The recent article about job losses from the closing of LSU Earl K. Long Medical Center drew some online comments blaming Obamacare for the closure of EKL.
To help offset the cost of the uncompensated care charity hospitals provide to low-income and uninsured people, these hospitals receive funds through the Medicaid and Medicare Disproportionate Share Hospital programs.
But on the assumption that the number of uninsured people will dramatically decrease as they get coverage under Obamacare starting next year, those payments to the charity hospitals are being reduced.
As a result of this funding shift away from charity hospitals and toward Medicaid expansion (i.e. health insurance for low-income people), those dollars end up being spent more wisely.
For example, which costs less: Giving someone health insurance so they can afford to go to the doctor when they realize their chest cold is just not going away. They are examined in the doctor’s office and sent home with a prescription for a $5 antibiotic, recover quickly, and return to work.
Or: Admitting someone to the hospital for a week after the secondary bacterial infection they didn’t know they had has blossomed into a life-threatening case of pneumonia. (But in the meantime while they were sick, but not yet too sick, they continued to work at the restaurant preparing and serving food to others).
By declining the Medicaid expansion, Gov. Bobby Jindal has really stuck all of us with a double whammy: a larger population of sicker people who end up in the emergency room, where the higher cost of their care ends up adding to all of our costs — but now with fewer emergency rooms for them to go to, which increases wait times for everyone.
Jindal’s protestations about Medicaid being inefficient and lacking flexibility ring hollow when you consider how often he touts Bayou Health. Since February 2012, that’s been our regular Medicaid program for which Louisiana was allowed the flexibility to transition from a fee-for-service model to one where most enrollees have their health care overseen by private managed-care plans.
During the 2012 session, the Louisiana Legislature directed DHH to research and report on how to raise Louisiana’s persistently low (e.g. 49th in 2012) health ranking. Available at http://new.dhh.louisiana.gov/assets/docs/LegisReports/SCR111-2012R.S..pdf , the report concludes that lack of health insurance, along with smoking and obesity, is weighted most heavily in that ranking. The report cites Bayou Health as a “coordinated care system that should lead to better access to health care, more choices and improved patient health.”
Why couldn’t the expansion be run the same way? Is Gov. Jindal counting on us to overlook the findings of his own administration?