We\u2019re Going to be Managed<\/p>\n\n\n\n
It looks like Medicaid in Idaho will now come under the \u201cmanaged care\u201d umbrella<\/a>.<\/p>\n\n\n\n I hope you don\u2019t just shrug. But you probably will, since you don\u2019t think this affects you. It does. It affects all of us.<\/p>\n\n\n\n The medical profession has long touted the sanctity of the doctor patient relationship. Except when it came to who pays. We should now be realizing, we all pay. And we are all paying way too much.<\/p>\n\n\n\n Most of us don\u2019t know what this \u201cmanaged care\u201d thing means. I would argue most of our legislators don\u2019t know either. But they pass the laws, and we send our taxes. We should be expecting more from them. And us.<\/p>\n\n\n\n Many states have done this before.<\/p>\n\n\n\n Here\u2019s the simple description. Idaho puts our $3B Medicaid payment system\/ patient care system out to contract. The details of such a contract are very important. Idaho will need to hire some $mart people to design this.<\/p>\n\n\n\n Big companie$ bid.<\/p>\n\n\n\n We grant a contract.<\/p>\n\n\n\n And the money continues to $huffle, but the bid winner gets their take. Their stockholders benefit from their profit. Maybe you have United Health in your portfolio.<\/p>\n\n\n\n Somebody needs to be paying attention.<\/p>\n\n\n\n Has the legislature been paying attention to how the multibillion-dollar MediCaid budget has been spent? Remember, they are \u00bc time employees.<\/p>\n\n\n\n Oh, that\u2019s right, they had a \u201cwork group\u201d that looked at Medicaid managed care. Mostly Republicans, and they couldn\u2019t come up with a recommendation. But here we are, late in a legislative session, and this big money deal is done.<\/p>\n\n\n\n It seems a bit like Elon got their ear. Slash and burn.<\/p>\n\n\n\n People need care. Don\u2019t let me go all liberal on you, it\u2019s just some numbers.<\/p>\n\n\n\n About 300,000 Idahoans are on Medicaid. So, if you are in a room of seven here in Idaho, the odds are one of you is on this program.<\/p>\n\n\n\n Some are pregnant, some are children, some are disabled. And some, maybe 90,000 are in the \u201cexpansion\u201d population. These are folks who make too little to go on the Idaho Exchange and buy health insurance there.<\/p>\n\n\n\n So, our legislators believe some big health care company can manage the health insurance costs for all these different folks and save us taxpayers money.<\/p>\n\n\n\n Like I said, they are not alone. Over 30 states have done this. Have they saved money? Have they provided better care? The answer is not clear.<\/p>\n\n\n\n But the other Medi, MediCARE has done this.<\/p>\n\n\n\n You might have some experience with this, since George Bush II got managed care plans into MEDICARE (old folks need CARE).<\/p>\n\n\n\n MedicAID is for poor and disabled\/ MediCARE is for us old folks.<\/p>\n\n\n\n The managed care plans for MediCARE have a long track record, since it\u2019s been around for over 20 years. The results aren\u2019t great<\/a>. These big insurance companies don\u2019t save us money, and they kick off the expensive folks back to regular<\/a> MediCARE.<\/p>\n\n\n\n Maybe their shareholders<\/a> are happy.<\/p>\n\n\n\n This is the health insurance game. If you want to make a profit (who doesn\u2019t?) get rid of your high-cost patients. And provide the least care you can.<\/p>\n\n\n\n MediCAID will be no different. If we want a good delivery system, good care at lower cost, somebody will need to be paying attention.<\/p>\n\n\n\n When states contract with insurance companies for managed care, most require they can only keep 15% for \u201cexpenses\u201d, that is CEO pay, etc.<\/p>\n\n\n\n In Idaho, our current overhead is less than 3% of the budget.<\/p>\n\n\n\n Somebody\u2019s going to get very rich on this.<\/p>\n\n\n\n Maybe that\u2019s not news.<\/p>\n\n\n\n Maybe that\u2019s what everybody expects.<\/p>\n\n\n\n Health care is big business in this country, and we here in Idaho just bought in.<\/p>\n\n\n\n I hope your portfolio flourishes.<\/p>\n","protected":false},"excerpt":{"rendered":" We\u2019re Going to be Managed It looks like Medicaid in Idaho will now come under the \u201cmanaged care\u201d umbrella. I hope you don\u2019t just shrug. But you probably will, since you don\u2019t think this affects you. It does. It affects … Continue reading