Stanley Feld M.D.,FACP,MACE
“Individuals and families who do not qualify for Medicaid or SCHIP but still need financial assistance will receive an income-related federal subsidy to buy into the new public plan or purchase a private health care plan.”
Barack Obama should do some arithmetic. A minimum wage worker without a healthcare insurance benefit does not qualify for Medicaid coverage in most states.
Presently in Texas a family can not earn more than $800 a month in order to receive Medicaid. A family of four can not live on $10,000 a year and think of buying health insurance. Moises has a very difficult time supporting his family earning $22,000 a year. He worries about getting sick every day of his life but can not spare a penny of his income for healthcare coverage. .
Poverty today is defined by a 1955 definition. It is not adequate. President Bush rejected the SCHIP program twice because he sees the deficit writing on the wall. Republicans want to eliminate entitlement programs not add them. An additional entitlement will bankrupt the country at a faster rate than our present Medicare and Medicaid programs.
Maybe we could help the needy with a healthcare insurance program that would create incentives to be responsible for their health (exercise, lack of obesity and adherence to medication), and medical care? Maybe we could create programs to stimulate corporate America to promote wellness and exercise social responsibility to combat obesity? This would be a worthwhile investment for our government. It might even be a better investment that protecting corporations in search of increasing markets in the name of globalization.
Obesity, addiction, non-compliance with recommended medical treatment is a huge cost to our system. It must be dealt with. Only the consumer can deal with these issues on a personal level.
Some states like Indiana and New Jersey have tried to increase the income level for the eligibility for Medicaid. The federal government has refused to fund these new definitions because it does not have the money to pay for it.
States that are in worse shape financially than the federal government need to fund the difference. The only way it can be done is by raising taxes.
The “bipartisan Romney plan” of universal healthcare coverage in Massachusetts is shaping up to be another disaster of fuzzy thinking. The intention was good. The cost overrun this year is in the range of over $400 million dollars. The present Massachusetts administrators are hailing their universal healthcare plan as a success because more people are insured. The problem is the administrators have left the pricing and control of the healthcare insurance coverage in the hands of the healthcare insurance companies. The plan has not eliminated any of the administrative inefficiencies of the healthcare insurance industry or encourages medical practice efficiencies. It does not encourage patient responsibility nor chronic disease management incentives.
The Massachusetts plan is certainly going to result in an increase in state tax is Massachusetts.
Barack Obama’s policy statement on Subsides is naive. It presents a false hope without a plan. All government subsides so far have gone to the wrong stakeholder. The result of a policy executed with this open ended philosophy will result in increased government cost. In effect the government is providing an entitlement for the healthcare insurance industry. They are leaving control of pricing and administration in the healthcare insurance industry’s hands. An increase in government spending will result in a decrease in healthcare coverage for the average person as well.
How can I say that? Recent past history has demonstrated it. As long as the healthcare insurance industry is in control of the pricing, government bureaucracy is suppose to oversee that pricing. Historically the price has increased and healthcare coverage has decreased.
To paraphrase Yogi Berra “it is the $600 toilet seats all over again”.