Harvey is a disaster.
It is also a massive shock to the Texas medical system.
It is a corner case that should be used to test any major health policy idea against. A few weeks ago, I outlined how I think about policy proposals. One element is critical:
2) Corner cases
The $12 million dollar man in Iowa is a market distorting corner case that drove every insurer but one out of the market. How does any policy handle a case like this? California has a $21 million dollar claim year from a single individual on Medicaid. What happens when state revenue collapses and eligibility goes up? Is this person sacrificed?
If the United States was to adapt Medicaid block grants where the entire incremental spending above a baseline was the responsibility of the state as proposed in AHCA, BCRA, ORRA and now Cassidy-Graham-Heller, how would it work for Texas?
We know that there is going to be a significant hit to Texas tax revenue as the largest city in the state is shut down for at least a week if not months with only gradual resumption of normal activity. We know that people will be massively displaced. We know that evacuations are prime infectious disease transmission systems. We know that social networks are incredibly disrupted. We know that Houston is currently being bathed in sewerage and flood water.
How would Texas cope with an unexpected shock the size of Harvey to its healthcare and health finance system?
I had keyed on how does a system deal with a recessions like 2008-2009 as that scarred me. But similar questions need to be raised using Harvey or Katrina or Zika as the scenario generators for the hard edge cases when massive changes to the status quo are being proposed.
Msb
Turning down the Medicaid expansion was a really lousy decision.
Thanks, Republicans in Texas! /s
ArchTeryx
Hoocouldanode that denying a quarter of your population access to medical care would be a bad idea – particularly in a high transmission environment like a natural disaster?
Hurricanes don’t care if you are rich or poor. Neither does cholera. The poor always suffer more, but widescale natural disasters are something of a leveler.
Too bad Texas Republicans believe in human sacrifice.
Mike Furlan
The goal of Medicare Block grants is to as quickly as possible to zero out the grant.
Texas: “Do you expect me to cope?
Republicans: “No, Texas, I expect you to die.”
Fair Economist
The Republicans in Austin are going to slash state spending too, because they have to balance the budget – to avoid – um, er – hyperinflation!
Ceci n est pas mon nym
You know those bastards will be calculating a way to make the mortality fall on Democratic-leaning areas.
WV Blondie
When the Obama administration set up its plan to save the U.S. auto industry – and President Obama had already made it clear he was going to tackle healthcare – I hoped he would use the industry as an opportunity for healthcare pilot programs. Between the employees themselves, their dependents, and all the retirees, there could have been at least two, maybe three, groups large and diverse enough to have statistical significance, and everyone could see what worked, both in terms of cost and in terms of health outcomes. It’s always seemed to me that one whopping big problem with legislation setting up big programs (e.g., ACA) is having some sense of how good intentions work out in the real world.
Snarki, child of Loki
@Ceci n est pas mon nym: “You know those bastards will be calculating a way to make the mortality fall on Democratic-leaning areas.”
Adult-onset Zika is a terrible thing. Who amongst the GOP base has not felt its sting?
jc
This blog is Trump’s Harvey.