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9-15-05 Medical Costs, Health Insurance, Prescriptions & Medicaid

Health costs are making a larger class of paupers; which in turn is adding to the Medicaid program stress.  If we take folks off Medicaid, they will be wards of the County who must provide for indigents.  It will also drive up costs for the ones who are paying.  It is in a vicious spiral.



September 12, 2005


Medical Costs, Health Insurance, Prescriptions & Medicaid


By Wendell Dawson, Editor, AVOC, Inc.


My wife and I both come under Medicare coverage this year.  We also have other health insurance coverage.  None of these carriers pay very much on prescriptions.   At the same time we are better off than many folks.


For sometime, the wealthy could pay for care and poor citizens were covered under Medicaid. This left much of the middle class to struggle with medical expenses.   As age weakens body defenses, more health issues arise.  Monthly medications can become prohibitively expensive.


Many folks with borderline income or assets have been disqualified from the Medicaid program.  They are left to fend for themselves.  One cannot have significant assets and be covered by Medicaid.


Health costs are making a larger class of paupers; which in turn is adding to the Medicaid program stress.  If we take folks off Medicaid, they will be wards of the County who must provide for indigents.  It will also drive up costs for the ones who are paying.  It is in a vicious spiral.


It seems that Medicaid ought to be a sliding scale and let folks with modest assets pay part of their costs.  That is preferable to requiring them to be paupers before they can get assistance.  It would allow the citizen to maintain some dignity at a stressful time in life.


At some point, the national congress, state legislatures and real leaders will have to address the health coverage question.  It is not going away and, sooner or later, it hits most of us or our relatives.

8-28-05 Medicaid Still Huge Challenge for Georgia


The Macon Telegraph



August 28, 2005


Medicaid: A question of who pays, and when

Thursday, the Department of Community Health had some good news and a dire warning. The good news first. It seems Medicaid benefits will not be reduced in the fiscal 2007 budget. That's welcomed news for the state's 1.5 million Medicaid recipients. …… Cuts in fiscal 2007 were foretold, but according to Tim Burgess, the DCH commissioner, the board was able to avoid them, thanks to some one-time savings and changes in procedures.

According to the Atlanta Journal-Constitution, DCH will save $14 million by monitoring and enforcing eligibility requirements, compacting administrative functions, paying less for prescription drugs and by seeking faster reimbursements from hospitals when it overpays.

Even though the heavy hammer has been withheld - for now - it still sits waiting. For the past two years, Georgia has received and extra $00 million from federal sources using an accounting scheme the Government Accounting Office said was improper. That's what led to a June agreement between the state and the U.S. Centers for Medicare and Medicaid Services. while the state, for now, doesn't have to pay the money back, those payments have stopped. That has left an almost $50 million hole. …..

That money will not be around to help balance the next budget. …….

The state's Medicaid spending is rising by double digits each year, reflecting the inflating costs of health care. Medicaid gobbles up 43 percent of each new state dollar. Many doubt significant cost-savings can be achieved by the HMOs without cutting benefits or Medicaid rolls…….

The state's poor had better hang on and so should the hospitals who service them. Covered or not, the poor will still get medical care. However, when they do, they will be sicker and require more treatment - and those services will be delivered through the most expensive door of the hospital: The emergency room.

9-13-05 Insurance Risk Pool for Uninsured?

The Georgia Report      -      CapitolImpact.Com

September 12, 2005

Political Notes – Is it safe to go into the pool?

By Tom Crawford

There are thousands of people who are unable to get health insurance coverage because they have chronic illnesses or pre-existing medical conditions that make them too expensive a risk for an insurer.

A legislative study committee held a public hearing Monday morning on one proposal for helping these uninsured Georgians: the creation of an insurance risk pool that would provide healthcare coverage.

“This is an important issue for a lot of people, for a variety of reasons,” said the committee chairman, Rich Novack, a retired executive for Blue Cross Blue Shield of Georgia.

Novack said the committee will prepare recommendations for Gov. Sonny Perdue by Dec. 15, but said the panel’s findings won’t necessarily result in the creation of a risk pool. “There is nobody here who can guarantee you that will occur,” Novack said.

While the committee heard testimony from several individuals who need but can’t get health insurance coverage, they also heard warnings from insurance experts about the high costs that a risk pool could incur. The risk program set up in Texas is facing an $8 million deficit, while Oregon’s risk pool has run up a $0 million deficit.

There are 32 states that have these types of health insurance risk pools and “we haven’t seen any states do it right yet,” said Jim Kinder, the CEO of the Self-Insurance Institute of America.

Kinder said a risk pool should be an insurer of last resort for people who cannot get coverage, not a “dumping ground” for Medicaid recipients. He also recommended that a broad-based funding source, such as a tax increase, be used to pay for such a program and spread the risk over a larger segment of the population.

The potential costs of a risk pool to provide coverage for 7,000 uninsured Georgians has been estimated within a range of $0 million to $0 million. The possibility of an operating deficit appeared to make some of the legislators on the study commission a little nervous.

“Somebody’s going to have to pick up the costs, but it shouldn’t necessarily be the state,” said Sen. Ralph Hudgens (R-Comer)…….