Good list of ten myths about Medicaid (pdf).
Myth 3—Medicaid spending is out of control.
FACT: The per enrollee cost growth in Medicaid (6.1 percent) is lower than the per enrollee cost growth in comparable coverage under Medicare (6.9), private health insurance (10.6), and monthly premiums for employer-sponsored insurance (12.6).
One would think this next would be obvious, but apparently, it’s not:
Medicaid is a program that is most in demand when the country is experiencing economic difficulties. Over the past few years Medicaid spending growth increased due to a sharp rise in enrollment of children and parents in low-income families during tough economic times. However, the spending growth has moderated as the economy has improved. Although Medicaid costs continue to increase, so do health care costs throughout the American health system, indicating there is a more systemic issue of rising costs.
Myth 6—Medicaid is a welfare system for people who don’t work.
Fact: Sixty-five percent of people who receive Medicaid are from working families.
The program was originally designed to provide coverage to welfare recipients, but it was separated from the welfare system in 1996. Among those beneficiaries who are out of the workforce—such as individuals with severe disabilities—Medicaid coverage serves as a supplement to their cash assistance and provides needed health coverage.
Oh, and Medicaid isn’t one size fits all rigid, either, so there’s no earthly reason conservative governors can’t “innovate” right now. They don’t need Ryan’s plan, unless they’re planning on throwing people off:
Myth 2—Medicaid is a rigid, one size fits all program.
FACT: States have taken advantage of Medicaid’s flexibility to customize their program-about two-thirds of Medicaid spending is for “optional” services or populations. Medicaid is designed with minimum federal standards, which require states to cover certain populations and provide certain benefits to key populations. In many ways it is a system that operates as 50 separate state coverage programs, with states having the choice to cover populations and services beyond minimum standards.
a republican
What? Do you think FACTS will convince me? Pfaugh!!
Comrade Dread
That’s all well and good, but you should know that facts have no place in our political system.
They’re boring. They’re inconvenient. They don’t get you elected.
Screaming loudly about how the everyone should pay for themselves or go get drunk and perform self-surgery like the old American pioneers, and not like you damn pussy hippies who want the government to take care of you and meet your every need, and you’re just too damn lazy to get a job…
Now that’s the stuff people want to hear.
PurpleGirl
I’ve mentioned this before but it bears repeating: When I lost my health insurance through COBRA, it took a few months but I finally looked into NYC’s municipal hospitals and Medicaid. My experience the last 6 or 7 months is that I’m getting better care and attention than I did from the private group practice I’d been going to.
Martin
Medicaid costs vary considerably by state.
And look at how many red states received a better than 1:1 match from the feds.
Roger Moore
@PurpleGirl:
But, but that’s unpossible. Free Markets! Invisible Hand! Government is the problem, not the solution! *Head Explodes*[/wingnut]
JoeG
do other “free” government’s politicians lie so blatantly to their citizens?
NJ Guy
This is an issue that is so frustrating to try to explain to my Republican friends. My wife has her own business and do some consulting work part-time. Thank goodness for her association insurance, but we could never afford it for the whole family.
NJ Familycare allows us to cover our kids on a sliding scale based on our yearly income. The worst part about it is the lack of dentists that accept it (and the condescending looks from uneducated, judgmental doctor’s office personnel), but for the most part it’s the difference between barely making ends meet and living comfortably, despite not being able to find fulltime work with benefits for over a year.
PeakVT
Medicaid is a program that is most in demand when the country is experiencing economic difficulties.
Well no wonder Republicans hate it. It goes against their principle of kicking people when they’re down.
Hunter Gathers
When I got laid off, I didn’t even bother with COBRA. We went strait to Medicaid. And it’s 10 times better. We got to keep our doctor, and don’t have to deal with the bullshit that is Anthem. But then again, I live in Illinois, where we don’t elect TeaBagger Governors.
Han's Solo
Republicans prefer myth to fact, so don’t expect this to change any “Wingnut minds.”
Montysano
There was a recent BJ post about health care that had a link to an article at Reason.com. Having never visited the often-mocked site, I clicked over.
I’ve been around for a while and Am Aware of Most Internet Traditions, but the comments at Reason were truly shocking, running along the lines of “Fuck Grandma and her busted hip. She should have known she was buying into a Ponzi scheme (i.e.Medicare) these last 40 year!!” It was stomach-churning.
As a Nation, it’s one thing to say “We truly can’t afford to care for the elderly and weak”; it’s quite another to proudly declare that we just don’t want to.
demz taters
@PurpleGirl: I feel the same way about my socialized care from the VA.
Omnes Omnibus
@Montysano:
In the case of the US, making the first statement is really just a “serious” way of making the second one. We can certainly afford to do it. We just need to care enough to do it.
jonas
Attacking Medicaid and Medicare as programs for rising costs is like attacking service station owners for the high price of gasoline: they’re just passing on the costs they incur because of oil markets. Medicare is busting our budget not because of the program, but because the costs of our health care system are out of control.
Costs are still going up in other countries with single payer or universal health care, mostly due to more expensive technologies and increased demand from aging populations, but they’re increasing at a far slower — and more manageable rate — than ours.
Martin
@Montysano:
Out of ideological spite, no less.
Elie
@jonas:
And in part, behind, or rather, supporting the runaway costs are salaries and income to providers AND the number of ancillary services and companies (read “consultants” – actuarial, management, data and analytic)who provide services to the health care providers, insurers and the government. Uwe Reinhardt (Princeton health economist) has written about the lifestyles Americans are happy to provide not only to docs but also the supporting administrative and managerial infrastructure of the institutional providers and all the other “consultants”.
Kay, thanks again for succinctly summing up these critical facts about Medicaid. It can’t bear repeating enough. Its no different, in fact, in some ways worse, for the private sector.
Remember though, this is gonna be a hard hard fight. The last time this was tried with trying to give managed care plans a little power over docs back in the 90’s, we know what happened: the managed care plans were villified and the docs and providers allowed to go back to their same ol same ol.
atlliberal
In Georgia, you don’t qualify for medicaid, no matter how poor you are, unless you have a dependent child. If you finally (after one to two years) get approved for disability, you go on medicare. (I discovered this when a friend of a friend needed a place to stay and a week later was hospitalized with asthma, emphysema, bronchitis as well as an anxiety disorder and could no longer work.)
atlliberal
“Flexibility” is not always a good thing.
Poopyman
OT, but yesterday’s post on titling Palin’s movie is still going on. Awesome!
Carry on.
Omnes Omnibus
@atlliberal: The flexibility to do things differently should come with a requirement that certain minimum standards of coverage be met.
Chris
@Han’s Solo:
“The great enemy of the truth is very often not the lie — deliberate, contrived and dishonest — but the myth — persistent, persuasive, and unrealistic.”
JFK knew what he was talking about.
cckids
Kay, thank you for your consistent attention to this. As I’ve stated before, my (severely disabled adult) son has been on Medicaid since he was 1 year old and my employer-provided health insurance threw him off. While it is often a pain in the ass (unlike ANY other health insurance, right?), and sometimes docs are hard to find, IT KEEPS HIM ALIVE. The rest of our family has been insurance-less since 2005; we fall into the crack between being completely poverty-stricken & being able to find an extra 4-500 per month for coverage. Having to stress & worry about how or if you can afford to take a child to the doctor sucks mightily. Knowing that the child who most desperately needs health care will always be able to get it saves my sanity. His medical bills are unimaginable. Thank FSM for Medicaid. If we were thrown onto the “free market” for him, he’d be dead.
Chris
@Montysano:
But people do. It’s most of the reason Ayn Rand’s popular on the right. At the end of the day, plenty of the True Believers are just plain tired of having to pretend to care, of having to mouthe platitudes like “of course we care about the poor, we just think the free market is the best thing for them…”
Ayn Rand and those like her (like the person you linked to) do away with that and go the whole nine yards to say “fuck the poor, let ’em die in the streets.” And because a ton of people felt that way in the first place, they’re wildly popular.
atlliberal
@Omnes Omnibus: but that would be “socialism” ;)
bago
Costs are skyrocketing because of our fucking retarded informational infrastructure, billing especially. The HL7 spec is being abused by every hospital network, half of the staff is on the phones with insurance companies working out billing, paper is being used to store vital info,and it takes 3handwritten forms to even begin a procedure, of which half of the data has already been submitted.
DATABASES PEOPLE! Learn ’em. Fuck!
BDeevDad
I find it ironic and sad that most people who are spreading these myths have never had a major medical issue in their lives until they are old enough to get medicare.
Sad_Dem
I look forward to the Democratic Party’s ad campaign that informs voters of the 10 Republican Lies about Medicaid.
Madeline
Nursing homes, nursing homes, nursing homes. I personally know of at least half a dozen elderly people, two of whom are in my family, that used Medicaid to pay for their nursing home expenses. Neither my grandmother nor my aunt were poor, but both lived into their 90ies (my aunt is still living) and their own assets sure didn’t last long once they started paying $3-$6K per month in a nursing home.
I simply can’t believe that there aren’t many, many families with this same experience. Nursing homes are expensive and your own money gets used up in the blink of an eye. Without Medicaid, what does Paul Ryan suggest these people do?
catdevotee
@Madeline: I read recently that 60% of Medicaid payouts were for nursing homes, so yes, there are lots of families who would be bankrupted to pay for Granny’s care if there were no Medicaid.
Maude
@cckids:
New Jersey is changing Medicaid for some recipients.
PurpleGirl
@Madeline: Without Medicaid, what does Paul Ryan suggest these people do?
The children and grandchildren should go into debt for their senior relatives and, when the times comes, go bankrupt. Because we all must be responsible for ourselves. The alternative is probably feed the oldsters poison.
Madeline
@PurpleGirl: I guess in Mr. Ryan’s world, my aunt will have to choose the poison, since she never had any children. I wonder if Paulie has any frickin’ idea how paralyzed with fear a frail, 90 year old woman gets when she’s running out of money, can’t physically take care of herself anymore and has no other option besides a nursing home?
The anguish they so blithely foist on people who are already hurting makes me sick to my stomach. Or else it makes me want to smack somebody hard across the mouth.
Ruckus
@Madeline:
To be blunt, he expects them to die. Earlier. Much earlier than necessary.
People who think like that are what us lay people refer to as sociopaths. They are amoral.
rikyrah
@Madeline:
ICAM Madeline.
there are plenty of folks who CANNOT AFFORD what it costs to have Mom or Dad in the nursing home.
I’ll say it again..
they better wake.the.fuck.up.
Elie
@Chris:
sorry that I am late to the responses and comments —
That’s called getting “civilized” and moving up the evolutionary chain. Very independent of POLITICS, anthropologists and archeologists evaluated ancient civilizations by their ability to take care of the weak and powerless… It is very easy not to care about the weak and powerless. That mental state is called WILD ANIMAL. Its easy and immediate. The strong overpower and destroy the weak and that is that. We have centuries of a different value system working as well… how about for starters, the soldiers hauling their wounded from the front? We have many societies of humans all over the earth that work together to provide a net under those who are helpless and weak. Those that do not are considered — uncivilized and primitive (though I use that term with a great deal of cynicism since nothing is more “primitive” than modern mankind).
Elie
@Madeline:
And lest you think that nursing homes are “overcharging” for care, do the math yourself. Think about what someone should be paid for all the “body care” – bathing, lotioning, feeding, watching for safety. Then, the next level of care: CARING: tenderness, remendering preferences, kindness, anticipating want and need, looking for “bad things”, communicating needs to appropriate chain of commmand. Add following up and nagging when things don’t get done or when things are done BADLY. Put a dollar value on THAT. How much is a painful ulcer on your backside worth? How much being offered fluids and water timely? How much getting the right meds on time?
I could go on….We are hiding in false modernity and chosing that over being civilized. Lets hope we wake up. The costs are huge to stay the way we are…..
Joey Maloney
11. MYTH: Points one through 10 are myths, that is, stories from a distant past whose origin is so lost in the mists of time that no one really knows where they came from.
FACT: They are LIES, currently and actively promulgated by the Republican party in an effort to keep the American public ignorant about the basic facts of its government.