Thursday, April 15, 2010

The High Cost of Low Cost Insurance

I just read an article in my daily Medscape review entitled, Uninsured, Medicaid Recipients Recieve Substandard Migraine Care. My immediate response was...Duh! Aparently, it took researchers at Harvard Medical School to uncover this mystery! I'm sorry, but the truth is: the federal government, through CMS (commission on medicare & medicaid) has made it so difficult for any provider...physician, hospital, home health company, nursing home, you name it) to meet their expenses by providing care for these patients that nobody wants to do it anymore. The reason many (if not most) physicians will not see Medicaid patients is that they earn somewhere between $15-$30 per patient. In his June 29, 09 article, David Burda, editor of Modern Healthcare Magazine told us that the standard Medicaid Margin for hospitals overall was (according to the American Hospital Association) Minus 17%. You heard it right...-17%. By the way, Medicare is much better, hospitals only lose 5.9% per year. Would you enter a business knowing up-front that you were going to earn -17% each year? I don't think so!
Is it any wonder nobody wants to see Medicaid patient. This system is unfair to all. It under-pays the providers and is demeaning to low-income people. This could all change if CMS would pay providers fairly for what they do. The part that is so depressing to those of us who deal so intimately with Medicaid is that in our new health overhaul, the "uninsured" who will in 2014 become insured will be insured by guess who...Medicaid. As my friend John Eads used to say, "What a goat rope!"