Rick Perry does the right thing for Texas: No Medicaid expansion or health exchange

If you have a link to alternative numbers please provide them.

 

I don't - but bad data is not better than no data. It would be like using a CNN.com online poll if you don't have a better one.

 

I dont support gov. health care but I agree Perry is a Moran.

 

How can you disregard the Texas Medical Association's numbers so easily? Is their 67% for 2000 bad data?

 

I don't think it's at all a stretch to suggest we're already paying more than a few hundred dollars per year for the average uninsured parent. If an average person spent less than that on medical care, then insurance is a massive scam. Something like 80% of premiums has to go to medical coverage - so if your average insurance plan costs $3000 per year, then a patient is spending approx $2400 on average. So the idea that an uninsured patient would cost more than a few hundred is pretty reasonable.

The state would be spending $6 billion over several years to get $100 billion in subsidies from the federal government. That's a net win however you look at it. Those patients are already getting coverage - generally as emergency treatment. They would just now get it in a more efficient way, and the federal government would cover the vast majority of the costs - all of that is money that flows from outside of the state to inside the state.

 

All of it is bad data, because of the survey methodology:

Survey Methodology
Since 1990, TMA has conducted a biennial survey of a representative sample of Texas physicians focusing primarily on health care practice, economic, and legislative issues. The survey findings provide a cross-sectional snapshot and a longitudinal tracking of physician opinions on key health care issues and their experiences to support the association’s policy development, political focus, and strategic planning process. The 2012 Survey of Texas Physicians was conducted by TMA as a monthly e-mail survey. Approximately 27,917 Texas physicians were e-mailed a personalized link to the first part of the survey along with an announcement outlining the purpose of the survey. Preliminary data was gathered from 1,139 physicians for a response rate of 4 percent.


All of the data is suspect when you have voluntarily email responses because there is self-selection in who responds. For example, only people who have lots of time, or who care enough to proactively click the link and respond, etc. People who are content or disinterested are less likely to respond than people who are thrilled or angry and have something to say. It's not a random sample, and thus it's not scientifically sound.

 

ER costs are the only care currently provided. If you have any numbers to backup the claim that adding 1.6 million people to medicaid will pay for itself on a state level I would love to see them as well.

How is medicaid efficient? How is adding costs to an already drowning system losing providers every year a good move? When the money comes from the education budget, or when the feds change the percentage in a few years due to their own budget crisis Texas is left with the bill.

 

OK so do you think the numbers are increasing and if so any basis at all for that belief? Do you believe an additional 1.6 million people in the program will make the profitability of the system better for providers and thus convince them to join?

 

No idea of the validity of this as it's just a quick google search but:

http://shades7.hubpages.com/hub/How-About-Some-Non-partisan-Facts-on-Health-Care-Reform


According to the Federation for American Immigration Reform (FAIR), in 2004 California's estimated cost of unreimbursed medical care was $1.4 billion. Texas estimated its cost at $850 million annually, and Arizona at $400 million.


I don't know how much of that is from the potential Medicaid patients.

Medicaid is considered extremely efficient - mostly due to its low reimbursement rates.

Simply put, the two choices are this:

Option #1: Uninsured patient waits until he has an emergency, and then his care is fully subsidized by the state / local governments or the insured. *Someone* in Texas is paying for that care.

Option #2: Medicaid patient gets regular care, and 95% of that is paid for by the federal government

There is endless research showing that getting regular care is cheaper overall than emergency care. So not only are you cutting the actual costs of medical care, you're getting the federal government to pay most of the cost.

 

No - I agree with you in a general sense on Medicaid. As I said in the original post, there are likely real problems with the Medicare/Medicaid systems. I just think the data that TMA is using to show that is not sound. But I don't think anyone would suggest that dumping all those people into the ER is a better / more efficient solution to the problem.

 

Upon further review, it appears that is an estimated cost from illegal immigrants (these numbers are being used in the fight against illegal immigration). Texas is estimated to have 1-2 million illegal immigrants, so if they use medical care at the same rate as the 1.8 million that would be covered by Medicare expansion, you're looking at similar cost in the $800 million annual range that would be saved.

 

Texas is paying billions of dollars per year for a few million to have medical coverage. Depending on the source this expansion will eventually costs billions annually. Medicaid is a dismal failure in Texas and I don't think it is crazy to fix the currently failing system (find ways to fund it, find ways to keep providers in it) before massively expanding it. In the real world, you can give Medicaid to everyone but if providers lose money for each one they see, they won't see them. So the coverage becomes more and more worthless. Saying medicaid is efficient because it pays providers less than the actual costs leads to the providers fixing that problem themselves.

 

There are two separate problems here. The above is one problem - but again, Texas wouldn't be paying billions per year. As you mentioned, the cost is several hundred million per year to Texas, with federal government picking up between 90 and 100% of the cost. It's hard to see how having the feds cover 90% of your medical costs is less beneficial to Texas than having Texas cover all of the emergency costs.

This is a separate problem, but it's self-addressing to some extent through the free market. If Medicare doesn't pay for itself and all the providers drop it, it then also doesn't cost the government anything. So then your concern about the Texas budget goes away on it's own. Or Medicaid addresses the reimbursement problem, which increases viability and cost, but again would be mostly funded by the federal government.

Either way, the people of Texas already get medical care and the costs of the uninsured are already subsidized. The question at hand is whether to insure those people to reduce the emergency costs and improve overall health, and whether to have the federal government subsidize much of the cost of doing so. Right now, Texas has chosen less efficient care and turned away a massive subsidy.

 

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How about we round up all the conservatives and ship them off to Antarctica. You want no government? There ya go.
Its funny.

Conservatives control government; no talks of secession from THE SOCIALIST COMMIE NAZIS.
Liberals control government; the south wants to secede.

Seriously?

 

EDIT: I hate this guy.

 

Don't blame me, I voted for the coyote.

 

I voted for Kodos.

 

Yeah, probably a better way of putting it.