Thursday, February 5, 2009

Let the SCHIPS fall where they may

Some things have a lot of unintended effects, especially when they are done by those who don't understand the problem at hand. SCHIP seems to be a classic example. Many thought that "oh, great kids without insurnace will now have it and get better care", the problem is that it is the opposite. This is how it works, and how SCHIP will most likely be the death nail for our pediatric hospitals and many the pediatric medical practices.

In the great scheme of things, hospitals break even or lose just a bit on Medicare. They lose money on Medicaid and self pay. They make their money on private insurance. Infact, money from private insurance is what balances the losses from Medicare, Medicaid and self pay. Pediatric hospitals accross the country are cutting back, especially in California where the private insurane is decreasing and government payors are increasing. Now enter SCHIP. This is a government program that is supposed to provide health insurance for children whose parents make too much for Medicaid but who dont want to or cant afford private insurance. The problem is this. If you have a choice of getting a family health plan through your employer or pocketing the cash and taking the free government insurance, which one will you take? Better yet, will your employer even offer family coverage? Anyway, more and more kids will be swiched over from private to government insurance. This government insurace pays at the Medicaid rates. So there is a decrease in the private insurance which keeps the hopitals and medical services open and increases the money losing government insurances. The end result. The pediatric hospitals close and medical services refuse to see Medicaid and SCHIP. You now have effectively limited and decreased the care for the kids.

This is already a problem as it is very difficult to find medical care for kids with Medicaid and SCHIP. In California, where the pediatric cut backs are already huge, there is a crisis already. It is only going to get worse. Our pediatric hospital squeeked by last year because of the telethon, but they dont expect to survive this year.


SeaSpray said... should send this into Newspaper editorials. Better yet...the government. No.. not the government.

Sean Hannity has effectively been calling attention to the bailout debacle and all the pork. Send it to him or Rush. These guys are a thorn in the democrats side and is why they would like to get the airwaves law reenacted.

Now dems don't have the full support of their party because they are afraid of not getting reelected and so they have to rework it again.

Why can't they just say no to all the extraneous pork and only a lot money for where it will truly do the most good in stimulating the economy?

It scares me that the Chinese have bought up so much of our debt. It's all so mind boggling.

You make so many good points...logically pointing out the consequences.

Can't pediatric providers unite? Their voice needs to be heard.

As well as yours and every other voice of reason during these trying economic times.

Andrew_M_Garland said...

Healthcare: They will pretend to pay - We will pretend to treat
About politica control of healthcare promises and payments.

In speech after speech Gov. Blagojevich hammered home the “fact” that he had granted insurance coverage to so many in Illinois, through various means. How has this actually been implemented? State payments to medical providers has been dramatically slowed.

Delaying payments has the same effect as reducing payments, since the state doesn’t catch up for a long time. The payment delays ensure that providers need to hold a big “rainy day” fund, since their employees want to be paid cash rather than IOU’s.

Medical providers can do little except complain to their local legislators. They can’t sue the State to speed up payments, and if they did, the state wouldn't care. Unlike insurance, which may be popularly perceived as unfair, there are no avenues of appeal if you feel the state is killing your business.

The US will likely move to a backwards program of medical socialism by increasing coverage and then squeezing providers with reduced and slowed payments. Federal transfers to states will not make up the cost for unfunded mandates.

Medical providers will begin to crumble financially and move away from treating state and federally insured patients, or do it in the most bare-bones and cheap manner possible.

SeaSpray said...

Morning Throckmorton! :)

You might be interested to read Dr Rob's perspective on EMRs. His blog is Musings of a Distractible Mind.

He makes a good case for using them nation wide.

SeaSpray said...

And one more.

The Independent Urologist also has a post up about EMRs.

Both Dr Rob and I.U. make a good case for using them.


I wonder what flaws they have encountered?