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Health care act will cost more

Published 12:01am Sunday, November 4, 2012

Trying to understand the looming changes in our health care system and their impact on patients has been very difficult.

Hopes abound based off the promise of “affordable” care for all including “free” care for those who can’t afford any contribution toward their own care. Unfortunately, as in all other aspects of life, there is no “free lunch” in health care either.

The sad thing about the current system as laid out in The Patient Protection and Affordable Care Act, also known as “Obamacare,” is that before it gets started here in Mississippi it already apparently is underfunded.

I have gotten information from state legislators, hospital association representatives, the governor’s office, former Medicaid personnel and general news publications, and I am struck by the somewhat variable cost estimates of the approaching system we will have and also by the general consensus that: “It won’t work, but we have to do it anyway.”

First of all, Obamacare cuts out something known as Disproportionate Share Payments (DSH payments) to hospitals over the next few years under the premise that “everyone will be insured so the hospitals won’t need the money.” DSH payments are basically federal monies (our tax dollars) that hospitals receive each year to help offset some of the cost for the care of the currently uninsured patients.

Secondly, and bear with me now, we currently have approximately 400,000 people served by the Mississippi Medicaid system. Nearly $4.5 billion was spent on their care for the 2012 fiscal year. Under Obamacare, about half of the newly insured in our country will get their new insurance through an expanded Medicaid system by raising the income level a person can earn and still qualify for Medicaid to 133 percent of the federal poverty level.

This will add approximately 400,000 more people to our Medicaid rolls. Normally Medicaid is jointly funded by our state and federal taxes with Mississippi blessed to receive a generous 74 percent federal match to our 26 percent state taxpayer contribution.

However, to entice more participation, Obama has promised that for three years the feds will pay “100 percent” of the cost for the new Medicaid, but not the old Medicaid, patients. After three years taxpayers will gradually have to help fund the extra patients with 90 percent eventually still paid by our federal taxes and 10 percent from state tax collections.

According to Ed Sivac of The Mississippi Economic Policy Center, who spoke at a recent chamber of commerce event, the total extra federal taxpayer money to take care of just the extra 400,000 new Mississippi Medicaid patients will be $11 billion over seven years, and this will be matched by 1.6 billion state taxpayer money. That amounts to less than $2 billion per year to treat 400,000 new people while we are currently spending 4.5 billion to treat 400,000.

Our hospitals, which average approximately 30 percent of their money from Medicaid, our nursing homes, pharmacists, doctors, home health nurses, DME companies, etc., who are paid by Medicaid will either not get paid adequately or will have to curtail services.

The usual political response is either that they don’t expect everyone who is eligible to actually sign up, or that the new Medicaid recipients will be healthier people and won’t use the health care system, or that our new health care system will be so efficient that it won’t cost as much to care for the patients.

If these numbers are true, we are all in trouble. Changes will occur in the delivery of health care in our country.

Costs are rising faster than inflation, and we have to care for the truly needy. But we have to do it in a way that does not ruin the care that most have been comfortable with and without bankrupting our country. Perhaps programs like the one in Indiana, which has resulted in savings but in a way apparently tolerable to over 90 percent of those in the program, would be a way to go.

It seems to offer choices of different levels of insurance with state contributions to health savings accounts that are controlled by the patients who are then able to control their own health care decisions and expenses. The vast majority of Americans could handle such empowerment. We voters aren’t as stupid as the president and his technocrats think we are.

Dr. Kenneth Stubbs

Concordia parish resident and Natchez internist

  • Anonymous

    something has to change……..the system we have is not affordable….

  • Anonymous

    Affordability of the current system vs. Obamacare both present issues. The doctors, hospitals, and other providers under the current plan bill out inflated rates, then accept about 15-20% of that amount as payment in full from Medicare or other insurance providers. Why not adjust those rates at the outset down into the range of 25% of current billed rates since apparently the settlement amount provides adequate income? Under this scenario, medical needs would become much more affordable and likely could become either self insured by many companies and individuals or cooperatives could enter the insurance market for competition against the big insurance companies. This may eliminate the need for Obamacare since many employers could hire more people with the savings in insurance costs and those people would be paying insurance premiums rather than being on Medicaid. Artificially high rates have created the perception of unaffordability yet the industry continues to stand on firm ground with the high rates while letting Obamacare become the perceived solution.

  • Anonymous

    READING THOSE LONG>CONFUSING DIEHARD REPUBLICANDO-THEY-REALLY-THINK-WE-ARE-THAT-DAM-DUMB< ? STUBBS, YOU NEED TO STICK TO WHAT YOU KNOW BEST, CHECKING TEMPERATURES. BELIEVE ME NOT, THEY ARE SOME DESPERATE. I'M LOVING EVERY SECOND OF IT, I LOVE TO SEE THOSE NO GOOD FOR NOTHING SUCKERS SCRAMBLE. THEY ARE *VERY* AWARE IF THAT LYING MITT LOSES, THIS IS THE END FOR THEM. FOX LYING NEWS WILL SLOWLY DISOLVE, BECAUSE THERY LIES WILL BE USELESS. IT TOOK A SUPER STORM TO OPEN UP MR. CHRIS CHRISTIE EYES. DID YOU SEE HIM ? MR MITT WAS OUT THERE SHOVELING A COUPLE CASES OF BOTTLE WATER FOR THE CAMERA, WHEN THE CAMERAMAN TOOK A BREAK, HE TOOK A BREAK. FROM THE WAY THOSE DIEHARDS BEEN CONDUCTING THEMSELVES OVER THE LAST FOUR YEARS, I'M INCLINED TO BELIEVE THAT IF FRED FLINTSTONE WAS RUNNING AGAINST THE PRESIDENT, THOSE NUTS WOULD CAST THERE VOTE FOR HIM. THOSE PEOPLE ARE BEYOUND MY REACH. I'M NOT GOING TO TRY AND SWAY ANYONE WHO TO VOTE FOR; ALL I'M GOING TO SAY IS: VOTE-VOTE-AND-VOTE.

  • Anonymous

    READING THOSE LONG>CONFUSING DIEHARD REPUBLICANDO-THEY-REALLY-THINK-WE-ARE-THAT-DAM-DUMB< ? STUBBS, YOU NEED TO STICK TO WHAT YOU KNOW BEST, CHECKING TEMPERATURES. BELIEVE ME NOT, THEY ARE SOME DESPERATE. I'M LOVING EVERY SECOND OF IT, I LOVE TO SEE THOSE NO GOOD FOR NOTHING SUCKERS SCRAMBLE. THEY ARE *VERY* AWARE IF THAT LYING MITT LOSES, THIS IS THE END FOR THEM. FOX LYING NEWS WILL SLOWLY DISOLVE, BECAUSE THERY LIES WILL BE USELESS. IT TOOK A SUPER STORM TO OPEN UP MR. CHRIS CHRISTIE EYES. DID YOU SEE HIM ? MR MITT WAS OUT THERE SHOVELING A COUPLE CASES OF BOTTLE WATER FOR THE CAMERA, WHEN THE CAMERAMAN TOOK A BREAK, HE TOOK A BREAK. FROM THE WAY THOSE DIEHARDS BEEN CONDUCTING THEMSELVES OVER THE LAST FOUR YEARS, I'M INCLINED TO BELIEVE THAT IF FRED FLINTSTONE WAS RUNNING AGAINST THE PRESIDENT, THOSE NUTS WOULD CAST THERE VOTE FOR HIM. THOSE PEOPLE ARE BEYOUND MY REACH. I'M NOT GOING TO TRY AND SWAY ANYONE WHO TO VOTE FOR; ALL I'M GOING TO SAY IS: VOTE-VOTE-AND-VOTE.

  • http://www.facebook.com/Bob.Buie.Sr Bob Buie Sr

    Deuce, you are a classic example of “intellectual nakedness”!
    Bob Buie Sr

  • Anonymous

    After my divorce I could not get health insurance because I was “uninsurable” because of a pre-existing condition. I always had and paid for insurance but now I was $hit out of luck and one medical emergency from being totally destitute. Because of Obamacare I have been paying my premiums and am fully covered. Since we are the greatest nation in the world, we should have affordable healthcare for everyone, otherwise all our great resources are just for the select few.

  • Anonymous

    Yeah, well thanks to Obamacare, MY health care insurance premiums went up by almost $140 per month!!!!!!!!!! WHAT !!!????? Thanks, Obama- now I get to foot the bill for medical coverage for dead-beats. Obamacare stinks

  • Anonymous

    Um, no. Your health care insurance premiums have been going up and up and up long before Obamacare took place. That’s why they are in the insurance business — they can raise your premiums whenever they want. Now, under Obamacare, the insurance companies are held to not spending more than 20% of your premium on anything but direct health. They cannot spend less than 80% of your money on direct healthcare and cannot spend more than 20% on the premiums on administrative costs. If they do, they owe it back. Of course, the insurance companies would like it the other way around and are gouging as they have in the past. Now, they are being held accountable. So, go ahead and vote for the rich companies, if you want. They’ll gladly accept your money and continue to gouge you of everything they can at the lostest cost to them.

  • Anonymous

    Please post my response to burnleyc. I provided some valuable information and referred to a federal government link. Are you cencoring my right to provide information that the taxpayer pays for? Well you don’t need the link. Just go to healthcare.gov and click on

    Your Insurance Company & Costs of Coverage

    The Affordable Care Act includes features that promote transparency and hold insurers accountable for how they spend your premium dollars and rate increases. “Medical Loss Ratio” and “Rate Review” are two features of the health care law that are in place and making a difference for consumers.

    Medical Loss Ratio: Insurers must, in general, spend 80% or 85% of the premium dollars they take in on health care costs and health care improvement activities. If they do not, they must provide refunds to policy holders. Learn more about Medical Loss Ratio.

    Rate Review: Health insurance companies must tell consumers when they want to increase insurance rates for individual or small group policies by an average of 10% or more. Learn more about Rate Reviews.

    Use the search tool below to find a basic profile of your insurance company or information about Medical Loss Ratio (MLR) and Rate Reviews. To get started, select your state, enter the name of your insurance company, or enter the company’s NAIC Number (consumers can find the NAIC Number on their policy document, from their state Department of Insurance website or by contacting their insurer). Then select Overview, MLR, or Rate Reviews and click the Search button. You can also use the Rate Review tool further down the page to find rate increases where you live. Note: Not all states currently have rate reviews to report.

  • Anonymous

    The Natchez Democrat is stealing my comments! Put them back.

  • Anonymous

    The other one, too!

  • Anonymous

    I responded. But The Natchez Democrat stole it. You insurance company has been and will forever be so — raising your premiums. Under Obamacare they are now being held accountable. If you go to my comment after ND stole the one I posted to you, up above, if they don’t steal it again, you can use a search tool to see if you are being gouged by your insurance company — Thanks to Obama.

  • Anonymous

    Classic case for voter id – vote-vote-and-vote???????????????????????

  • Anonymous

    The Natchez Democrat needs to have some accountability for swiping comments from commenters. I posted a comment to burnleyc and ND swiped it. This is disgraceful! We need freedom from this press so we can have what they are here for — freedom of the press to provide to their readers information that could be a matter of life and death and what their government can really do for them.

  • vilou09

    Fyi…. they have to approve everything with a link in it. They didnt pull it, it just hadn’t posted yet.

  • vilou09

    I’ll respect you a lot more if you give us a little information about yourself…
    Are you on Medicaid, Medicare, welfare, food stamps, etc? And do you have a job?
    Inquiring minds would like to know where you’re coming from with your stance against Romney and for Obama.

  • Anonymous

    Nope, it’s been over an hour. They swiped it!

  • Anonymous

    The above is fact, not opinion. It is information you can use. Kind of like a manual. For someone to dislike this is epitome of ignorance since the act of ignoring is ignorance.

  • vilou09

    Doesn’t matter. They will still monitor it.

  • Anonymous

    You can’t not like this post, either; you haven’t seen the comment!

  • Anonymous

    Wait until they steal one of your comments. You won’t like it, either.

  • Anonymous

    Fine, but what else do they have to do to monitor a government site? They have already let the second one through, but swiped the one reply to burnleyc.

  • vilou09

    Why can you not get it through your thick head?
    They dont WANT to “swipe” anything. I doesn’t matter if you include a link to the disney channel, they’re still going to keep it off the site until they approve it. That’s ANY hyperlink from ANYBODY, it automatically does it.
    They are just humans- and it’s SUNDAY- and im sure by the time the moderator got to approving your comment, you’d already sent 10 of them. That’s overtrafficking, and unacceptable on a forum such as this.

    GOD!! I feel like im explaining trigonometry to a CHILD!!

  • vilou09

    Btw, they have “swiped” my comments before. Because I used a hyperlink. Idiot.

  • Anonymous

    They approved a link to the parent site since I posted a comment to burnleyc. Why can’t you get that through your head.

  • http://www.natchezdemocrat.com Kevin Cooper

    The comment system does not allow hyperlinks to go up automatically. I believe it’s set up that way to prevent spammers or teenagers from posting links to porn or other stuff for kicks. The system flags them for review prior to posting. We are more thinly staffed on the weekends and thus it took us a bit longer to clear these. No one is censoring your comments (beyond adherence to the site’s rules).

  • vilou09

    I got your back, Kevin!

  • Anonymous

    Thank you for finally posting my reply to burnleyc. I would believe if you had not approved a comment with a link between now and then which just proves my point.

  • http://www.natchezdemocrat.com Kevin Cooper

    Thanks, Vilou09. :)

  • http://www.natchezdemocrat.com Kevin Cooper

    I don’t understand what point you’re attempting to prove, but what I wrote was the truth. No one here is secretly trying to suppress your opinion. Had we wanted to do that, we could have just eliminated your ability to post entirely.

  • Anonymous

    You did eliminate my comment until I raised hell. The way I can prove that is that you approved a comment of mine with a link since then. Get it? So you approved one but not the other. Now you have approved the other, cya.

  • http://www.natchezdemocrat.com Kevin Cooper

    Incorrect. First, we didn’t eliminate your comment at all. It was never posted because Disqus flagged it because of the linkes, as Vilou09 referenced. When we noticed comments were flagged (the system e-mails several of us), we began working these. It’s a Sunday, so it’s likely our reaction time to these is much slower than it might be during the week, when several of us are in front of a computer all day long. I hadn’t seen your complaining comments or what I’ve now seen is a bunch of rants on Facebook until after we started approving the comments. I’m not positive (and cannot check right now because the comment queue has been cleared) but I think the comments that are in the “flagged” queue show up in reverse order. so as we’re working the list, we’re working from the most recent comment first, to the oldest. That might explaining the timing conspiracy you’re seeing.

    Your comments are welcome, but anytime someone includes links to a third-party site (I think links to natchezdemocrat.com are excluded from the auto-flagging, but I may not be correct) it’s going to be flagged by the system and thus delayed from going onto the site live.

  • Anonymous

    The link was to a dot.gov site, Kevin. The very same one someone approved after I posted my comment to burnleyc. So, if it was in the queue, it was there when someone approved my second comment with the link but with-held my comment to burnleyc (until I raised a fuss). I was infuriated as I should have been. (Besides, I have been edited from posting from natchezdemocrat.com when it doesn’t suit you.)

  • http://www.natchezdemocrat.com Kevin Cooper

    Are all of your comments not approved and showing up now? Even if we approved them in the reverse order in which you posted (which I think we did) all should be visible now. I’m sorry that you’re infuriated by this. You’re simply infuriated at a computer program, though, because no one here read your comment and decided to withhold it, as you allege.

  • Anonymous

    So you just approve whatever whenever but if there is something there before hand you just didn’t see them?

  • http://www.natchezdemocrat.com Kevin Cooper

    There is nothing to concede. I’m simply trying to explain to you what occurred. You are welcome to continue to believe there’s something fishy going on, but it’s simply not true. There’s no conspiracy, no attempts to censor. Had your comment simply not included a website link, the comment would have appeared without the delay. As far as the timing of which comment was approved first, all I know is the comments show up in a list. The list is in reverse chronological order. Working from the top of that list means we approve more recent comments first.

  • http://www.natchezdemocrat.com Kevin Cooper

    Thanks, vilou09, for trying to help explain this. You’re correct, the system flags any and all links.

    Thanks.
    Kevin.