Category: Health Care

Designing An Alternative to Medicaid Expansion

Key components for an alternative to Medicaid expansion: Catastrophic insurance. A private insurance policy provides catastrophic coverage, protecting individuals (and taxpayers) from large, unexpected expenses and giving individuals peace of mind that they are covered if they need major surgery or need expensive treatment for a condition such as cancer. Private insurance means individuals avoid the problems with many providers refusing to see new Medicaid patients. Reasonable cost sharing. The coverage is not free, but requires reasonable payments of up to 5 percent of income. This limits “crowd out” where individuals who are already paying for insurance drop their private insurance for the “free” government coverage. According to the Census Bureau, 222,000 adults with income below the Federal… View Article
RON BACHMANSenior Fellow, Georgia Public Policy Foundation Georgia Public Policy Foundation senior fellow Ron Bachman discussed Medicaid expansion and improved access to health care during a recent guest segment on GPB’s “On The Story.”  The video is available online.  Bachman supports improved access to healthcare for all Georgians but he opposes Medicaid expansion. “I am worried about access to real quality healthcare,” said Bachman. “In the private market 79 percent of physicians accept children but in the Medicaid market only 47 percent do.  One of the reasons we have our emergency rooms and hospitals packed with so many Medicaid patients is that primary physicians won’t see them so their only choice is to go to emergency rooms.” The panel… View Article
There are many downsides to adding even more people into an expensive, over-regulated Medicaid program,[1] but that doesn’t mean Georgia shouldn’t try to propose a better option. This is an opportunity to create a less expensive, more effective plan.   Goals of Expanded Access: Insure for unexpected, expensive health care outcomes to protect individuals and taxpayers Improve health outcomes by improving access to primary care Discourage expensive trips to emergency rooms for routine care Discourage crowding out private insurance coverage Called “the most innovative and successful reform of Medicaid in the history of the program” by Forbes magazine’s Avik Roy, Indiana’s expansion of health insurance to low-income citizens is a good model to analyze. Healthy Indiana[2] The Hoosier State’s… View Article
The federal government spent more on broken state-run exchanges than it did on its own troubled system. Of the 14 states, plus the District of Columbia, that established their own health insurance coverage under Obamacare, seven remain dysfunctional, disabled, or severely underperforming. Development of those exchanges was funded heavily by the federal government through a series of grants that totaled more than $1.2 billion—almost double the $677 million cost of development for the federal exchange. The Reason Foundation published a rundown of the troubled state exchanges and the federal grants they qualified for. Oregon No exchange failed more fully or more spectacularly than Cover Oregon. The site was touted as an ambitious, expansive vision for what a state-run exchange… View Article

Concierge Care for the Little Guy

By Jordan Bruneau Imagine filing a home insurance claim every time the neighbor’s kid cut your lawn. That’s how physician Lee Gross sees the U.S. health care system: We use insurance for basic maintenance. Filing claims for a stubbed toe or cold has driven up the cost of health insurance in much the same way that filing claims for a fresh coat of paint or carpet cleaning would drive up the cost of home insurance. “We are taking affordable primary care,” Gross says, “and bundling it together with a health insurance program that has to cover hospitalizations, chemotherapy, expensive surgeries and end-of-life care.” The key to bringing down health insurance costs, he claims, is to divorce basic maintenance from insurance-based… View Article
By Medicaid needs reform, not expansion. This federal–state health care program provides health care to over 60 million Americans and consumes a growing portion of state and federal budgets. Research shows a long history of Medicaid enrollees having worse access and outcomes than privately insured individuals.[1] Due in part to low reimbursement, one in three doctors refuses to accept new Medicaid patients.[2] Despite access issues, Medicaid spending continues to grow. In 2010, total federal and state spending on Medicaid exceeded $400 billion.[3] Instead of reforming Medicaid, the Patient Protection and Affordable Care Act (Obamacare) expands eligibility to all individuals earning less than 138 percent of the federal poverty level (FPL).[4] The Medicaid program is… View Article

ER Costs vs. the new model of Direct Primary Care

The cost of the average ER visit is $969. Cost of primary care for a year under a new model: $600 to $720 a month for adults, with lower fees for children, according a New York Times report. In this new model, called Direct Primary Care (DPC), “patients pay a monthly flat fee directly to a personal physician—cutting out the insurance companies—to cover primary care, is known as concierge care. Long existent as a niche market, it has been derided as an elitist model for the rich and never seriously considered as a health reform for the general population.” In “Concierge Care for the Little Guy,” Jordon Bruneau, describes the practice of Dr. Lee Gross: For $83 a… View Article

With Health IT, Familiarity Breeds Content

By Greg Scandlen Health Affairs recently announced its top 15 articles for 2013, and has made them available to nonsubscribers. The top article was by a pair of RAND researchers updating what is known about the health information technology (HIT) roll out from the 2009 HITECH law, appropriating $20 billion to upgrade information technology throughout the health care system. It doesn’t take long ― like just the abstract ― to figure out that people haven’t learned a blessed thing from flushing $20 billion down the toilet.  A team of RAND Corporation researchers projected in 2005 that rapid adoption of health information technology (IT) could save the United States more than $81 billion annually. This original “study” was horrendously flawed. They… View Article

Georgia Should Maintain its Leadership in Charity Care

Regardless of Georgia’s decision on Medicaid expansion, hundreds of thousands of Georgians will remain uninsured. One immediate way to help the uninsured (and save money) is to provide access to primary care clinics instead of expensive and unnecessary trips to emergency rooms. Thanks to leadership and private support, Georgia is a national leader in charity care. Leveraging this great asset should be the first step to helping the indigent and uninsured. In 2004, the Sutherland Institute of Utah, a state-based think tank like the Georgia Public Policy Foundation, published a study titled, “To the Least of These – A Moral Case for Providing Authentic Charity Care.” The study, and a later study in 2008, outlined a charitable health… View Article

Nine Reasons to Question Medicaid Expansion

The federal Patient Protection and Affordable Care Act (PPACA) expanded Medicaid to all individuals under age 65 with incomes up to 138 percent of the federal poverty level (FPL). The U.S. Supreme Court ruled, however, that states are not mandated to expand Medicaid coverage. As of January 2014, Georgia and 23 other states had chosen not to expand Medicaid. Although most reports have indicated 650,000 uninsured individuals are impacted by Georgia’s Medicaid expansion decision, approximately 240,000 have incomes between 100 percent and 400 percent of the FPL and will be eligible for subsidies in the exchange. That leaves about 410,000 who have incomes below the poverty level but are not currently eligible for Medicaid or other subsidies.[1] So by… View Article

“I am here today to thank the Georgia Public Policy Foundation for your role in building a fiscally conservative, pro-growth state. Not only did you help pave the way for a new generation of leadership, you continue to provide key policy advice and to hold us accountable to the principles we ran on. In short, you have had a transforming influence on this state. We are healthier, stronger, and better managed because of your efforts.

State Senator Eric Johnson, President pro tempore, Georgia State Senate more quotes