Saturday, March 16, 2013

Medicaid: there are statistics and then there is reality

Capital reporter Bobby Harrison pushes Medicaid expansion in the Northeast Mississippi Daily Journal after using some personal anecdotes:

"Maybe, expanding Medicaid to cover people earning up to 138 percent of the federal poverty level, or $15,400 for an individual or $31,800 for a family of four, is not the right thing to do in Mississippi.

After all, we surely do not want to do anything else to foster an environment of government dependence in Mississippi.

But the flip side is that we are the most unhealthy state in the nation. The truth is that we spend more money treating diseases on the more expensive back end instead of the less expensive front end than any state in the nation.

Surely, the people in this state are smart enough to come up with some alternative where we are not throwing money at a health care system and getting practically no bang for our buck.

What that answer is may be debatable, but it is fairly evident what we are doing now is not working.

Just look at the statistics
." Column


Yes, Bobby, lets look at some statistics. Karl Denninger published some other statistics in The Market Ticker: The federal government is spending $800 billion more on Medicaid and Medicare than it receives in contributions. There is no separate tax for Medicaid as there is for Medicare. However, Mr. Denninger argues health care costs paid by the U.S. Government are exploding with no end in sight and are thus unsustainable:




"Here's the reality: Medicare and Medicaid services, including the "slide it to the states" for Medicaid, spent $1.053 trillion in FY2012.

We took in just $201 billion in Medicare taxes.

That is, the government is spending five times what it is taking in on health care.

Where is the discrepancy? In the Medicaid department; the "as spent" figures, unless you look real closely, hide the giveaway to the states. But that of course is BS as there is no magical money fairy.

For Social Security (including disability) the government took in $572 billion in FY2012. But the government spent $773 billion on both retirement and disability, or 35% more than it taxed.

That's not the only shocker. We gave $77 billion to people in the form of Earned Income and Child credits in excess of tax liability -- that's the amount that we literally handed out in welfare for simply being alive.

And we did not spend $180 billion on interest either -- we spent $359 billion.

We can survive the Social Security problem.

We cannot possibly survive spending five times what we take in via Medicare taxes and lying about interest cost will blow up in our face as well
." Post

The federal government at some point will pull the rug out from under the states on Medicaid as the current path will force it to do so. Whether or not such rug-pulling will be voluntary or involuntary when the government is forced to make cuts remains to be seen. However, there is no question the trend is unsustainable. Something the local pro-Medicaid expansion forces wish to ignore. If you think you are seeing a Medicaid war now, wait until you expand Medicaid and then remove people from the program several years from now when the state is forced to do so.

$1 trillion v. $200 billion. Yes, Bobby, lets look at the statistics and then ask the question: "can we afford it? down the road. The problems with PERS and MPACT are created in no small part because the legislature in its infinite wisdom decided to expand benefits when the money was flowing like the River Jordan. However, the famine that visited the land of Israel did visit the budget and those two programs. Those arguing for more Medicaid benefits have learned nothing and forgotten everything.

7 comments:

Anonymous said...

Harrison makes a very important point in his column - a point that is keenly applicable to not only the Medicaid debate in MS, but to the overall healthcare issue nationally: Our healthcare ecosystem is functioning in such a way that we treat symptoms and diseases AFTER diagnosis, which costs significantly more (5x, 10x+) than preventative care. Diabetes alone accounts for almost 1/3 of the healthcare costs paid by Medicare. Diabetes, along with coronary artery disease -- two of the biggest cost drivers in MS and elsewhere -- are largely controllable and preventable by lifestyle choices. Until and unless we start directing resources to the prevention of these disease states, this healthcare horror movie will continue to run, and it will not end well. If we were to spend the current resources in our Medicaid program in the right way, we would not need additional funds, and we would probably save tens of millions of dollars of our current Medicaid allocation.

Anonymous said...


I fail to see why I should have to pay for "cashier's, construction workers and Cooks" when i offer my employees health insurance. All 126 of them, so why the hell do you want my taxes to pay for others employees and companies that don't provide? Maybe they should offer and we as a state don't have too.

Anonymous said...

If we would prevent illnesses we would not have to treat them. What a concept, 5:18.

Kingfish said...

That is one point I had not thought about. Any employers currently providing health insurance to those employees below the proposed income limit. Will they then terminate the insurance and dump them on Medicaid?

Anonymous said...

Of course, they will and will argue that if they increase their profits, they'll put more money into the economy and create jobs.

And, it will be a boon to the health care industry.

Obamacare would never have passed otherwise.

Anonymous said...

KF, the employer could not dump the "part" of his workforce that is below the proposed income limit. Employer would have to dump all coverage. Don't know if that is what you were meaning, but don't read it in your comment.

While I don't disagree at all with your competing statistics, and its hard to come to the defense of Harrison, I don't see the "personal anecdotes" you reference in your opening post.

Anonymous said...

An important point to remember is that Obamacare requires most employers to provide coverage for their workers or pay a tax penalty of the workers' wages of up to 8 percent. Also, small businesses are granted tax credits for worker health care expenditures, and will be benefitted by choices of insurance providers competing though the employer's state's health exchange. An employee provided insurance by his employer would not be eligible for the expanded Medicaid coverage. Arguably, the penalties paid by employers not providing health coverage pays for the expansion of Medicaid. Am I wrong???



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