Feb 20 2009
Sounds like a good idea
I was struck by the flood of criticism about the stimulus bill that is coming from some “analysts” on the major networks. For example, Karl Rove, as guest Bush administration apologist/news “analyst” on Fox news critiqued the stimulus bill’s increase of funding for the National Institute of Health.
“Give $2 billion to the National Institutes of Health. What is that going to do to employ somebody in a manufacturing plant?”
Aside from pointing out the irony that Mr. Rove also critiqued the idea of giving money to the automobile industry - money that would “employ somebody in a manufacturing plant” - we must look at the idea of “throwing money away” by improving the American healthcare system.
One of the provisions in the stimulus bill was for an increase in Federal contributions to Medicaid. Medicaid is administered by states which also contribute a majority share to the pool of funds. The Federal government them uses some of its funds to offset that cost and keep states from having to raise taxes and/or cut benefits. Let us examine several important questions about Medicaid:
Who Qualifies? According to the New York State Department of Health, anyone who can not afford insurance is covered by Medicaid, including (but not limited to) people on disability, workman’s compensation, and unemployment assistance (please note, no state uses the term “benefits”). Additionally, if you or a family member is critically ill and can not afford the cost of treatment even IF you have health insurance, Medicaid will defray some, if not most, of the costs.
Why do “the poor” get free healthcare when I’m a Self-pay Entrepreneur/Middle Manager with high out-of-pocket/a law-abiding tax-payer? According to Consumer Affairs, a leading consumer advocacy group’s website, the number one cause of Bankruptcy in the United States is medical bills. in 2005 alone, 50% of Middle- and Working-Class families that had to file bankruptcy did so because of medical bills that their insurance would not pay. Families in these situations receive Medicaid as well, particularly if the patient still requires treatment.
Why do Medicaid Patients clog the Emergency Room all the time? Medicaid has a limit on the places a patient can go because of the bureaucracy involved and fraud which occurs both at the hands of the patient and at the hands of the medical care provider. Occasionally, but very rarely, according to the Illinois State Police Taskforce on Medicaid Abuse, Medicaid Recipients are able to fake illnesses or injuries well enough to get medicines or treatment they do not need. More commonly, unscrupulous medical providers, in order to pad their profits, double bill or charge for patients who do not exist. This is a persistent crime which costs states funds, and increases regulations which discourages urgent care facility and some late-night clinics from treating Medicaid patients. The patients are then forced to head to the local ER for acute care, a move which costs 4 to 5 times as much as equivalent care at an urgent care facility.Waits can exceed 12 hours in some metropolitan areas such as Los Angeles, Chicago, Atlanta, and so on.
Essentially, states - who themselves are facing a more serious budget shortfall - would receive more federal funding from money the U.S. government has borrowed in order to prevent a catastrophic loss of services for the poor, unemployed, under insured, and underemployed. $2 Billion dollars over the course of the next, say, two years may seem like a lot, but consider this: According to The National Priorities Project, the war in Iraq costs the taxpayers in the state of Ohio alone, over $26.2 Billion dollars between March 15th 2008 and March 15th 2009.
Other critiques have come out of somewhat-left field (to forgive the ironic analogy), such as an argument against the Medical Information Act which would convert the heavily bureaucratic apparatus of medical recording and billing from paper to electronic records alone. On a somewhat conservative blog website, an uncited quote of Karl Rove thusly:
“Rove pointed out very clearly that $20 billion of the bill goes for Health Information Technology, this will streamline the process eliminating the need for data entry clerks, receptionists and other hopital (sic) office staff “
According to Physicians for a National Health Program, 31% of every dollar spent on health costs, both from public funds (such as Medicaid and Medicare) and from private funds (BlueCross/BlusShield, Humana,etc.) goes to non-medical bureaucratic costs. Arguing that eliminating, or at least dramatically reducing, this overhead cost is akin to arguing that we should do away will cell phones and email in favor of bringing back the pony express; it makes no rational sense. Certainly, literally hundreds of poorly-trained technicians, who completed at most a 1 year certificate program, would most likely lose their medical transcription, medical recorder, or other paper-shuffling jobs, but as these are general clerical skills, their marketability in other fields - such as business - is still viable. Additionally, this may motivate some of the people working in these positions to enter into colleges and universities and expand their expertise, earn more money, and thus pay more in taxes, purchase more goods or services with their increased income, and generally have a higher cost of living than they had before. According to the Bureau of Labor Statistics, the average wage of a 1-year certificate-holding medical transcriptionist is $14.00/hour. By comparison, a Medical office Manager (who would not be in danger of losing their job, according to Rove et. al.) earns upwards of $78,000 a year.
Additionally, a reduction in the overall cost of health care would not only benefit Medicaid recipients, but the American taxpayer as well; streamlines record-keeping reduces fraud, makes payments smoother, and may entice some medical providers to offer health care to Medicaid patients that would normally go to Emergency Rooms for their ailments.
Improvements to the health care system of the United States is badly needed. Some more information to fuel the debate over “wasting” medical health care dollars (all sources according to the World Health Organization, unless notes otherwise):
1) The United States’ health care system ranks #37 in the world; Costa Rica ranks #36, Morocco #29, Cyprus #24, Iceland #15, Japan #10, Australia #9, Oman #8, Spain #7, Singapore #6, Malta (a tiny island in the Mediterranean) #5, Andorra (ditto) #4, San Marino (another Mediterranean country) #3, Italy #2, France #1. Cuba (with 50+ years of embargoes) ranks #39.
2) The United States spends 15.2% of its Gross Domestic Product on health care costs. France spends 11.2%, Italy 8.9%, San Marino 7.3%, Andorra 6.3%, Malta 8.4%. Cuba spends 7.4%
3) The United States spends 40% of its GDP on “Defense” costs.
Now while it may be easy for anti-Obama or anti-Democrats to believe the ideas and alarm bells rung by people like Karl Rove, it is much more important to put things in perspective, understand the context they are offered in (in this case, Mr. Rove is not out to”help” the administration succeed), and to do your own research through reputable sources that check their facts. If conservatives are going to deride the “mainstream media” for its “bias” then they should also realize that their own news and opinion outlets, such as Fox, Limbaugh, and Rove, are equally “biased” and will twist information just as much as they think MSNBC, Al Frankin, and Katie Couric do.
QED
—————-Resources——————
Fox News interview with Karl Rove 3 Feb 2009
Rove on the “cost” of the stimulus (unsourced)
New York State Department of Health, Medicaid FAQ
Consumer Affairs, cause of bankruptcy
Illinois State Police, Medicaid Fraud Unit
National Priorities Project, cost of War in Iraq to Ohio (PDF )
Bureau of Labor Statistics, Medical Transcription
_____ , Medical Office Manager
U.S. Healthworks Medical Group, cost of ER vs. urgent Care
World Health Organization, Rank of Health Care Systems
Stumble It!