Citing budgetary constraints, Florida’s Republican-led Legislature is prepared to push the state’s Medicaid payment system off the public dole and into private pockets. —ARK
The New York Times:
Florida lawmakers are poised to scrap the traditional model in which the state pays doctors for each service they perform. Instead, almost all of Florida’s Medicaid recipients would be funneled into state-authorized, for-profit H.M.O.’s or networks run by hospitals or doctors. H.M.O.’s or networks would also manage the long-term care of the elderly, shifting them away from nursing homes and leading to an expansion of in-home care. Lawmakers who support the bill say the state needs this flexibility in curtailing the exploding cost of Medicaid.
The Florida legislation is being closely watched by other states as they tackle the rapid growth of enrollment and the cost of care. Because Florida has three million Medicaid patients and a high number of uninsured people, a swift jump into managed care would be significant. And while many states use managed care for Medicaid users in one form or other, the Florida proposals stand out because they would set possible limits on services, giving the state and H.M.O.’s the right to deny some benefits that are now offered to patients. This would require federal permission.
“If Florida adopts this method of looking at managed care, other states will definitely look at that, and this is a tool we can use,” said Michael W. Garner, the president of the Florida Association of Health Plans, which lobbies for H.M.O.’s. “The toolbox is pretty empty right now.”
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All i can say is that the details are even worse than my simple comment about medicaid and ambulances. I can prove it, but am not at liberty to do so.
In fact i originally had some details included but for privacy sake i removed them. it would be wrong to give details. my screen name combined with my profession combined with those details would likely violate several people’s privacy.
several people… which means that unnecessary medicaid ambulance rides happen often. Unfortunately I refuse to speak much more about it. That is my problem. I dont blame you if that leaves you unsatisfied.
As for the ultimate motivation behind what i write, which you attribute in a Leftist sing-song way to racism, well, that reflects on you and not on me. Truly that is your problem.
For example, an ambulance ride saves them gas money so they will wrangle for the ambulance even though they should have driven themselves.
***********
I’m calling BS on this one, OM! Did you just make this up or did you get it from that racist, Rush Limbaugh, or any of the other racists masquerading as “conservatives” on talk radio and Fox Noise? Calling an ambulance for a situation that cannot possibly construed as a 9-1-1 call is a crime.
Besides…you don’t get a ride BACK from the hospital! So either you have spend money on carfare, or somebody has to drive to get you anyway. This doesn’t even parse as logical. See? It’s BS.
Years and years of free care allows medicaid patients to obtain care in expensive ways, and many of them become trained to use rather high cost services.
Unlike the people who have money(have to pay) who would not seek inappropriately expensive care, people with medicaid insurance have years of habitually obtaining care without any regard to cost.
Unlike people with HMO insurance who have learned to access care in accordance with the decision of their doctor, many people with medicaid just go for the quickest easiest route. For example, an ambulance ride saves them gas money so they will wrangle for the ambulance even though they should have driven themselves. It is a miracle that some people with medicaid havent or wont abuse the system even though they have been on it for years.
Over the course of years persons on medicaid have been taught to be less and less responsible for themselves, and that leads to poor quality outcomes for them. The government has to think for them, make burdensome rules for them, which by the way is what government likes to do. And the more people they do this for the happier the government is!
Yet the medicaid system, for all the money spent, all the rules made, places the medicaid patient in the back seat. Medicaid is the worst payer out there for doctors, so most every doctor tries to limit their medicaid caseload. Medicaid patients require more paperwork and downtime than anybody else, thanks to the government. Consequently, medicaid patients have to wait a very long time to see specialists. It isnt fair, but thats how it is.
Yes, the government created this low quality, unfair, long waiting line, expensive mess. Now they cant afford it.
Various solutions are being tried, but the medicaid HMO is the worst. It pushes the problem onto the doctor’s lap. It makes the doctor the financial risk holder and rule maker/enforcer instead of the state. The patient has not been held responsible all these years, and s/he isnt going to suddenly learn responsibility now. The doctor will be the one with the power and responsibility to control the spending and try to improve care at the same time.
There will be many unhappy people in Florida.
The medicaid patients will rightly see the doctor as standing in the the way of them getting their hangnail* fixed in the Emergency Room like they did last year. The doctor is placed in an adversarial relationship with the patient. That is not a good thing for doctors.
It turns the doctor into something like a policeman patrolling a neighborhood that has lived under lawlessness* for years.
Medicaid HMOs will make the doctor responsible for cleaning up the financial and quality fiasco that is medicaid. Some of what i said was *exaggerated* for brevity’s sake but as a whole it is true. If you understand what i wrote you will get up to speed on what is happening. After hearing a few more people talk about this from other points of view you will be well informed.
Hope we never go medicaid HMO in my state, but I hear the distant rumblings.
Euthanasia, when properly executed (no pun intended) can be a
Godsend(again no pun intended). Patients with no hope,
whether young or elderly, can be given a ticket to a better
place. Part of the money saved can be used to build centers
for the final voyage. See the film, “Soylent Green” to get an
idea of how to design these centers and the concept of
demographic recycling!
By SarcastiCanuck, April 28, 2011 at 9:48 am Link to this comment
(Unregistered commenter)
Wow,these GOPers now fuck you over with smiles on thier faces and your money in thier pockets.Anyone whose household earns less than $150K a year and votes for the republicans needs a HMO sponsored lobotomy.
From the art: “It can’t work,” said Representative Elaine J. Schwartz, a Democrat, who held community meetings on the program in Broward County. “It undermines the basic purpose of Medicaid, which is to provide services. If the private sector could have made money on Medicaid, they would have. With this plan, we are basically handing them $20 billion. Two groups of people will suffer: the patients because they are bamboozled and the taxpayer who is not getting their money’s worth.”
*************
But Rick Scott is the kind of crook who sees nothing wrong with this and WANTS to put $21 billion of taxpayers’ money into the HMOs’ hands. After all, his wife “owns” a similar corp.
I’m surprised the GOPers aren’t proposing that VERY sick seniors be cut off completely and brought to “death camps” to die. Much cheaper that way. Like medieval Japanese Daimyos, who, when a servant was too old or sick to perform, would have him beheaded to save the cost of caring for him.
Well, whaddaya know! The Florida GOPers are now actually creating the ‘Death Panels’ for the elderly, run by the HMO’s and other private Health Insurance profiteers, that the Tea Partiers and other whacko republicans falsely claimed were part of the President’s health care plan.(Which, BTW, is now the law…and still sans ‘Death Panels’)
Care for some Hemlock, you lying, hypocritical GOPers?
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By OzarkMichael, April 29, 2011 at 2:23 pm Link to this comment
All i can say is that the details are even worse than my simple comment about medicaid and ambulances. I can prove it, but am not at liberty to do so.
In fact i originally had some details included but for privacy sake i removed them. it would be wrong to give details. my screen name combined with my profession combined with those details would likely violate several people’s privacy.
several people… which means that unnecessary medicaid ambulance rides happen often. Unfortunately I refuse to speak much more about it. That is my problem. I dont blame you if that leaves you unsatisfied.
As for the ultimate motivation behind what i write, which you attribute in a Leftist sing-song way to racism, well, that reflects on you and not on me. Truly that is your problem.
Report thisBy Inherit The Wind, April 29, 2011 at 7:52 am Link to this comment
For example, an ambulance ride saves them gas money so they will wrangle for the ambulance even though they should have driven themselves.
***********
I’m calling BS on this one, OM! Did you just make this up or did you get it from that racist, Rush Limbaugh, or any of the other racists masquerading as “conservatives” on talk radio and Fox Noise? Calling an ambulance for a situation that cannot possibly construed as a 9-1-1 call is a crime.
Besides…you don’t get a ride BACK from the hospital! So either you have spend money on carfare, or somebody has to drive to get you anyway. This doesn’t even parse as logical. See? It’s BS.
Report thisBy OzarkMichael, April 28, 2011 at 3:34 pm Link to this comment
I would hate to see this in my state.
Years and years of free care allows medicaid patients to obtain care in expensive ways, and many of them become trained to use rather high cost services.
Unlike the people who have money(have to pay) who would not seek inappropriately expensive care, people with medicaid insurance have years of habitually obtaining care without any regard to cost.
Unlike people with HMO insurance who have learned to access care in accordance with the decision of their doctor, many people with medicaid just go for the quickest easiest route. For example, an ambulance ride saves them gas money so they will wrangle for the ambulance even though they should have driven themselves. It is a miracle that some people with medicaid havent or wont abuse the system even though they have been on it for years.
Over the course of years persons on medicaid have been taught to be less and less responsible for themselves, and that leads to poor quality outcomes for them. The government has to think for them, make burdensome rules for them, which by the way is what government likes to do. And the more people they do this for the happier the government is!
Yet the medicaid system, for all the money spent, all the rules made, places the medicaid patient in the back seat. Medicaid is the worst payer out there for doctors, so most every doctor tries to limit their medicaid caseload. Medicaid patients require more paperwork and downtime than anybody else, thanks to the government. Consequently, medicaid patients have to wait a very long time to see specialists. It isnt fair, but thats how it is.
Yes, the government created this low quality, unfair, long waiting line, expensive mess. Now they cant afford it.
Various solutions are being tried, but the medicaid HMO is the worst. It pushes the problem onto the doctor’s lap. It makes the doctor the financial risk holder and rule maker/enforcer instead of the state. The patient has not been held responsible all these years, and s/he isnt going to suddenly learn responsibility now. The doctor will be the one with the power and responsibility to control the spending and try to improve care at the same time.
There will be many unhappy people in Florida.
The medicaid patients will rightly see the doctor as standing in the the way of them getting their hangnail* fixed in the Emergency Room like they did last year. The doctor is placed in an adversarial relationship with the patient. That is not a good thing for doctors.
It turns the doctor into something like a policeman patrolling a neighborhood that has lived under lawlessness* for years.
Medicaid HMOs will make the doctor responsible for cleaning up the financial and quality fiasco that is medicaid. Some of what i said was *exaggerated* for brevity’s sake but as a whole it is true. If you understand what i wrote you will get up to speed on what is happening. After hearing a few more people talk about this from other points of view you will be well informed.
Hope we never go medicaid HMO in my state, but I hear the distant rumblings.
Report thisBy Blackspeare, April 28, 2011 at 1:28 pm Link to this comment
Euthanasia, when properly executed (no pun intended) can be a
Report thisGodsend(again no pun intended). Patients with no hope,
whether young or elderly, can be given a ticket to a better
place. Part of the money saved can be used to build centers
for the final voyage. See the film, “Soylent Green” to get an
idea of how to design these centers and the concept of
demographic recycling!
By SarcastiCanuck, April 28, 2011 at 9:48 am Link to this comment
(Unregistered commenter)
Wow,these GOPers now fuck you over with smiles on thier faces and your money in thier pockets.Anyone whose household earns less than $150K a year and votes for the republicans needs a HMO sponsored lobotomy.
Report thisBy Inherit The Wind, April 28, 2011 at 5:42 am Link to this comment
From the art:
“It can’t work,” said Representative Elaine J. Schwartz, a Democrat, who held community meetings on the program in Broward County. “It undermines the basic purpose of Medicaid, which is to provide services. If the private sector could have made money on Medicaid, they would have. With this plan, we are basically handing them $20 billion. Two groups of people will suffer: the patients because they are bamboozled and the taxpayer who is not getting their money’s worth.”
*************
But Rick Scott is the kind of crook who sees nothing wrong with this and WANTS to put $21 billion of taxpayers’ money into the HMOs’ hands. After all, his wife “owns” a similar corp.
I’m surprised the GOPers aren’t proposing that VERY sick seniors be cut off completely and brought to “death camps” to die. Much cheaper that way. Like medieval Japanese Daimyos, who, when a servant was too old or sick to perform, would have him beheaded to save the cost of caring for him.
Report thisBy TDoff, April 27, 2011 at 7:27 pm Link to this comment
Well, whaddaya know! The Florida GOPers are now actually creating the ‘Death Panels’ for the elderly, run by the HMO’s and other private Health Insurance profiteers, that the Tea Partiers and other whacko republicans falsely claimed were part of the President’s health care plan.(Which, BTW, is now the law…and still sans ‘Death Panels’)
Report thisCare for some Hemlock, you lying, hypocritical GOPers?