Saturday, August 8, 2015

John Kasich's Silly "St. Peter" Complex on Medicaid

In the first GOP primary debate, many believe this response by GovernorJohn Kasich on Medicaid expansion in Ohio, hit the ball out of the park:

Unfortunately, Kasich's 3-point justification is so off the tracks it's almost laughable.

The implication that 10,000 mentally ill inmates in his prison system wouldn't be there if they simply had Medicaid is a ridiculous assumption and impossible to prove.  The biggest problem with the seriously mentally ill is anosognosia. In other words, they don't think that they are sick, won't seek treatment, or take medication.  In this country, 55% of the mentally ill suffer from anosognosia.

Then, there's the rationale that Medicaid somehow helps the 80% of the prison population who are drug addicted.  Here's what says about that:
 "If you’re incarcerated you can use the Marketplace to apply for Medicaid coverage in your state. Medicaid won’t pay for your medical care while you’re in prison or jail. But if you enroll in Medicaid while you’re incarcerated you may be able to get needed care more quickly after you’re released."
Are we also supposed to believe that 80% of Ohio's prison population is being treated for drug addiction and being released back into the general population?

In his final justification, Kasich claimed that expansion of Medicaid will reduce emergency room usage.  This is flat wrong and is right out of the Democrats playbook.  Study after study has shown that more Medicaid patients increase emergency room usage. Oregon, expanded Medicaid on their own and emergency room usage went up 40%.  A Colorado Hospital Association study found that, in states that expand Medicaid, emergency room access was up 5.6%. In those that didn't expand, the increase was just 1.8%.

The simple truth is that Medicaid is a broken system because it pays doctors and hospitals just pennies on the dollar for the care they provide.  As a result, fewer and fewer accept Medicaid patients.  A 2014 Merritt-Hawkins study showed that just 45.7% of doctors in five different specialties in 15 markets accepted Medicaid patients.  This is a notable drop from 55.4% in 2009 and, because those patients can't find a convenient doctor, they wind up using the closer emergency rooms.

Expanding Medicaid, hurts the poor because the number of doctors who will see them  gets smaller by the day.  As a result, they need to travel further for their care.  That is, if they can even afford to travel to see a doctor.  Is this was St. Peter really wants, Mr Kasich?  You and other Governors should fix Medicaid before dumping more people into it.

Lastly, he said that Ronald Reagan expanded Medicaid three times.  So, he did.  But, at that time reimbursement rates for treatment were very near the costs being incurred.  Today, doctors and hospitals are paid an average of 56 cents on every dollar.


Morning Joe Panel: Kasich's Debate Performance 'Reaganesque', Medicaid Answer 'Best of the Entire Night':

John Kasich: GOP debate winner?:

Anosognosia and Medication Noncompliance:

Doctors Face A Huge Medicare And Medicaid Pay Cut In 2015: 

Obamacare's Medicaid Expansion Is Nothing to Brag About:

2014 Survey: Physician Appointment Wait Times and Medicaid and Medicare Acceptance Rates: Incarcerated People:

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