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States Limit Medicaid Hospital Stays, Highlighting Inadequacy of Health Care Financing

by | Nov 4, 2011

Jennifer Popik, J.D. Robert Powell Center for Medical Ethics

By Jennifer Popik, Robert Powell Center for Medical Ethics

USA Today piece from last week titled, “More states limiting Medicaid hospital stays,” reports that an increasing number of states are dramatically limiting hospital stays under Medicaid to as little as 10 days a year to control rising costs.

Medicaid, an expensive joint Federal/State health care program, primarily for the poor and disabled, is a perennial source of state budgeting fights.  Because Medicaid relies on general tax revenues, the money available depends on the health of the state economy and the available budget.  The amounts set aside are not related to what is actually spent on health care but are based off of budgeting ‘best guesses’ coupled with what tax dollars the state could cobble together.

This has the effect of leading state governments to arbitrarily reduce Medicaid reimbursements.  The USA Today article, written by Phil Galewitz,  documents that,

 “Arizona, which last year stopped covering certain transplants for several months, plans to limit adult Medicaid recipients to 25 days of hospital coverage a year, starting as soon as the end of October. Hawaii plans to cut Medicaid coverage to 10 days a year in April, the fewest of any state”

Further, as Galewitz writes, “Advocates for the needy and hospital executives say the moves will restrict access to care, force hospitals to absorb more costs and lead to higher charges for privately insured patients.”

While this move to charge the privately insured more might come as unwanted news, especially in a down economy, this does have several advantages that should come as welcome news to right-to-lifers.  Although it may seem counterintuitive, it is true that, as a whole, Americans can afford health care.  For a webinar on how, see here [http://nrlcomm.wordpress.com/2009/06/13/hcrwebinar/].

Even so, how can we ensure that people have access to healthcare?

The National Right to Life Committee (NRLC) proposes that instead of this cost-shifting occurring unevenly and inefficiently in hospitals, it be done more fairly and efficiently through insurance.  The full proposal is available here [www.nrlc.org/MedEthics/VariableWithhold.pdf].

The NRLC plan would require insurers to provide their fair share of basic health insurance policies to those the government determines will otherwise be unable to afford it at sliding scale discounts varying with income and assets.  Insurance companies would take into account the need to finance these required discounts when setting their premium prices, just as hospitals now have to take into account the need to finance undercompensated and uncompensated care in their emergency rooms when setting the prices for their services.

This would mean that the level of health care for all would effectively be set, not by legislative votes establishing varying levels of taxes, but by the collective decisions of many citizens (and employers) deciding what premiums they were willing and able to pay for health insurance, with the cost of covering the uninsured taken into account in those decisions.  The level of health care provided would never exceed what the economy as a whole could afford, but neither would it be held, by government constraint, below what Americans would freely choose.

Yet as the level of available health care changed, the health care available to those otherwise unable to afford it would change with it.  A rising tide reallywould lift all boats.

The right-to-life movement believes that every human being has the right to life from inception to natural death, including the right not to be denied life-saving medical treatment through health care rationing.

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Categories: Health Care