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Medicaid Withdrawal? Or all hat and no cattle? - 11/6/2010 10:21:24 AM   
Musicmystery


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One of the issues in the "Oh no! Health Care!" hue and cry is that states have ALWAYS had the option to opt out of Medicaid/Medicare if they so chose. They never did, because they/voters recognized the benefits over the drawbacks.

So I wonder how much of this is just talk. If they actually do something, should be interesting!

After all, they get substantial federal matching dollars (the feds pay 60%), and they'd have to make that up (or abandon health care services).

On the other hand, it would save federal dollars....if they want to run/pay for this themselves, go ahead!


Texas Lawmakers Consider Medicaid Withdrawal
By EMILY RAMSHAW
Published: November 6, 2010
http://www.nytimes.com/2010/11/07/us/politics/07ttmedicaid.html?_r=1&hp

Some Republican lawmakers — still reveling in Tuesday’s statewide election sweep — are proposing an unprecedented solution to the state’s estimated $25 billion budget shortfall: dropping out of the federal Medicaid program.

Far-right conservatives are offering that possibility in impassioned news conferences. Moderate Republicans are studying it behind closed doors. And the party’s advisers on health care policy say it is being discussed more seriously than ever, though they admit it may be as much a huge in-your-face to Washington as anything else.

“With Obamacare mandates coming down, we have a situation where we cannot reduce benefits or change eligibility” to cut costs, said State Representative Warren Chisum, Republican of Pampa, the veteran conservative lawmaker who recently entered the race for speaker of the House. “This system is bankrupting our state,” he said. “We need to get out of it. And with the budget shortfall we’re anticipating, we may have to act this year.”

The Heritage Foundation, a conservative research organization, estimates Texas could save $60 billion from 2013 to 2019 by opting out of Medicaid and the Children’s Health Insurance Program, dropping coverage for acute care but continuing to finance long-term care services. The Texas Health and Human Services Commission, which has 3.6 million children, people with disabilities and impoverished Texans enrolled in Medicaid and CHIP, will release its own study on the effect of ending the state’s participation in the federal match program at some point between now and January.

State Representative John M. Zerwas, Republican of Simonton, an anesthesiologist who wrote the bill authorizing the health commission’s Medicaid study, said early indications were that dropping out of the program would have a tremendous financial ripple effect. Mr. Zerwas said that he was not ready to discount the idea, but that he worried about who would carry the burden of care without Medicaid’s “financial mechanism.”

“Because of the substantial amount of matching money that comes from the federal government,” Mr. Zerwas said, “there’s an economic impact that comes from that. If we start to look at what that impact is, we have to consider whether it’s feasible to not participate.”

State Senator Jane Nelson, Republican of Flower Mound, who heads the Senate Public Health Committee, said dropping out of Medicaid was worth considering — but only if it made fiscal sense without jeopardizing care.

Currently, the Texas program costs $40 billion for a period of two years, with the federal government paying 60 percent of the bill. As a result of federal health care changes, Ms. Nelson said, millions of additional Texans will be eligible for Medicaid.

“I want to know whether our current Medicaid enrollees, and there certainly could be millions more by 2014, could be served more cost efficiently and see better outcomes in a state run program,” she said.




< Message edited by Musicmystery -- 11/6/2010 10:25:06 AM >
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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/6/2010 11:29:49 AM   
Musicmystery


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And just out of curiosity, what about your state?

Would you take a 60% loss of matching funds to withdraw from Medicaid?

And how would you then deal with the loss in services?

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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/6/2010 11:34:51 AM   
slvemike4u


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Okay before I even think about the questions posed in your second post....allow me to respond to the first.
Just let them fucking seceede....and make sure they take the fucking Dallas Cowboys along with them.Hell they can dust off the old flag...hell they had their own constitution back in the day didn't they,well there you go they are all set for nationhood.

_____________________________

If we want things to stay as they are,things will have to change...Tancredi from "the Leopard"

Forget Guns-----Ban the pools

Funny stuff....https://www.youtube.com/watch?v=eNwFf991d-4


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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/6/2010 11:50:25 AM   
Musicmystery


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Well, troops/fence along the Texas/states border would be easier/cheaper then trying to police all that coastline and Mexican border.

AND we wouldn't have to worry about the cost of oil or hurricane damage to Texas.


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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/6/2010 1:09:01 PM   
slvemike4u


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And Texas would than get to execute all the innocent men they choose ...with nary a peep from the rest of us.

_____________________________

If we want things to stay as they are,things will have to change...Tancredi from "the Leopard"

Forget Guns-----Ban the pools

Funny stuff....https://www.youtube.com/watch?v=eNwFf991d-4


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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/6/2010 3:31:07 PM   
Musicmystery


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And with the competition from Venezuela, we could even see oil prices drop.

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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/6/2010 3:37:57 PM   
slvemike4u


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Works for me....

_____________________________

If we want things to stay as they are,things will have to change...Tancredi from "the Leopard"

Forget Guns-----Ban the pools

Funny stuff....https://www.youtube.com/watch?v=eNwFf991d-4


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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/6/2010 3:42:44 PM   
Musicmystery


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After all, their only way around us (until such time as they get their own navy) would be to make a deal with Mexico. Now that would be rich!

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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/6/2010 3:45:11 PM   
slvemike4u


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One of them  just might swallow the other....and wouldn't that be poetic justice.

_____________________________

If we want things to stay as they are,things will have to change...Tancredi from "the Leopard"

Forget Guns-----Ban the pools

Funny stuff....https://www.youtube.com/watch?v=eNwFf991d-4


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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/6/2010 4:20:15 PM   
TreasureKY


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lol... You boys having fun?  

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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/6/2010 5:22:13 PM   
slvemike4u


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A little...yanno a slow sat nite(local dungeon is closed on the first sat of the month....sucks)and this is sort of filling in the blanks.Feet free to join in ,just jump in with whatever irrelevant thought that comes to mind

_____________________________

If we want things to stay as they are,things will have to change...Tancredi from "the Leopard"

Forget Guns-----Ban the pools

Funny stuff....https://www.youtube.com/watch?v=eNwFf991d-4


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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/6/2010 6:16:56 PM   
TreasureKY


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We don't do dungeons, but it's a quiet night here anyway.  Firm is off in the library reading a new book.  We had planned to try a new dance club tonight, but honestly... neither one of us felt like even getting dressed today.  Yanno... bored, but too bored to do any different. 

Sucks being an ol' fogey sometimes. 

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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/6/2010 6:20:26 PM   
slvemike4u


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No shit....I would give my left....Let's just say I would surrender something I treasure....just to sleep thru the night minus the bathroom trips.
Getting old sucks.

_____________________________

If we want things to stay as they are,things will have to change...Tancredi from "the Leopard"

Forget Guns-----Ban the pools

Funny stuff....https://www.youtube.com/watch?v=eNwFf991d-4


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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/6/2010 7:52:22 PM   
TreasureKY


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I can understand that.  Pity we don't value the benefits of youth as much until we're beyond it. 

Course, that goes for many things in life we take for granted. 

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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/6/2010 8:47:32 PM   
DomKen


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quote:

ORIGINAL: slvemike4u

No shit....I would give my left....Let's just say I would surrender something I treasure....just to sleep thru the night minus the bathroom trips.
Getting old sucks.

I'd give my left one to have those bathroom trips back. Perspective is everything.

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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/7/2010 9:36:05 AM   
Musicmystery


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So about the OP(s) -- opting out of Medicaid...a reasonable option? Or empty rhetoric?

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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/7/2010 9:39:33 AM   
slvemike4u


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Simple answer(and my apologies for derailing the thread) empty rhetoric.Much like talk of seceesion,and as likely to come to pass.

_____________________________

If we want things to stay as they are,things will have to change...Tancredi from "the Leopard"

Forget Guns-----Ban the pools

Funny stuff....https://www.youtube.com/watch?v=eNwFf991d-4


(in reply to Musicmystery)
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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/7/2010 11:51:34 AM   
Musicmystery


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No problem...it was fun imaging what the world would be like if they left.

I've sometimes pondered what if Lincoln had just said, "Fine, go."

We'd be a smaller nation, not a world power, but with a strong industrial base and economic power.

England would be more powerful, with the Confederacy largely dependent on British trade. They'd also have been hurt by Apartheid-like resistance to slavery.

Latin America would be more independent and more powerful, and likely with strong ties to European/Asian nations (in the absence of a strong/unified U.S.).

Republicans would be liberal, the whole Civil Rights thing never playing out in the Republic. Democrats would largely remain in the Confederacy.

"Conservatives" would mean the mid-West. And the economic stagnation following the Civil War would never have happened, nor would the reaction to Reconstruction.

And while our poorer neighbors to the South shielded themselves off with Protectionism, we'd be trading with the world.

Frankly, I think we'd be pretty happy. And the South would have their pride.





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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/7/2010 2:33:44 PM   
MercTech


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What we had before Medicaid: Public Health Service clinics where everyone could be seen for basic health care... publicly funded acute care clinics. And a visiting nurse program that provided for immunizations at the school so all kids got their shots when needed.

Medicaid was sold as a cost saving measure so that instead of waiting in line for a clinic, poor people could just go to any local doctor, show their card, be seen, and the doctor would bill HEW.

What we got was 90 cents on the dollar of a huge budget for bureaucrats whose purpose is to find reasons to deny care under Medicaid and when they pay are so slow (6-18 months) that many doctors and clinics will no longer see medicaid patients.

Medicaid is a program sold to the public as one thing and in practice, it doesn't provide the benefit as intended.

Now, is Texas replacing Medicaid with a clinic initiative? If so, kudos for using their tax funds productively instead of on bureaucrats.

Stefan

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RE: Medicaid Withdrawal? Or all hat and no cattle? - 11/7/2010 3:05:15 PM   
willbeurdaddy


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quote:

ORIGINAL: MercTech

What we had before Medicaid: Public Health Service clinics where everyone could be seen for basic health care... publicly funded acute care clinics. And a visiting nurse program that provided for immunizations at the school so all kids got their shots when needed.

Medicaid was sold as a cost saving measure so that instead of waiting in line for a clinic, poor people could just go to any local doctor, show their card, be seen, and the doctor would bill HEW.

What we got was 90 cents on the dollar of a huge budget for bureaucrats whose purpose is to find reasons to deny care under Medicaid and when they pay are so slow (6-18 months) that many doctors and clinics will no longer see medicaid patients.

Medicaid is a program sold to the public as one thing and in practice, it doesn't provide the benefit as intended.

Now, is Texas replacing Medicaid with a clinic initiative? If so, kudos for using their tax funds productively instead of on bureaucrats.

Stefan


Rick Perry was on one of the news shows this morning and he is very serious about withdrawing from Medicaid and re-structuring delivery to the poor. He didnt specify a clinic model, but that has to be a big part of it. Pawlenty was on at the same time and seems to be headed down the same path.

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and harken
to the barking of the dogfox,
gone to ground.

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