until Medicaid enrollment grows too large. The Mayo Clinic warned three months ago that Medicaid enrollment has reached the tipping point. The renowned clinic announced it will have to turn away some Medicaid patients, or put them at the back of the line, behind patients with private insurance.

 

Read it here

 

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Article 3: Veterans Helped By Obamacare Worry About Republican Repeal Efforts, NPR, Stephanie O’Neill June 28, 2017 

Clay’s summary: I recently learned that vets have to pay premiums for their healthcare. And I am still angry about that so hard for me to summarize this article. Can we make their care free before we cover everyone else in Medicaid?

Key Passage from the Article

There are about 22 million veterans in the U.S. But less than half get their health care through the Veterans Affairs system; some don’t qualify for various reasons, or may live too far from a VA facility to easily get primary health care there.

Many vets instead rely on Medicaid for their health insurance. Thirty one states and the District of Columbia chose to expand Medicaid to cover more people — and many of those who gained coverage are veterans.

The GOP health care bill working its way through the Senate would dramatically reduce federal funding for Medicaid, including rolling back the expansion funding entirely between 2021 and 2024.

Medicaid coverage recently has become especially important to Ramos — a routine checkup and blood test this year showed he’s infected with hepatitis C. California was one of the states that chose to expand Medicaid, and the program covers Ramos’ costly treatment to eliminate the virus.

“Right now, I’m just grateful that I do have it,” he says. “If they take it away, I don’t know what I’m going to end up doing.”

Read it here

 

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Article 4: Cardiac Arrests Dropped Under Obamacare Medicaid Expansion, Forbes, Tara Helle, June 29, 2017

Clay’s summary: There are clearly specific procedures and conditions improved by having easier access to care. Can we focus on those?

Key Passage from the Article

Cardiac arrests among previously uninsured middle-aged adults dropped by 17% after they got insurance through the Affordable Care Act, or Obamacare, a new study shows. The incidence of cardiac arrests remained the same among adults age 65 and older, a group that had consistently high rates of health insurance coverage before and after the ACA, primarily through Medicare.

“The fact that was this decrease was not observed in the elderly, who have near-universal access to healthcare, makes the availability of insurance one of the likely causes of the drop in cardiac arrest rate,” said lead author Eric Stecker, MD, MPH, an associate professor of cardiology at Oregon Health & Science University in Portland. “This study reinforces the results of prior studies which have shown that pretty consistently giving access to insurance significantly improves engagement in preventive care.”

Read it here

 

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Article 5: Why the fear-mongering on Medicaid is totally overblown, Washington Post, June 28th, 2017

Clay’s summary: You might want to put down your Andy Slavitt, Michael Moore, and KFF Foundation echo-chamber devices (twitter feeds) before reading this one. And if they find out you read this one, you’re totally kicked out of the #Resist club.

Key Passage from the Article

A recent New York Times op-ed from three health-care experts described the effort as a “direct attack on our elderly, our disabled and our dignity.” A Post commentary charged lawmakers with “gutting Medicaid so they can give a giant tax break to their billionaire buddies,” threatening life-saving treatments for a young boy with a congenital heart condition. A long-time political adviser charged on national television that sponsors would “kick some kid out of his wheelchair.” And a left-leaning think tank further upped the ante by publishing contrived estimates of the numbers of people (handily broken down by state) who will supposedly be killed by the proposed legislation.

You don’t need to support the pending health-care bills to recognize they bear little resemblance to this explosive rhetoric, nor do you have to support the legislation to realize that our deteriorating political environment is making it impossible to make policy decisions with the appropriate reflection and care.

 

 

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