“When one person suffers it is a tragedy, when millions do, it is a statistic.”
As abhorrent as quoting Josef Stalin might be, the monster was right.
Opponents of Obamacare love to cite specific examples of people “harmed” by PPACA. As we’ve seen, while their “examples” are false, wildly distorted, and/or fake, they are also powerful as few bother to read the follow-up debunking stories.
Amidst all the complaints about Obamacare from individuals “suffering” under their new policies, it is easy to miss out on the big picture..
From a reader (thank you JR) came this – 4 million people with mental health issues will not gain coverage under Obamacare. They will not have access to Medicaid, because the state legislators and/or governors don’t want to accept federal dollars to expand Medicaid.
These are real people – boys, girls, moms, dads, grandparents, friends, neighbors, sisters, brothers, wives, husbands, classmates.
They are suffering from bi-polar disorders, deep depression, addiction, autism, severe anxiety and panic disorders. We are talking about seriously ill people, some with disorders similar to the perpetrators of the Newtown Connecticut and Navy Yard shootings; others who, without treatment, will never become productive, fulfilled, tax-paying members of society. Instead they will be a burden on us all.
There are 11 southern states that have, for reasons of their own have refused to expand Medicaid as of now. According to the piece in Insurance Broadcasting, “More than 1.1 million uninsured people who have serious mental health and substance abuse conditions live in just two states — Texas (625,000) and Florida (535,000).”
What does this mean for you?
The next time someone tells you what a great country we live in, ask them if this is how great countries treat their most vulnerable citizens.
When state politicians cut their own social support budgets while refusing to help those desperate for help, we become a smaller, meaner, and less-civilized society.
The full report is here.
It’s really unfortunate that you had to resort to quoting Stalin to push your liberal agenda. While the social aspect of wanting everyone to have coverage is a good intention…the economic impact simply won’t work. You need to become aware of “intent vs. impact.” While an intention can be good, the unintended impact can be very negative.
The math simply does not work!
Brent – thanks for the comment. As to my “agenda”, I find it really unfortunate that you find it necessary to use labels to categorize my “agenda”. If you’ve read MCM you may recall I have consistently decried Medicare part d, a decidedly non-“liberal” stance.
I don’t understand your statement that “the economic impact simply won’t work…The math simply does not work!”
What support do you have for that assertion? What credible, un-biased studies support that claim? Look forward to your response.
As to your statement that “an intention can be good, the unintended impact can be very negative.”, I would suggest that is my central point. The unintended impact of rejecting medicaid expansion is, indeed, very negative.
cheers
Thank you for the link to the report. Appreciate it. Good article.
Joe, I love you. You are smart, funny, and compassionate . I may be wrong but I believe that the provision of federal dollars for expanded Medicaid are temporary and the demand to continue the expansion is permanent. That is why there is a reluctance to expand this benefit in some states. I fully agree that how we look at mental health care and funding mental care is wrong and I agree that the Republican party should own a generous portion of blame for this problem. Our society and Government are reflective. How we look at each other and treat each other day by in the Street is a bigger issue to me. How I interface with the homeless schizophrenic in the parking lot of Trader Joe’s speaks to who I am as an individual and who we are as a society. I am glad to be part of the dialog even when we disagree.
John – love you too, man.
the federal contribution for Medicaid is set at 100% thru 2017, then it declines – 95 percent in 2017, 94 percent in 2018, 93 percent in 2019 and 90 percent in 2020 and beyond.
Unfortunately Rubio and his ilk have been lying about “unfunded mandates” when referring to Medicaid expansion; he knows this is false.
good to disagree without being disagreeable.
Joe:
With so many States running deficits, any expansion will cause painful (economic and political) choices to be made for any expansion; be it for 5%, 6%, 7% or 10% matching funds. And the Federal subsidy isn’t “magic” money. That 100% – 95% for the expansion has got to come from somewhere.
Allen – welcome back. agreed the $ has to come from somewhere. id suggest higher taxes on the wealthiest, end subsidies for fossil fuel and lower military spending.
Amongst Southern politicians, Medicaid is a dog-whistle term for black people’s health care.
The South opposed Medicare at first because it integrated hospitals. The South only accepted Medicaid if the individual states could control eligibility.
The white South does not want poor black people to be comfortable, and that includes health care. It wants these folks to migrate to more liberal states.
Michael Lind covers this well an article called “Uninsured Like Me.”
Health care must be analyzed with a racial filter!
What percentage of the population with mental health/substance abuse issues are Veterans eligible for care by the Veterans Administration Inpatient/Outpatient programs? The report by Miller at the AMHCA does not seem to cover this percentage of the population.
Joan – this is pretty easy to figure out. about 1 percent of the population are veterans with disabilities, however the majority are over 65. therefore, we can estimate the percentage of the MH SA population included in the study is pretty small – likely less than 10 percent – at most.
Hey Joe,
When I said that the math does not work, I was referring to the fact that in order for Obamacare to function, it is predicated on the fact that it needs buy-in from the younger age group. (ironically, these are the same people who voted for him). However, because the younger demographic has seen their premiums increase substantially, they are not buying in. Who then, will pay when the law states that pre-existing conditions cannot be denied?
Will premiums not increase as a result? Wasn’t the program sold in the first place as a solution to reduce medical costs? Do you not find this misleading and infuriating?
Looks like the younger demographic will learn the hard way that you get what you vote for!
Brent – thanks for the note. A couple observations.
1. There are MANY components to “obamacare”; the exchanges and mandate being two of them. I’d suggest the definition of “Obamacare functioning” is much broader than enrollment demographics. One might want to add other criteria, including Medicare cost increases (currently running lower than the CPI); Medicaid cost-per-member, also running below original projections; outcomes (too early to tell).
2. Re your statement that “because the younger demographic has seen their premiums increase substantially, they are not buying in.”, I’d suggest that a) it is too early to tell one way or the other, however b) the most recent data indicates buy-in is increasing, and c) experience in Massachusetts indicates this is to be expected. That said, we will know a LOT more in 60 days.
3. Re how the “program” was sold; cost control was one leg of the stool; universal coverage was another and improved quality the third.
4. Finally, I have a lot of faith that insurers will figure out how to control costs now that they can’t cherry pick via underwriting and benefit manipulation. They will, and are, developing strong and effective programs to do just that. This isn’t just a membership question, it is very much a care management question.
Appreciate the dialogue.
I don’t want a penalty for third man in but a couple of points:
1) Joe, I cannot take Brent’s stance on a Liberal agenda, however, I generally can read a headline and guess with pretty good certainty what side of the political spectrum side you will land on. That’s not good or bad, it’s just a simple obervation. Rationale for your stances are always well thought out and supported by facts (or an interpretation of facts) which is much more than we get elsewhere. That much is appreciated. While you point out that you, “have consistently decried Medicare part d, a decidedly non-”liberal” stance,” you also have consistently pointed out it was passed under a Republican congress, inferring blame and getting a shot in where you can (just an interpretation).
2) “One might want to add other criteria, including Medicare cost increases (currently running lower than the CPI).” Aren’t Medicare cost increases determed by CMS and how much they are willing to pay for procedures? It’s not truely indicative of “costs” that a provider incurs for delivering procredures (which is a problem in and of itself), only what CMS is willing to pay. CMS can inflate or reduce reimbursement, therefore “costs” are at their discretion. The that fact that they have come in under the CPI increases isn’t really a true indicator.
Thanks for the forum for discussion.
No worries about the third man penalty Greg; this is a self-officiated conversation.
re 1), I’d suggest that these labels are precisely the problem. re Medicare part d, I’d note that strong conservatives and I agree on the legislation; that doesn’t make me a conservative or them liberals. I don’t hew to any particular agenda, but do delight in tweaking those who choose to label me…
re 2), oh were it only possible for CMS to regulate Medicare cost increases. They do have some sway over medical PRICE increases however the physician component is addressed thru the SGR – a political football if ever there was one – and utilization and the intensity of services are the other two components of the cost equation (in addition to membership of course). On these last two, CMS and their proxies have done a credible job of improving results, but not by fiat. In fact, they are specifically prevented from doing so by the 2003 MMA act among others.