Medicaid

Federal and State spending has been increasing about 10% per year, and is expected to increase. The trouble comes in that Bush and Congress do not want to provide the funds, and neither do the States who have their own fiscal troubles:

May 9, 2005 Center on Budget and Policy Priorities
FRAMING THE CHOICES
By Robert Zahradnik, Iris J. Lav and Elizabeth McNichol
http://www.cbpp.org/5-9-05sfp.htm

State revenues increase, but not at the levels needed to fund the fast-growing Medicaid Cost. State Governors and Legislators have turned at least fiscally conservative, and remain opposed to Tax increases. Many States still pass backloaded Tax Cuts, which will cut additional Tax revenues in the face of rising Costs overall.


States Propose Sweeping Changes to Trim Medicaid by Billions
By ROBERT PEAR
Published: May 9, 2005
http://www.nytimes.com/2005/05/09/national/09medicaid.html?hp&ex=1115697600&en=a22d0d23988af62b&ei=5094&partner=homepage

This article clearly outlines the Thought pattern at the State level on methodology to trim Medicaid Costs. There are serious Outcome problems with this set of options. No Co-Payment system will raise more than marginal revenue when dealing with a subsistence medical insurance for Poor people; Collection Costs will exceed gainful benefit, while medical Costs will revert to Emergency Room Costs explosion. Limiting Medicaid rolls in an artificial manner will also lead to the previous described effect. Such Changes will always fail.

Author's Proposal:

Medicaid is Subsistence medical insurance, therefore, adequate rather than superior medical aid stands sufficient. Medicaid cannot survive dealing as freely in a highly-financed Private health market. Medicaid Rules of Payment must be altered:

1) Doctors, Clinics, and Hospitals must submit a Weekly and Monthly bill for their Medicaid patients. This will be a Combined Bill for all Patients, submitted in a manner where Payment can resemble reimbursement for Employee services.
2) Medicaid will pay a set price for Each medical service according to a Bluebook schedule of medical services--uniform through the U.S. for Medicare and Medicaid.
3) Doctors and Clinics will be paid a uniform rate per Patient visit not to exceed a Weekly, bi-Weekly, or Monthly remuneration level set by Bluebook schedule, whereas after payment of this amount; Doctors, Clinics, and Hospitals are considered Employees of Medicaid, or Medicare, and must provide medical aid for all Said Patients whatever their final number. lgl