Medicaid expansion not healthy for individuals, government: Sarah Bevins, Libertarian Party of Ohio
Sarah Bevins serves as Vice-Chair of the Executive Committee of the Libertarian Party of Ohio.
Guest columnist Sarah Bevins serves as Vice-Chair of the Executive Committee of theLibertarian Party of Ohio, and Director of the party's Communications Division. She writes in opposition to Ohio's expansion of Medicaid.
In 2013, Gov. John Kasich performed an end run worthy of Isaiah Crowell to bypass the state legislature and push through the Affordable Care Act's Medicaid expansion. According to some sources, this expansion has put 430,000 Ohioans on Medicaid this year.
No one, least of all Libertarians, is against people getting adequate medical care. That would not only be bad for those individuals, it would be a bad thing for society as a whole. But wanting healthcare for everyone isn't the same as wanting the government to do it. Expanding big government healthcare is being done with the best of intentions. But we all know what road is paved with good intentions.
Government-provided care, such as Medicaid, has a variety of problems built into the system. The most obvious problem is availability of care and how quickly it can be accessed.
Throughout its history, going back to its founding in 1965, healthcare providers have complained about the paperwork hurdles that must be jumped and the time it takes to get Medicaid payments. These problems were bad enough under traditional, government-administered Medicaid.
But today, in Ohio, much of the Medicaid is administered by insurance-company managed care groups that combine the worst features of government services and private insurance.According to some doctors who have been serving Medicaid patients for years, these plans pay even less for care than the state Medicaid agency.
Doctors are in practice to take care of patients, not to do paperwork or wait for reimbursement. A recent report by the inspector general for theFederal Department of Health and Human Services found that half of the doctors appearing on Medicaid lists could not accept new patients. Many were no longer at the addresses listed. Others either were not participating in the plan or had no appointments available for new patients.
The shortage of available providers means that not only is it difficult for a patient to find a doctor, it can also take a long time to get to see that doctor. Poor levels of reimbursement also incentivize doctors to see as many patients as possible as quickly as possible in order to bring in more money. Bureaucratic red tape can further add to wait times, by heaping requirements that must be met by patients before care will be provided.
Of course, there are other issues. Increased Medicaid spending is a burden on the Federal Government now, and the expansion offered by the President and accepted by Gov. Kasich will become a greater burden on state budgets later. Government spending on care today means higher deficits for our children tomorrow. Fraud and abuse add on even more cost.
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Medicaid expansion not healthy for individuals, government: Sarah Bevins, Libertarian Party of Ohio