Don't Tell Me It's Raining . . .
Our state Medicaid system is quickly becoming a running theme for Lasee’s Notes for a variety of reasons. This taxpayer-funded health care system in Wisconsin is on the verge of collapse and requires an enormous amount of state tax money to keep it running.
The Governor chose to make free (or largely free), government-funded health care the centerpiece of his State of the State address last week. The Governor wants to add tens of thousands (possibly hundreds of thousands) to the Medicaid rolls in our state and is able to look you straight in the eye and tell you it will not cost any additional money. Please, Governor, stop telling me it’s raining when you are . . . well, you know the rest.
The taxpayer-funded health care system for the poor, which is buckling under its own weight, has not increased provider reimbursement rates in 12 years. Would you continue working for 12 years without a raise? Medical providers can and do shift these losses.
No raise for over a decade means health care providers in our state are losing more and more money on Medicaid patients, which results in more and more costs getting shifted to medical insurance. Unless the Governor has a magic wand, health care providers will not see an increase in reimbursement rates anytime soon. They will see additional patients when the Medicaid rolls are expanded, patients (if the Governor has his way) that use health care provider services and those of us with private insurance pay more and more.
What would you do if you were running a store with a certain product on the shelf that was very expensive and you never made any money on it, year after year? What if you consistently lost money stocking that product in your store? What would you do? After a while, you might stop stocking that product.
That is exactly what the health care providers are starting to do, refusing to accept Medicaid. In the last couple of weeks, I have personally heard several reports of health care providers in Wisconsin who are going to stop accepting Medicaid. Providers in other states are doing the same thing. On the dental side of health care, lack of services is an epidemic as the number of dentists in this state who accept Medicaid grows very small.
Federal law mandates that to accept Medicare patients, a provider must accept Medicaid patients. Medicare patients are not as big of a burden as the under-reimbursed Medicaid patients. What happens to our Medicaid program when the medical side starts following the dental side and there are few providers left? What happens to our elderly when they cannot get into the doctor because their doctor of choice no longer accepts Medicare patients due to the lack of funding for Medicaid?
Now, imagine if you were on Medicaid and could not find a doctor or dentist in your area that would accept you. Where would you go? You would go to the one place that cannot turn you away - the emergency room. What if even more of our Medicaid patients were using the emergency room as their primary care physician? The expenses of this under-funded system would continue to climb.
Medicare patients (mainly our elderly) will be affected, too. Right now, nearly all medical providers accept both Medicaid and Medicare. So, Medicare users have their choice of nearly any provider in the state for their health care needs. When those providers decide to stop accepting Medicaid patients, they can no longer accept Medicare patients. Our seniors will be stuck with whatever is left when it comes to providers, instead of choosing who they want. All this happens because the state will not fairly pay its bills when it comes to taxpayer-funded health care.
Our Governor wants to add more people to this system and sign them up faster and easier.
Those of us with private insurance take it in the shorts. As we have discussed before, when providers lose money on Medicaid patients, we all pay the price in increased premiums to cover the losses providers take on Medicaid patients (the hidden health care tax). When Medicaid and Medicare patients start going to the emergency room for basic medical services, hold on to your wallet.
I applaud the Governor for trying to get more people on insurance. I share this goal. However, free, government-paid Medicaid and BadgerCare is not the answer to the health care problems in Wisconsin. The Wisconsin taxpayer-funded health care system bus is on empty and the Governor’s solution is not to fill the tank, but to pick up more passengers, shove them into the 4.6 billion dollar Medicaid bus in addition to the people already riding, and then keep driving forward at full speed. With his foot on the accelerator, he tells people watching the bus go by that it is completely safe and won’t cost taxpayers a cent more.
I realize I am starting to sound like a broken record. Under-funding Medicaid is wrong and irresponsible. Not increasing the reimbursement rates for 12 years is wrong. Adding people to the program when it is not funded properly is even more wrong. The state needs to do the right thing and not go down the easy road of making empty, broken promises to people who really need our help.
Lasee’s Notes is a weekly column by Representative Frank Lasee, 2nd Assembly District, covering events in the Legislature and statewide.