Patient Power

Waiting lists for Rhode Island Medicaid?

An article in last week’s Washigton Post shows how when you empower government to provide health insurance, you allow politicians to determine how, when, and if you get medical care:

Facing a severe budget shortfall, Rhode Island officials are seeking unprecedented authority to rein in Medicaid spending in a move that has alarmed Democrats in Congress and advocates for the poor. …

…Gov. Donald Carcieri (R) … said the pressures of a “national economic downward spiral” had forced the state to confront skyrocketing health-care costs, “the single largest expenditure of the state’s budget.”

“The Medicaid waiver would allow the state to implement reforms to protect the long-term viability of the program as well as the individuals it services,” Carcieri said at the time. …

By the state’s own estimates, the combined total of state and federal expenditures would fall substantially short of projected needs, with the gap growing from $231 million next year to nearly $500 million in fiscal 2013. Rhode Island proposes to fill that gap by delivering health care more efficiently, primarily by reducing demand for such high-cost facilities as nursing homes and increasing the availability of in-home and community-based care for the elderly and the disabled.

But the proposal also seeks to charge poor families a premium for using the emergency room instead of visiting a primary-care doctor, to increase co-payments and premiums beyond the level set by federal law, and to restrict access to certain facilities and “optional” services, such as dental care, including by establishing waiting lists and “restricting services to certain geographical areas of the state.”

Sound familiar?  Government pays the medical bills for a segment of the population, the programs costs more than expected, and to contain costs, politicians restrict patients’ access to medical care. 

There are some positive aspects, namely, the fee for using the ER unnecessarily, and increasing premiums and copayments.   These measures help remove the illusion that health care is “free,” and can hence encourage Medicaid patients to be cost-conscious when seeking medical care.  

Yet, while a bad government program is better than a really bad one, we should not be satisfied with incrimental improvements.  Politicians should not force citizens to donate to charity, and Medicaid is a government-run charity.

(via EconLog)

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