The expansion of Medicaid under Obamacare has become a major sticking point in the senate’s attempt to craft a bill to replace Obamacare because many states have taken the Obamacare bait to increase their Medicaid roles. The following article on California’s Medi-Cal program shines a bright light on how the expansion of Medicaid is endangering our health care system. Nancy
California is a case study: One patient suing the state says she went to Mexico to get her gall bladder out.
July 19, 2017 by Allysia Finley Ms Finley is a editorial writer for the Journal
If ObamaCare’s expansion of Medicaid were measured merely by growth in enrollment and spending, California’s Medi-Cal program would rank as a huge success. Since 2012, Medi-Cal has added six million beneficiaries, primarily able-bodied adults of working age. Covering them last year brought California nearly $20 billion in additional federal funds. If Medi-Cal were a state, its population of 14 million would make it the fifth-largest in the U.S. The program’s $103 billion budget is about three times the size of Illinois’s general fund.
But despite the surge in enrollment and spending—or perhaps because of it—Medi-Cal has failed to fulfill its stated goal of improving health-care access for the indigent and disabled. Arecent reportfrom the Santa Clara County Civil Grand Jury highlighted the conundrum many of the state’s Medicaid enrollees face: “You’ve Got Medi-Cal, but Can You Get Medical Care?”
By extending Medi-Cal to younger, healthier people—many of whom could be better served by the kind of bare-bones private insurance that ObamaCare outlawed—California has made it harder for those who most need low-cost care to get it.
Medicaid operates as an open-ended entitlement, meaning the federal government covers a predetermined share of state spending, regardless of the total cost. Traditionally, the feds have matched California’s outlays dollar for dollar. States where the per capita income is lower receive a more generous match. Nevada, for example, receives about two federal dollars for each one it spends.
Remember the IPAB, Independent Payment Advisory Board (Death Panel as Sarah Palin so lovingly called it !). We haven’t heard much about it in the last few years but the deadline to kill it is coming up by August 15.
Please call your representatives and tell them that it is very important to kill IPAB before the deadline. Nancy P.S. Your very life may depend on it being killed !!!!
If the House acts fast, it can abolish a bad ObamaCare provision.
By
Grace-Marie Turnerand
Doug Badger
Ms. Turner is president, and Mr. Badger a senior fellow, at the Galen Institute.
July 25, 2017 6:47 p.m. ET
All eyes are on the Senate as it debates what to do about ObamaCare. But the House has a last chance this week to abolish one of the law’s most dangerous creations: a board with sweeping, unchecked power to ration care.
The Independent Payment Advisory Board—what critics call the death panel—would be an unelected, unaccountable body with broad powers to slash Medicare spending. But the law contains a living will for IPAB. If the president signs a congressional resolution extinguishing the panel by Aug. 15, it will never come into existence.
The real deadline is closer, since the House plans to recess Friday and not return until Sept. 5. But if the House does act, the Senate will have time to follow, since it plans to remain in session until mid-August.
The IPAB’s powers would be vast. If government actuaries find that Medicare spending would exceed caps established by ObamaCare, the board is required to write a plan to stay under the caps. Congress can pass its own bill to reach the target if it acts promptly—but if not, the secretary of Health and Human Services must implement IPAB’s plan, which would be exempt from judicial review.
This article was written the day before the election but contains very sobering and alarming information on the fiscal health of our country and what the next president has to deal with. As if there is not enough bad news in this article, the federal debt is approaching $20 trillion very quickly and increasing the debt ceiling will face Congress and the president by a March deadline. Nancy
The President’s luck is about to run out—on his successor’s watch.
ENLARGE
U.S. President Barack ObamaPHOTO:GETTY IMAGES
EXCERPT FROM THIS ARTICLE:
The tragedy is that Mr. Obama spent his political capital not on growing the economy but on growing entitlements and raising costs for business via regulation. The next President needs to make faster economic growth the policy default, or every other political priority will be hard or impossible to meet. The deficit burden will get worse faster.
The final major lesson is that the next President can’t count on the continuation of low interest rates. The Federal Reserve has been Mr. Obama’s best friend not named Chief JusticeJohn Robertsas its monetary policies have helped finance a record debt blowout at lower cost. Mr. Obama issued more Treasurys than any President in history, and the Fed bought $1.7 trillion worth from 2009-2014. That helped guarantee there wouldn’t be a shortage of demand.
Congratulations to the President-elect, whoever you are, because you’re going to need it. Our deadline arrived Tuesday before we knew the election outcome, but not before we can say with confidence that PresidentObamais leaving his successor a large and growing federal budget problem.
That’s the message in the Congressional Budget Office’s summary, released Monday, of the fiscal year that closed in September. Though the subject barely came up in the campaign—little policy substance did—the federal fisc is once again heading for trouble. There are some lessons in this for the next President, who will quickly realize that Mr. Obama’s fiscal luck has finally run out—on his successor’s watch.
As with HillaryCare, a single payer, national health-care system has always been the goal.
By
PHIL GRAMM
Mr. Gramm, a former chairman of the Senate Banking Committee, is a visiting scholar at the American Enterprise Institute.
October 18, 2016EXCERPT FROM THIS ARTICLE: For the ObamaCare of today to be transformed into the HillaryCare of 1993 and finally into a nationalized health-care system, a president is needed who has the willpower to impose the coercive details, nail down hard deadlines and unleash agencies to tighten controls and squeeze the life out of private insurers. In 1993 Hillary Clinton unapologetically proposed to do just that. If she is elected president she will have the unilateral power under ObamaCare to do it. The loss of what remains of Americans’ health-care freedom is an election away.
In claiming earlier this year that the current U.S. health-care system “was HillaryCare before it was called ObamaCare,” Hillary Clinton was telling the truth—but not the whole truth. In 1993, while first lady,Mrs. Clintonled a task force to deliver universal health care to the voters who elected her husband. She failed. After many revisions, the final bill stalled in the Senate for lack of Democratic votes.
HillaryCare was a comprehensive plan for the government to take over the health-care system, with program details and cost-control measures precisely defined. Having learned from that defeat, the Obama administration left as many details as possible to be written during implementation after ObamaCare became law. With few details to defend and the clear falsehood that “if you like your health-care plan you can keep it,” President Obama pushed through his “signature” legislation.
WhileBill Clintonrecentlydenouncedthe Affordable Care Act’s effect on the health-care market as “the craziest thing in the world,” ObamaCare was never anything more than a politically achievable steppingstone. As with HillaryCare, a single payer, national health-care system has always been the goal.
Congress should stop this venture in bad medicine and flawed economics.
By
JEFFREY L. VACIRCA Dr. Vacirca is CEO and chief of clinical research at NSHOA Cancer Center
Federal bureaucrats announced earlier this year that they plan to upend the way Medicare Part B pays for drugs. The goal? To save money by getting doctors to alter their treatment choices. That’s bad medicine, flawed economics and destructive public policy—and Congress should pass legislation to stop this ill-conceived experiment.
Medicare plays a crucial role in the lives of more than 55 million Americans. It is the only way some seniors can get access to the drugs that keep them alive. The new policy from the Centers for Medicare and Medicaid Services will jeopardize this access by inserting the government between doctors and patients in an unprecedented way.
ENLARGE
PHOTO:GETTY IMAGES
The idea is to use financial incentives to push doctors to make “value-based care” decisions and prescribe cheaper treatments. Unfortunately, modern-day medicine isn’t as black and white as the administration seems to think. Take cancer care, my specialty. There are very few instances when the substitution of a less expensive cancer drug is appropriate or safe for patients. After all, there is a reason the newer, more advanced drugs—such as those that helped former PresidentJimmy Carterput his cancer into remission—are considered groundbreaking.
The federal bureaucracy is anti-patient, anti-family and anti-medical care. Reform is essential
ByTim Murphy
Mr. Murphy, a Republican, is a U.S. representative from Pennsylvania and a psychologist in the Navy Reserve Medical Service Corps.
Oct .9, 2015
EXCERPT FROM THIS ARTICLE:
In 1955 there were 558,000 inpatient psychiatric beds in the U.S. Today there are fewer than 45,000. The severe shortage is due to the decades-long deinstitutionalization that began in the civil-rights era. But it has been exacerbated by a Medicaid reimbursement rule known as the “institutions for mental diseases exclusion,” which prohibits federal matching payments for inpatient care at psychiatric hospitals with more than 16 beds. My bill moves away from the arbitrary 16-bed cap and establishes a clinical standard for patients with serious mental illness.
These past few months have brimmed with tragedy. Americans are struggling to make sense of horrific acts of mass violence like the August shooting on live television in Roanoke, Va., and last week’s college campus shooting in Roseburg, Ore.
We all know how this plays out in Congress: a moment of silence on the House floor and a fraternal feeling of melancholy when the flag over the Capitol is lowered to half-staff. But that moment of silence will not heal the hearts of those who lost a loved one, and it will not stop the next tragedy. Here and now we need action; we need real change.
That’s why I’ve authored the Helping Families in Mental Health Crisis Act. The bill focuses resources and reform where they are most needed: to foster evidence-based care, fix the shortage of psychiatric hospital beds, empower patients and caregivers under HIPAA privacy laws, and help patients get treatment well before their illness spirals into crisis.
As chairman of the House Oversight and Investigations Subcommittee, I led a congressional investigation into our failed mental-health system after the 2012 Sandy Hook Elementary School shooting. What we found was shocking and disgraceful: a wasteful federal bureaucracy that is anti-patient, anti-family and anti-medical care. The federal government has more than 112 programs that deal with mental health in one way or another, yet a person with serious mental illness is 10 times more likely to be in a prison cell than a psychiatric hospital bed.
Mark Sklar Dr. Sklar is an assistant professor of medicine at the Georgetown University Medical Center and at the George Washington University Medical Center.
Sept. 12, 2014
It has been four years since the passage of the Affordable Care Act, so I thought it may be useful to provide the perspective of a physician providing daily medical care. I am an endocrinologist in Washington, D.C., and have been in solo private practice for 17 years after seven years at an academic institution. Since 1990, the practice of medicine has changed significantly, seldom for the better.
In the 1990s insurance companies developed managed-care plans that greatly increased their profits at the expense of the physician. With the Affordable Care Act, we are seeing new groups profiting from changes to the health-care system. Entrepreneurs and hospital executives are capitalizing on organizing physicians into groups called Accountable Care Organizations from which they will take a very substantial percentage of collected income. Now that physicians are being required to use electronic medical records, the companies that develop them are harvesting money from physicians’ practices and from hospitals.
The push to use electronic medical records has had more than financial costs. Although it is convenient to have patient records accessible on the Internet, the data processing involved has been extremely time consuming—a sentiment echoed by most of my colleagues. To save time, I was advised by a consultant to enter data into the electronic record during the office visit. When I tried this I found that typing in the data was disruptive to the patient visit. My eyes were focused on the keyboard and the lack of direct contact kept patients from opening up and discussing their medical and personal problems. I soon returned to my old method of dictating notes and pasting a print-out of the dictation into the electronic record.
Yet to avoid future financial penalties from Medicare, I must demonstrate “meaningful use” of the electronic record. This involves documenting that I covered a checklist of items during the office visit, so I spend 90 minutes each day entering mostly meaningless data. This is time better spent calling patients to answer questions or keeping updated with the medical literature.
If electronic records ever allow physicians to obtain data from previous laboratory and imaging testing, it will improve costs and patient care. So far, however, the data in electronic records—like paper charts—can’t be shared unless physicians work in the same health-care system.
My practice quickly adopted the new Medicare requirements for electronically prescribing medications. Yet patients often do not want their prescription sent electronically. They want a physical copy—either because they don’t trust the Internet or because they don’t need to fill the prescription immediately. If I don’t electronically prescribe for a certain number of Medicare patients, I am penalized with a decrease in reimbursement that can rise to a maximum of 5%. Patients should have a choice in how their prescriptions are delivered, and physicians shouldn’t be penalized for how the patients choose. (more…)
