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Thursday, March 05, 2015

Free health care is killing the states

Republican Charlie Baker of Massachusetts is only the latest governor to discover that Medicaid is eating his state's budget. Roughly one in three dollars Massachusetts state government spends goes to Medicaid. He has proposed trimming about 6% from the $13.3 billion the state will spend on Medicaid in the budget.

Medicaid spending has relentlessly risen 57% in the last dozen years in Massachusetts, causing the state to cut spending on prisons, roads and other services. That is the pattern throughout the United States, as state governments are intimidated into spending all they can on Medicaid in order to knock down federal subsidies. In West Virginia, medical lobbyists harp for every $1 the state spends it gets $3 -- while our roads go to pothole hell.

The hospitals, doctors and the rest of the $2.7 trillion medical industry have excellent  lobbyists and now get more from the federal government from Medicare and Medicaid than the Department of Defense spends -- 27% of the federal budget vs. 16% for the military.

And the Medicaid and Medicare spending are mandatory!

States put up $3 for every $4 the feds spend on Medicaid -- and again, the Best Lobbyists In The World pressure states to spend hundreds of billions each year on the medical industry. This is what drives up medical prices ("costs" is a euphemism).

From the Boston Herald:
The state is staring down a $1.8 billion budget gap entering next fiscal year, Gov. Charlie Baker will announce today when he unveils his first budget — a $38 billion proposal that includes deep cuts to the state’s Medicaid program but keeps his vow not to raise taxes.
The deficit, which Baker is expected to detail at an afternoon press conference, is driven in part by nearly a $1 billion in new net spending at MassHealth and exceeds even the projections of the Massachusetts Taxpayers Foundation, which had pegged the total gap at $1.5 billion in recent weeks.
Closing it consumes a large part of Baker’s fiscal year 2016 budget offering, which according to administration officials, sticks to his pledge of not raising taxes and fees or dipping into the state’s so-called $1.2 billion “rainy day” fund.
To close the gap, Baker wants to slice $761 million from the mammoth state Medicaid program, including through a review of the eligibility of more than 1.2 million subscribers, which his budget team estimates will save $210 million. Though federally required, the so-called “re-determination” process hasn’t been done since October 2013, when the state’s beleaguered Health Connector web site first launched, according to officials.
Among other health-care reforms, the governor proposes limiting opioid prescriptions to 14 days and not increasing reimbursement rates to nursing homes.
If you want to know why all those mean old Republican governors turned down Obamacare, this is why. Federal money is a drug, pushed by those who benefit most from it: The medical industry.



  1. FUNNY! Jon Stewart Takes on Hillary’s ‘Wrong Email Address-Ghazi’ Scandal

    1. That wasnt funny. It was like a bunch of 4th graders laughing at the adults in the room because they are too immature to understand whats going on.

  2. 1--We can't afford to get that much Federal taxpayers' money.

    2--Government is less than 1% of government spending? Ah don' b'lieve it. Huh uh.

  3. that's funny, Michigan's expanded Medicaid is doing just fine. I guess governor Snyder knows how to run a state. So much for those talking points Huh Don?

  4. Patrick,

    Massachussetts is abbreviated MA, not MI. Perhaps that's the reason you didn't address the subject matter.

  5. Wish I knew where it was all going. I'm a physician, and by our group's analysis, we are being reimbursed 64 cents for every dollar we earned doing the same work in 2006. And that's before taking inflation into account.

  6. This doesn't surprise me a bit. The hospital where I work sees mostly Medicaid patients who have no problem checking in every other week whenever their tummy hurts. They treat the hospital as a first class hotel, rack up thousands of dollars in bills as the doctors do their best to run a battery of tests to find out what's going on (gotta practice defensive medicine!) and then get them back home with this week's bag of pills. None of them paying for a bit of it. Wash, rinse, repeat.

    1. ^ ^ ^ THIS ^ ^ ^

      I also work at a hospital with a large amount of Medicaid patients. The worst offenders are exactly as described above: Weekly, if not multiple times per week readmissions, for maladies that are quite nebulous. Education about going to an Acute Care clinic instead of tying up an Emergency room falls on unheeding ears. Abdomen pain? "I want my Dilaudid because I'm busting from pain", then proceed to play on their smart phone eating whatever fast food their relatives snuck in. Clock-watching regarding pain meds. Any and all education goes in one ear and out the other. Threats to call the administration hotline if you're 5 minutes late with their pain meds, even though they look utterly asymptomatic when you surprisingly walk in on them.

      Before you hit the "reply" button, know that this is a small subset of people. They're a fraction of the people who actually need help, but know this- that population subset is growing and figuring out how to game the system. OPM.

  7. It's an easy life spending OPM.

  8. In a different context, people who demand that States "fully fund" Medicaid will scold the rest of us on the subject of "sustainability". Socialist schemes are never sustainable, except of course for those who are appointed to run them.

    -- theBuckWheat

  9. Cutting funding on Nursing Homes? What's next, Soylent Green?