Tuesday, November 29, 2011

Where are your Medicaid tax dollars going?

I've got some inside info that will help answer this question, but first, a little story about Jack's childhood--funny aside, many of my friends claim that I could not possibly have actually had a childhood, and that I must have always been an adult.

Anyway, when we were kids, my brothers and I didn't go to the doctor often.  We went for our physicals every couple of years, and if we were sick we only went if one or more of the following conditions were met:

A.  Vomitting and/or diarrhea for more than a day or two.

B.  Strep-throat, tonsilitis or some other serious malady of the throat.

C.  Ear infection.

D.  Some sort of major injury that could not be healed with RICE.

E.  Something that appeared to be a serious illness like pneumonia, bronchitis, or whatever.

That being said, there are tons of parents who bring their kids in for shit that is not serious.  "Oh, my child has a runny nose."  "My child has cold symptoms."  "He's had a cough for 2 days and it won't go away!"  Every time someone wants to schedule their kid to come in for a cold or a runny nose, I want to scream, because 95% of the time the family is on Medicaid.

Isn't that odd that families with private insurance seem to go to the doctor less?  Now, some of you who think universal healthcare is a good idea might be thinking "way to go dumbass, you just proved our point!  If you have free health insurance, you'll go to the doctor more and get better care!"  What you don't realize, is that going to the doctor for every little thing actually drives up the costs.

Why does Medicaid take up so much money?  Because the cost is shifted from the recipients onto the tax payers.  They don't have to pay anything for their care, so of course they're going to go to the doctor for every little fucking thing.

You know what the doctor will likely tell them if their kid has a cold?  Get plenty of rest, drink lots of fluids, and go buy some dimatap or something.  When they bring their kid in for a common cold, they're wasting the provider's time and resources that could be devoted to patients who are actually sick and need care.  And they do it because it's at no cost to them.

Going to the doctor every time you get a cold is not going to improve your overall health.  People who have to pay their own premiums and don't wish them to go up will just take care of themselves or their children so long as the problem doesn't actually require anything from a doctor.  That's the way it should be.

So how the hell can we drive down costs by getting people to go to the doctor more often?  I know the argument is that if people go more often, they'll be more likely to get big problems diagnosed early before it becomes an expensive medical issue.  But really, how many people fall into that category?

Now I'm just speculating here, but my guess is that for every person who ends up having a serious, expensive medical issue later in life, that the cost of everyone else who ends up never having an expensive issue but goes to the doctor all the time will come close to equalling that.

What people are seeming to not understand is that the solutions people are proposing to fix healthcare and make it more affordable are little more than accounting tricks.  Both sides are only suggesting that the cost be shifted rather than mitigated.  Paul Ryan wanted to shift the cost of Medicare onto the recipients.  The HCR bill shifts the costs onto everyone.  None of these things are designed to make practicing medicine less costly and more efficient.

For those of you who think the cost would go down by mandating that everyone have health insurance and then advocating that they visit the doctor more, I think you're sadly mistaken.

2 comments:

Jersey McJones said...

Medicaid isn't what you think it is, Jack.

http://www.kaiserhealthnews.org/charts/2009/medicaid.aspx

http://facts.kff.org/results.aspx?view=slides&topic=1

http://facts.kff.org/chart.aspx?ch=465

http://facts.kff.org/chart.aspx?ch=472

So, it may seem to you, by anecdote (and you know what that's worth), that things are a certain way, but they are not.

In fact. 5 million children who are qualified for Medicaid are not even enrolled! 67% of expenditures go for the disabled and elderly, though they represent only 25% of enrollees. And over a fifth of the payments go to MCO's - because, as we know, the private sectors always does everything so much better (my ass).

JMJ

Silverfiddle said...

Jersey: You just described a jacked up Government program.

Thank you. Case closed.