The topic of Medicaid continues to preoccupy the minds of our nation’s governors. Yesterday, the National Governors Association presented its recommendations on Medicaid reform to a Congressional panel. There was a lot of consternation surrounding proposed co-payments for Medicaid enrollees. In Minnesota, most Medicaid enrollees already are required to pay co-payments for things like prescription drugs and clinic visits. I also pay a pretty hefty monthly premium for my Medcaid coverage (but that’s because I’m employed). In theory, I’m not opposed to the idea of co-payments. Health care is one of those things in which people should feel invested, even if it’s at a very basic level. A small co-payment for things like ER visits might encourage people to seek treatment sooner, before a crisis develops. I think co-payments could be structured in such a way so as to protect even the poorest beneficiaries, perhaps through a federal cap that limits co-payments to a certain percentage of income.
As I keep saying, Medicaid needs reform to remain sustainable and this is one option of many worth considering. I get frustrated with lawmakers, many of them fellow Democrats, who seem unwitting to look at even modest changes to Medicaid. I’m totally with them on ensuing access to quality care for as many people as possible, but I think that goal doesn’t necessarily clash with making the system a little more participatory as well. Don’t tell anyone, but I think Medicaid could serve as the precursor to some kind of national health insurance. And if we’re serious about making national health insurance a reality, we need to start by addressing the problems and inefficiencies in the current model.
“I could think Medicaid could serve as the precursor to some kind of national health insurance. And if we’re serious about making national health insurance a reality, we need to start by addressing the problems and inefficiencies in the current model.” -amen to that! Perhaps if tax dollars paid for healthcare then the focus would be more on curing people then on hooking us on treatments that only treat the symptoms and have us coming back for expensive visit after visit.
My application for Medicaid hasn’t been completed yet, so I am not fully informed about it…does every state have a co-pay set up? I was told that my medical services would be 100% covered, which doesn’t necessarily preclude co-pays, it just wasn’t mentioned. Here in NJ, a lot of the community aid programs, including health clinics, work on a sliding scale. I agree that Medicaid/Medicare need to be reformed, and that patients should certainly contribute to their healthcare. But there are also very disturbing cases where providers will bill patients up to 50x higher rates for services that are not covered by insurance/Medicaid. That is, they have a rate they charge and are paid by insurance and/or Medicaid. But if that coverage runs out or does not cover something for that patient, then they hike up their rate when they bill that patient separately. I’ve seen this with my own bills, and have a hard time fighting it, despite written proof. While I understand that providers are not always getting the fees they should get for services, it doesn’t seem right that they take advantage of the system that way. By doing this, they impoverish more patients, who then have to apply for more aid, which isn’t available. Shouldn’t there be a way to reform the system to break this cycle, not to mention putting crooks in their place? 😉
Perhaps if our Congress folks had to rely on medical care as the constituents do they would be more interested in reform. Same with their pensions and salaries too. 🙂