When ‘Single Payer’ Won’t Pay

Published July 26, 2017

Medicaid used to be the program providing health care and medical services to the poor. Before Obamacare, Medicaid covered primarily poor retirees, children in poor families, and the disabled living in poverty — the “truly needy.”

Despite all the hysterical name-calling about the Republican bill before Congress, everyone on Medicaid today is individually grandfathered under that bill, as public policy expert Betsy McCaughey has recently explained. No one presently on Medicaid will be thrown off under the Republican bill.

Obamacare’s great innovation was to expand Medicaid to working-age, nondisabled adults not living in poverty (with income up to 138 percent of poverty). That has added about 16 million more dependents to Medicaid since Obamacare became operational, an increase of almost 30 percent in just five years. As a result, nearly 70 million Americans are now dependent on Medicaid, which was originally supposed to be a safety net program for the poor.

But adding millions more Americans to taxpayer dependency on Medicaid is not a solution for the uninsured. Even though Medicaid already spends hundreds of billions a year in federal and state funds, the government does not pay doctors and hospitals enough to assure that the poor dependent on the program can get essential health care when they need it.

That is why medical studies show that health outcomes for the poor dependent on Medicaid are not any better than for the uninsured. Scott Gottlieb, now director of the Food and Drug Administration, discussed some of these studies in The Wall Street Journal in March 2011 (“Medicaid Is Worse Than No Coverage at All.”)

One study of major surgical procedures “found that being on Medicaid was associated with the longest length of stay, the most total hospital costs, and the highest risk of death.” Another study of throat cancer “found that Medicaid patients and people lacking any health insurance were both 50 percent more likely to die when compared with privately insured patients.”

Similarly, a study of heart patients “found that people with Medicaid who underwent coronary angioplasty were 59 percent more likely to have strokes and heart attacks, compared with privately insured patients. Medicaid patients were also more than twice as likely to have a major, subsequent heart attack after angioplasty as were patients who didn’t have any health insurance at all.”

The deadly problem was illustrated by the case of 12-year-old Deamonte Driver, from a poor Maryland family on Medicaid. When Deamonte complained of a toothache, his mother tried to find a dentist who would take Medicaid. But only 900 out of 5,500 dentists in Maryland do.

By the time she found one, his tooth had abscessed, and the infection had spread to his brain. Now she needed to find a brain specialist who took Medicaid.

Before she could find one, the boy was rushed to Children’s Hospital for emergency surgery. He called his mother from his hospital room one night to say, “Make sure you pray before you go to sleep.” In the morning, he was dead.

This is why the Congressional Budget Office is wrong to even count those on Medicaid as insured. Medicaid has gone from a program of assuring essential health care to the poor to effectively an institutionalized means of denying health care to the poor (by failing to pay the doctors and hospitals enough to treat them).

This is exactly what would happen to all Americans under the Democrats’ much revered, so-called “single payer” health reform dream. They never question what happens under “single payer” when the single payer won’t pay?

The much-denounced Republican health reform plan includes fundamental Medicaid reforms that would address this problem by transferring control over Medicaid to the states through block grants, or similar options. The states, as in Indiana and Rhode Island, have proven that they can reform Medicaid to better serve their needy poor, actually assuring access to health care.

[Originally Published at the Washington Times]