Marc YachtThe Florida House’s rejection of Medicaid expansion money affects more than just the poor. A recent Tampa Bay Times editorial outlined 25 reasons to accept the federal money.
Because of House members’ rejection, 800,000 low-income Floridians are now shut out of health care coverage. Many working poor who now pay high premiums for Obamacare face high deductibles. One rightly questions the value of insurance without protective subsidies.
Significant numbers of uninsured will continue to use Florida emergency rooms. That pressures insurance premiums and health care costs to rise. A fully insured population would break the cycle of escalating health care costs.
By refusing the expansion money Florida lost $700 million in 2016, and billions more down the road. That loss ripples outward to affect healthcare providers, pharmacies, medical equipment suppliers, the business community and all Florida residents.
Arguments against accepting the money are disingenuous at best and relate solely to the ideological hatred of President Barack Obama. Many who support that bias work against their own interests. The opportunity for comprehensive care will be lost to hard-working families. Federal taxes paid by Florida residents are then sacrificed to Obamacare-friendly states.
In all fairness, Medicaid offers second-tier discounted coverage. Many doctors reject it. However, it does open the door to a full range of services including primary care, specialty care, and hospitalizations.
Free clinics rarely offer comprehensive services. Placing the Medicaid insured into managed-care models further reduces the options for care because those insurers profit by limiting patient care. That conflict of interest has defined the managed-care model. Also, doctor scorecards unfairly flag physicians for statistically driven increased patient costs. The health care management model can determine what services a doctor may perform. Yet the physician remains responsible for outcomes.
In spite of all the emphasis on healthcare cost containment, the U.S. significantly exceeds per capita healthcare costs worldwide. Wise efforts should be directed at reducing administrative costs that can consume 20 percent or more of the health care dollar. Such costs result from the fragmentation of insurers, complex billing practices and onerous oversight.
A valid argument exists that Obamacare is too expensive to provide universal coverage. Yet those same critics block every effort to reduce healthcare administrative costs. Naysayers protect not only highly profitable insurers but also protect provider profiteering. And, of course, the uninsured place further pressure on costs.
Whenever the circular arguments vis-à-vis the outrageous costs of health care occur, rarely is there any movement to effectively address excessive charges, administrative costs and fragmentation. Those remain off the table.
That brings up the “Medicare for All” model with administrative costs under 5 percent. Every provider would save significantly because of the simplicity of the coverage. It’s criminal to allow the profiteering to continue while criticizing the lack of resources to provide universal health care to Americans.
Universal coverage would allow all Americans access to needed preventive and episodic care. Chronic conditions would be addressed and no one would have to delay needed care for fear of cost.
We stand alone from wealthy nations that have successfully provided universal health coverage for decades. Those nations surpass us in the overall health and well-being within their countries. Such political confusion regarding affordable healthcare for every American is unforgivable.
Marc Yacht M.D., M.P.H. is a retired physician living in Hudson. This column courtesy of Context Florida.
