Wednesday, January 7, 2015

Walker lets BadgerCare doctor fees plummet...see, government is bad.

It's kind of upside down crazy. Scott Walker is all about supporting that old expensive health care system and its hefty doctors fees. After all, that's your problem and very free market.

But boosting slightly the already very low doctor fee structure in Medicaid is to costly. Technically, Medicaid fees are a bargain and cheap, and all President Obama wanted to do was pay doctors a much fairer fee, and keep them in the program.

Crazy. Who wants government to work? Not Walker:

Here's the real story, see for yourself. What we're seeing is a very incurious and dangerously misinformed governor and likely candidate for president. Bloomberg:
Medicaid Is Too Cheap: On New Year's Day, an Obamacare provision that temporarily boosted Medicaid payments to primary-care doctors expired. The pay doctors receive for seeing those patients will drop by an estimated 43 percenton average. The change could cause more doctors to stop seeing people on Medicaid, which covers the poorest Americans.

Conservatives will undoubtedly present the change as further proof that Medicaid, which is expanding thanks to the health-care law, isinherently flawed. There's another interpretation: If the goal is to cover lots of people at minimum cost, Medicaid is extremely effective. If anything, it's too cheap.

The chart shows that Medicaid spending per beneficiary is lower than average per-capita health costs. It also shows that, as of 2013, Medicaid spending was lower, in real dollars, than it was a decade earlier. (The uptick in 2013 probably reflects, in part, the extra money for primary-care doctors provided by Obamacare.) The optimistic interpretation is that Medicaid is a tremendously efficient program. The pessimistic one is that state administrators of Medicaid are pushing payments to unrealistically low levels.

The second interpretation is probably closer to the truth. And at some point, conservative warnings about the dysfunctions of Medicaid will become self-fulfilling: Providers will stop participating, pushed out by spending restraint that no other health-insurance program would dare match. If that happens, the program won't be to blame. While some states are boosting Medicaid payment rates in response to the end of the Obamacare top-up, many aren't. So those most responsible for doctors dropping out will be the state officials who complain about out-of-control costs, even as they squeeze Medicaid ever more tightly.

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