Another Obamacare Mess: Medicaid Dumping

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Among its many problems, ObamaCare expands Medicaid, the beneficiaries of which are almost twice as likely to die in the hospital than those with private insurance, according to recent studies.

In an op-ed published in The Wall Street Journal, American Enterprise Institute scholar Dr. Scott Gottlieb — a practicing physician — recently highlighted some of the problems with Medicaid and how ObamaCare expands the program by dumping more Americans into it.

According to Gottlieb, “Half of those gaining health insurance under ObamaCare will get it through Medicaid; by 2016, one in four Americans will be covered by the program.” ObamaCare accomplishes this primarily by raising the income thresholds at which individuals are considered eligible for the program, ensuring more Americans will be designated “poor.” It is estimated that this change will push an extra 25 million people into the program.

This creates numerous problems, especially since Medicaid is ineffective in its current form, and rife with problems. Simply “dumping in” millions more Americans is hardly a solution to our nation’s health care problems. In fact, as Gottlieb demonstrated in his op-ed, the policy is

likely to do far more harm than good.

For instance, Gottlieb examined a 2010 study published in the medical journal Cancer, which concludes Medicaid beneficiaries with head and neck cancer were “50 percent more likely to die when compared with privately insured patients — even after adjusting for factors that influence cancer outcomes.” He also highlighted a 2010 study published in the Annals of Surgery, which shows that “being on Medicaid was associated with the longest length of stay, the most total hospital costs, and the highest risk of death. Medicaid patients were almost twice as likely to die in the hospital as those with private insurance.”

Another report cited by Gottlieb, a 2011 study published in the American Journal of Cardiology, “found that people with Medicaid who underwent coronary angioplasty (a procedure to open clogged heart arteries) were 59 [percent] more likely to have ‘major adverse cardiac events,’ such as strokes and heart attacks, compared with privately insured patients.” And finally, he pointed to a 2011 study published in the Journal of Heart and Lung Transplantation, which concluded “Medicaid patients [undergoing lung transplants for pulmonary diseases] were 8.1 [percent] less likely to survive 10 years after the surgery than their privately insured and uninsured counterparts.” In other words, in some cases, having Medicaid is worse than having no insurance!

These are serious problems, and point to major flaws in Medicaid. Yet, rather than proposing common-sense solutions to fix this fundamentally broken program for the neediest Americans, President Obama’s new health care law simply dumps millions more Americans into it.

So why move forward with this expansion of Medicaid? Gottlieb proposed an insightful theory: “[T]he liberal solution to these woes has been to expand Medicaid. Advocacy groups like Families USA imagine that once Medicaid becomes a middle-class entitlement, political pressure from middle-class workers will force politicians to address these problems by funneling more taxpayer dollars into this flawed program.” This makes sense: after all, ObamaCare is full of provisions that are disastrous policy but politically advantageous to the administration’s friends and allies.

Dr. Gottlieb offered an interesting solution, one that I believe could free up more resources by tailoring the program to help the sickest and poorest Americans in need: “We need an alternative model. One option is to run Medicaid like a health program — rather than an exercise in political morals — and let states tailor benefits to the individual needs of patients, even if that means abandoning the unworkable myth of ‘comprehensive’ coverage.”

Medicaid was not created to provide comprehensive coverage to the middle class. It was intended as a safety net for the most vulnerable Americans. We should re-focus our efforts on providing them quality health care rather than dumping more people into a flawed program.

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