Saturday, June 13, 2009

Obama Sharpens Knife on Safety Net Hospitals & Dual Eligibles

President Obama looks more like his predecessor with each policy announcement. When George Bush enacted Medicare Part D Prescription Drug program, people covered by Medicare & Medicaid took a major hit. These are poor people, the elderly and disabled. Dual eligibles, averaging over 5 prescription drugs, faced prescription montly co-pays of $15 to $60. A new $720 annual bill is significant for the struggling. In 2007, I wrote:

In 2006 President Bush said in Dublin, Ohio, "And you probably read about kind of the dual- eligible problem. I don't know if you've had that problem here in Ohio, Governor. We're dealing with it. Our job is to solve problems when they arise." So what did George do? Not much. The problem lay in the pharmaceutical benefit design.

He did shaft those same dual eligibles by not informing them of their ability to be reimbursed for past medication expenses. Recall, these are the poor, frail disabled and elderly. Hundreds of million in federal funds intended to help dual eligibles likely ended up in the coffers of insurance companies.

Now the Obama team wants to go afte the same low hanging fruit. The AP reported:

For instance, it said, drug reimbursements might be reduced for people who receive both Medicare and Medicaid.

As for safety net hospitals that Bush loved to stress, Obama has plans.

The newly proposed $313 billion in savings, he said, "will come from commonsense changes."

He would cut $106 billion from payments that help hospitals treat uninsured people because his plan would cover nearly every American.

Horse hockey! Between undocumented residents and the chronically noncompliant, I expect well over 20 million uninsureds. Add a long term phase in and the numbers come down slower. Safety net providers will still be needed.

President Obama's commonsense changes include unenacted funding plans and tapping a struggling safety net system for money to cover the uninsured. That doesn't sound like common sense, unless your goal is for nonprofits to fail and be acquired by their for-profit brethren.

Now Change Means No Change From W.

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