BY: B. Keith Plunkett @Keithplunkett
Democrats and left-leaning groups have continued to push the expansion of Medicaid in Mississippi over the past few weeks.
A group calling itself the Mississippi Health Care Access Coalition has been touring the state using the same set of numbers released a year ago. They also say expansion will promote preventative care and create savings by reducing emergency room visits. That explanation, like many that continue to be promoted, has also been debunked by a study released this week.
Rep. Cecil Brown wrote an Op-Ed in support of expansion that went out to news outlets across the state last week. He used the recent passage of the incentive package to bring Yokahama Tire to Clay County as a comparison to incentivizing the creation of jobs in the medical industry by expanding Medicaid.
Out of all the explanations I have heard given by Democrats for expanding the program, I believe Rep. Brown’s has been the most well-thought out and presented so far. However, he still relies on an “apples-to-oranges” comparison of 2 industries that work nothing alike. Beyond the comparison of the dollar to dollar investment by the state, the government regulations and the return on investment are completely different.
There are plenty of conservatives out there who aren’t too happy about the Yokahama tax incentive plan and the state investment in a private enterprise. But, at least that offers a return from the private generation of wealth from creation of goods and provision of services.
Creating 9,000 jobs by expanding Medicaid, if that number is anywhere near correct, is still creating 9,000 jobs DIRECTLY dependent upon government continuing to subsidize.
State government investment in federal government subsidies that creates more government and more subsidy doesn’t create anything but more dependence. Where in that scenario does private investment begin to spin off and take up the slack? I think we all know history shows us that it doesn’t.
The expansion proponents rely on two basic arguments:
- The federal government will cut DSH payments to hospitals meaning hospitals in Mississippi who rely on federal dollars will have to close. This has already been revealed to be a bogus argument, and we have seen hospitals back away publicly from promoting it. I won’t go into it any further here, but you can read more HERE.
- Medicaid expansion will increase healthier lives through preventative care and therefore healthier outcomes for the working uninsured who now must rely on services via emergency room visits when they are sick.
As I have written before, there are many studies that show the actual physical outcomes of traditional Medicaid patients fall short of even those who have NO insurance.(Again, not going into that here, but you can read more HERE.)
Medicaid is a program with terrible health outcomes for those who are on the program now. Unfortunately, that still doesn’t clearly tell us how the expansion of the program would fare among those who are currently in relatively good health and “work but can’t afford health insurance.”
Like Rep. Brown’s investment argument, that too wasn’t a clear comparison. How will outcomes change as a result of a healthier group of people receiving benefits and therefore leading healthier lifestyles and participating in preventative care? We could only look to the outcomes the program has produced so far, from the sickest of the sick.
Until Now.
Now we do have just such a comparison. And, it proves once again that the basic arguments for expansion don’t stand up in the real world.
Oregon has been sited by some as an example of what Medicaid expansion would look like, and how wonderful it would be. The state expanded it’s program through a federal pilot project in 2008. The participants in the expansion were drawn from a lottery of working poor applicants. A health study group was formed to analyze the data of 6387 adults who were randomly selected to be able to apply for Medicaid coverage and 5842 adults who remained uninsured.
Measures included blood-pressure, cholesterol, and glycated hemoglobin levels; screening for depression; medication inventories; and self-reported diagnoses, health status, health care utilization, and out-of-pocket spending for such services.
The Results of the Study Don’t Look So Good.
The results of the study were released last week. It found no significant effect of Medicaid coverage on the prevalence or diagnosis of hypertension or high cholesterol levels or on the use of medication for these conditions.
The Oregon Health Study Group’s conclusion published in the New England Journal of Medicine was that the study showed that Medicaid coverage generated no significant improvements in measured physical health outcomes, and no measurable decrease in emergency room visits.
Hello?! Isn’t that what every study has told us over the past two decades?
The use of the services by new enrollees and the costs to the taxpayers providing those services increased. As did the mental well-being of the new enrollees due to a lessened financial strain.
Call me crazy but the cost of expanding Medicaid seems a lot to pay just so someone can feel better about dying faster.
Let’s get past this idea that government expansion creates anything other than a feeding frenzy and a reduction of service to those who really need it.
Medicaid should remain for the most needy among us. The last thing anyone wants are the disabled and elderly left to die alone and without medical services.
The Division of Medicaid is preparing to notify them that they are about to lose their coverage.
Democrat’s and this coalition should stop this ridiculous effort to throw the sickest among us out in the street to prove a political point. They should get to the table now and get this done.
The Oregon study is the last nail in the coffin. Pun intended. It’s time to reauthorize the program and move on.
About Keith: Keith Plunkett has worked on communications issues with a range of public officials from aldermen to Congressmen, and a variety of businesses, governmental agencies and non-profits. He serves or has served as a board member of several non-profit, civic and political organizations. Contact him by going to HorizonMediaMarketing.com or follow him on Twitter @Keithplunkett
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