Montana Expands Medicaid As Max’s Legacy Hurts Hundreds of Thousands of Americans

by William Skink

I can understand why Montana Democrats are celebrating Montana getting the green light from the Feds to expand Medicaid. Our state desperately needs any help it can get to insure uninsured Montanans.

But expanding Medicaid in Montana, at least for me, is overshadowed by a larger crisis of co-ops failing across America, leaving hundreds of thousands of Americans scrambling to figure out how to get insured.

Democracy Now! has a good piece on today’s show about this crisis, and by good I mean incredibly depressing.

As Montana Democrats cheer expanding Medicaid, it might be instructive to recall that it was Max and his gang of six who killed the public option, setting the stage for the predictable failure of co-ops whistle blower Wendell Potter warned about six years ago.

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About William Skink

I'm a poet and political cynic living and writing in Montana. You can contact me here: willskink at yahoo dot com
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32 Responses to Montana Expands Medicaid As Max’s Legacy Hurts Hundreds of Thousands of Americans

  1. JC says:

    The news that the feds are going to allow the Medicaid expansion will probably drive another dagger into the Montana Health Coop. They are going to lose all of their 100-138% of poverty level clients as they get shuffled onto Medicaid. I read somewhere that around 40,000 Montanans have subsidized policies, and about a quarter of them will be dropped off subsidized plans and moved to Medicaid, and about 10,000 people in the state are in the 100-138% category. SO whatever part of that the Mt. Health Coop had, they will lose.

    Interesting kerfuffle over at cowgirl, “Medicaid Slamming” someone called it.

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  2. Wendell Potter strikes me as someone not to be trusted, part of the PR practice of covering all sides of the debate, owning all the arguments, and leading the opposition. He became Obamacare’s biggest proponent after passage, even as the public option and single payer, which he supported, went down and are now gone from reach.

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  3. Big Swede says:

    “If you think HC is expensive just wait until it’s free”-P.J. O’Rourke,

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    • That quote, tossed around regularly by supposedly wise people, is both stupid and wrong. “Free” (publicly sponsored) health care works everywhere is has been tried. If you ever troubled yourself to actually look at evidence, you might kmow this. But your authoritative sources don’t clue you in, leaving you clueless.

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      • Big Swede says:

        Profit equals efficiency. Govt. has no incentive to save money with no competition. Public sponsored care downward spirals into rationed care. Single payer also becomes another tool to control the public with PC and anti religious BS like making the Little Sisters of the Poor purchase plans with birth control and abortion options.

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        • JC says:

          “Profit equals efficiency.”

          I think the pharmaceutical industry has proven that adage wrong in healthcare, many time over. Go look at the story about Risperdahl where the drive for profit pushed Johnson & Johnson into using profit goals to decide how to market the drug in illegal, unethical, dangerous, and insidious ways. And that’s just the tip of the iceberg.

          Face it Swede, the health care industry is unlike any other when subjecting it to capitalism. It just doesn’t respond to “the market” in the same ways. Which is why the rest of the free world has one form of single payer or another.

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        • Swede, this is from the dictionary:

          Evidence: the available body of facts or information indicating whether a belief or proposition is true or valid.

          “The deepest sin against the human mind is to believe things without evidence.” (Aldous Huxley, author of Brave New World.)

          You’re a sinner, Swede. All your beliefs regarding health care are unsupported by evidence … but your faith is never swayed. It is pointless to debate you, just as it is pointless to discuss the Mormon faith with a true believer.

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      • Big Swede says:

        By the way, go to your local doctor and tell him you want to pay cash for services with out governmental or insurance company intrusions and compare the costs.

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        • JC says:

          Cash pay has always been the most expensive way to purchase health care. Go look up some information about “chargemaster” and how inflated cash pricing is used to corrupt the system. Again, Brill’s done the heavy lifting.

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        • Big Swede says:

          I read Brill’s examples JC. You’re a smart guy so i want you to envision HC without governmental intrusion.

          For example if a citizen was allowed a catastrophic care policy (outlawed with the ACA) or better yet flew to a hospital ship anchored in international waters of the coast for care what would the personal cost be?

          I’d wager they’d be a small fraction of what they are because the taxpaying public is forced to pay for those who can’t pay domestically.

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        • Big Swede says:

          Medial Tourism, a expanding market.

          “Factors that have led to the increasing popularity of medical travel include the high cost of health care, long wait times for certain procedures, the ease and affordability of international travel, and improvements in both technology and standards of care in many countries.[6][7] The avoidance of waiting times is the leading factor for medical tourism from the UK, whereas in the US, the main reason is cheaper prices abroad.

          Many surgery procedures performed in medical tourism destinations cost a fraction of the price they do in other countries. For example, a liver transplant that costs US$300,000 in America costs about 91,000 USD in Taiwan.[8] A large draw to medical travel is convenience and speed. Countries that operate public health-care systems often have long wait times for certain operations. Using Canada as an example, an estimated 782,936 Canadians spent time on medical waiting lists in 2005, waiting an average of 9.4 weeks.[9] Canada has set waiting-time benchmarks, e. g. 26 weeks for a hip replacement and 16 weeks for cataract surgery, for non-urgent medical procedures.[10]”-Wiki.

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        • JC says:

          Swede, there are different forms of single-payer. It could be nothing more than the government collects a tax and the money flows to a private entity to pay private providers.

          As to your example, all a catastrophic policy does is to make sure that in the event of a catastrophic event, the providers get paid most of what is due. The deductible on a catastrophic policy is enough to bankrupt half of the country. So Catastrophic policies will drive bankruptcies sky.

          As to medical tourism, that will do nothing but cater to rich people who have the time and money to fly to cruise ships to schedule regular maintenance. This kind of a thing does nothing for preventive health care, emergencies, chronic care, pregnancies, and most of the rest of regular health care needs.

          These aren’t solutions Swede. They’re things that rich people think might benefit themselves, or ways to solve the issue for poorer people that won’t work.

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        • Big Swede says:

          Not so fast JC. Medical tourism, once available for the wealthy is creeping down to the common worker.

          “Some US employers have begun exploring medical travel programs as a way to cut employee health care costs. Such proposals have raised stormy debates between employers and trade unions representing workers, with one union stating that it deplored the “shocking new approach” of offering employees overseas treatment in return for a share of the company’s savings. The unions also raise the issues of legal liability should something go wrong, and potential job losses in the US health care industry if treatment is outsourced.[48]

          Employers may offer incentives such as paying for air travel and waiving out-of-pocket expenses for care outside of the US. For example, in January 2008, Hannaford Bros., a supermarket chain based in Maine, began paying the entire medical bill for employees to travel to Singapore for hip and knee replacements, including travel for the patient and companion.[49] Medical travel packages can integrate with all types of health insurance, including limited benefit plans,[50] preferred provider organizations and high deductible health plans.

          In 2000, Blue Shield of California began the United States’ first cross border health plan. Patients in California could travel to one of the three certified hospitals in Mexico for treatment under California Blue Shield.[51] In 2007, a subsidiary of BlueCross BlueShield of South Carolina, Companion Global Healthcare, teamed up with hospitals in Thailand, Singapore, Turkey, Ireland, Costa Rica and India.[52] A 2008 article in Fast Company discusses the globalization of healthcare and describes how various players in the US healthcare market have begun to explore it.[53]”-Wiki

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        • JC says:

          Nice, so not only do we outsource means of production, but not we outsource medical care. That’s basically an indictment of our healthcare system. If all of the healthcare systems in other countries can offer better/cheaper care, what are they doing right that we are not? Also, what happens when the dollar crashes and isn’t worth diddly?

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  4. Big Swede says:

    High deductibles, high administration costs, the potential of forced unionization of the entire HC system and covering 12+ million illegals will doom efficiency.

    Welcome to the revolution.

    http://frugalnurse.com/2014/02/save-money-self-pay-patient/

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    • Big Swede says:

      From the above link.

      “He also recognizes that our health care and personal health decisions are being controlled more and more by insurance conglomerates and big government, what he calls “bureaucratic medicine.”

      The new mandates and regulations of health care reform—Obamacare—are making health care and insurance more expensive for many, and creating more red tape for everyone—patients, doctors, hospitals, employers and insurance companies alike.

      For the young, insurance may seem like a bad deal that asks them to pay inflated prices for insurance that delivers few benefits. Others will find insurance is still unaffordable, and more will simply reject participation in what I call bureaucratic medicine and opt to escape Obamacare and become self-pay patients, who pay directly for most or all of their healthcare.

      Tens of millions more Americans will find themselves in high-deductible plans that require them to pay up to $5,000 or more for healthcare out of their own pockets before they begin to receive many benefits.

      My new deductible is $12,000—what’s yours?”

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      • The concept of “insurance” does not work in health care, except perhaps in the case of catastrophic illness. It is better to think of the delivery system as a “utility.”

        Can you imagine an insurance company standing between you and your ability to access the electrical grid? In that situation, it is easy to see that “insurance” companies merely exist to limit access to care and take resources out of the system without in any way improving it. They are the source of most of our problems, but because they have political power, we cannot get rid of them. They are leaches.

        Obama is as much a stooge of industry as Baucus, and “Obamacare” (written by insurance industry executives – Wellpoint’s Liz Fowler was the primary author) was not an attempt to fix our system. It was conceived to protect the insurance industry. This is painfully apparent to anyone with any powers of observation. It opened the floodgates to subsidy.

        Every other country on the face of the earth has figured out that health care is a utility, and that the profit motive exacerbates all the problems. It is best run by government.

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        • Big Swede says:

          Insurance worked fine until the Fed and local governments started messing with it.

          As far as”every other country” defense find me a comparable nation with the same population and the same amount of non-payers and illegals who have the quality of care and short wait times as we do. Then show me the long term financial viability of said single payer systems which are staying even with expenses without rationing.

          I don’t think the above example exists. And ifs it’s some European socialists paradise they’re about to be crushed by immigrants.

          The government has had it’s chances to show us how well they can handle HC. Native American Care and the Veterans are prime examples.

          And who created the ACA? It’s wasn’t the Koch brothers. By the way the ACA is approaching it’s death throes. http://www.nationalreview.com/article/426550/obamacare-failures

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        • “Insurance worked fine” for those who had it. But there was a problem – insurance companies do not like insuring the elderly, as they are the most likely to get sick. Consequently, in the 1960’s, senior health care was a national crisis at a time when we truly were the richest nation on earth. We instituted Medicare, and even though it is tied into a corrupt private sector to provide the care, even though private insurers still rake in major profits off supplemental care policies, the system works.

          VA is a shining example of government-run health care that works, and works well. The recent influx of PTSD plus some slanted reporting, has created the impression it does not work. As usual, you are short of evidence. Until you can demonstrated that you ahve gone beyond National Review for information, it is pointless to argue with you. You are low-infomration.

          Every other country that has universal health care has solved the problem on non-payers and illegals. By definition. Everyone gets care. It is cheaper and better than ours, everywhere. Want to know how I know this? “Evidence.”

          Of course ACA will fail. We all agree on that. It was not designed to succeed. It was designed to protect the insurance industry from single payer. God I wish you’d read something own and then. Really annoying to repeat, even then knowing you won’t read when it is repeated.

          one more thing – you do this constantly, and have been called out on it: You say your system, which obviously does not work, only fails becasue of governmetn. You say that otehr systems that are working, and working fine, will fail eventually. It’s all you got, in other words, you got nuthin’.

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        • Big Swede says:

          Resulting to personal attacks. Sign of weakness, wouldn’t ya think?

          If the NR or any other right leaning source is so wrong why don’t you address them specifically?

          Here’s Forbes on the VA management failure. http://www.forbes.com/sites/victorlipman/2014/06/25/va-hospital-scandal-above-all-is-a-failure-of-management/

          Management is what you want DC to do.

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        • No, Swede – you do that all the time too – one, you don’t read anything you don’t like, two you don’t answer arguments, three you rely only on chosen authority figures and ignore all other evidence, and four, when called out, say it’s a personal attack.

          You’re the armor-all boy.

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  5. Big Swede says:

    Here’s your shining example of VA management.

    WARNING, FOX NEWS CLIP!!!!!

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    • Swede – I have actually studied our health care system and VA over the years, and the problems and accomplishments of the program. Satisfaction among clients is far higher than in the private sector. It has advanced the computerized medical record field. It has problems, and those problems are magnified by its detractors for political purposes.

      You, on the other hand, have nothing but Fox news.

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  6. steve kelly says:

    While we’re repeating the fundamentals of the ACA, please understand that the “federal mandate” was first touted by the Heritage Foundation’s Heritage Plan. The federal mandate was/is essential to the Heritage Plan, which led to Gov. Romney’s HC Plan in Mass.

    The Heritage Plan, like Speaker Paul Ryan’s Plan supported by most House Republicans, didn’t stop there. It would have also destroyed Medicare by replacing it with a voucher system. Vouchers are to be funded by a VAT tax. It seems Republicans never give up on a “national sales tax” to dodge any and all direct tax on income or property. That’s a real “jobs killer,” right? But who needs an income when you’ve got a health care voucher?

    Like

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