Posted on 03/20/2017 11:34:38 PM PDT by nickcarraway
A proposal to spend $10 million next year to provide health care to 15,000 of the most chronically ill members of Idahos health coverage gap population failed in the Idaho Senate on Monday after nearly two hours of debate.
The bill, proposed by Sen. Marv Hagedorn, R-Meridian, who co-chaired an interim legislative working group that examined options for the states gap population, failed on a 13-22 vote. Those in the gap are the estimated 78,000 Idahoans who earn too much to qualify for Idahos limited Medicaid program, but not enough to qualify for subsidized insurance through the states health insurance exchange.
Hagedorn noted that among the working groups recommendations were that the 2017 Legislature take action to provide some kind of health care to some portion of that gap group. It also recommended that if Idaho accepted federal Medicaid expansion funds, it enact a conditional sunset expiration clause in case federal policies change. This is not that, Hagedorn said.
Instead, he said, the bill would tap $10 million in tobacco settlement funds to cover about 15,000 of the most chronically ill among the gap population with coordinated primary care and also would steer people who come to emergency rooms inappropriately into coordinated care programs.
We are all paying for these costs today, Hagedorn said. Nothing is free.
Hagedorn said the program would provide care, not insurance. If they get cancer or need surgery, he said, theyd be thrown back on the states existing catastrophic health care program, which is funded by local property taxpayers and the state general fund.
This sets up a foundation of coordinated care for the chronically ill gap population, he said.
Sen. Maryanne Jordan, D-Boise, said she wanted to acknowledge Hagedorns work on the issue, because its unbelievably important to Idaho.
But she said the types of efforts envisioned in the bill already are underway in Idaho through community health centers. And she said tapping the Millennium Fund endowment earnings, which come from tobacco settlement funds, will strip away funding for existing programs that use that funding, including the Project Filter anti-tobacco program and the Idaho Suicide Hotline.
I think we have a long way to go in this issue, and many more robust debates to have in the future, but, sadly, I dont think this gets us there, Jordan said.
Sen. Mary Souza, R-Coeur dAlene, urged support for the bill.
I believe that our health care system in the United States is upside down, she said. We focus on illness, illness pays very well, and theres a big revenue stream. If we are going to improve our lifestyle here in Idaho, we are going to have to flip that model upside down.
Souza urged senators, Improve the level of peoples wellness, rather than just feeding the illness machine.
She said the bill would start the process of innovations that Idahos health care system needs.
Sen. Jim Patrick, R-Twin Falls, said he didnt want to take funding away from other Millennium Fund programs.
I have a hard time supporting this legislation. For one thing, $10 million is a drop in the bucket its going to take $100 million, he said.
Hagedorn, in his closing debate, said, These arent deadbeats. These are people who have jobs. And they have health problems.
We need to encourage these patients, these participants, to get healthy, he said. At the same time we need to bend the cost curve. This is not a cure-all, totally granted, not a cure-all. But this sets the foundation for people to get healthy. There are people dying right now, people dying today, because they dont have health care. So weigh this: Wheres it better to spend our Millennium money? To help chronically ill people that dont have insurance get well thats the focus of this, nothing more.
With the defeat of Hagedorns bill, theres still one more proposal pending in the House, which also seeks to tap tobacco settlement funds to pay for some primary care for a portion of the gap population; that bill hasnt yet had a committee hearing.
This is what I have a problem with. If there's a need for the public to pay for something then the entire public should pay for it and not just one ostracized segment of it. In this case it's smokers. Next time it might be yogurt eaters or whatever. Those settlement funds are never paid for by the tobacco companies. They pass that cost on to their customers who end up paying for it.
This is one my pet peeves I guess. It's just wrong.
EXCELLENT!!
The transplants from California haven’t killed that place
Yet.
Used to be that alcohol taxes paid for federal government functions, among other like taxes (e.g. tariffs). Then along came the Sixteenth Amendment, supported by anti-alcohol forces among like-minded peoplethe same people that got the Eighteenth Amendment passedresulting in “the entire public” being put into bondage rather than those buying and consuming alcohol.
Notwithstanding, since when is there a real need for “the public” to be induced to pay for something, even “the entire public”? especially when the government is the one defining the need at its own will?
“There are people dying right now, people dying today, because they dont have health care”.
That is, if not an outright lie, at the very least a deceptive statement.
What it should read, is there are people dying right now because they are not insured, and chose not to see a doctor for that reason. Waiting till their health is in crisis before accessing the Emergency room for available health care.
These are some of the folks addressed in Medicaid expansion efforts, by some states, but not addressed by other states who see it as fiscal suicide to expand medicaid when the money is NOT there either federally or in the State budget.
Bottom line, do we bankrupt ourselves attempting to pay for insurance or health needs of the GAP population. The working folks who supposedly cannot afford insurance, and choose not to spend their money on seeing a Doctor as necessary.
Just maybe if we make it a crisis, everyone will agree to commit fiscal hari kari.
There are some viable medical models that have been regulated out of existence, rather than dying from market forces.
For example the subscription medical office. Anything the office can treat, it will treat, if you pay the monthly subscription to the service. Oddly enough it doesn’t get abused by malingerers.
But this is considered insurance in a lot of places if not all, which runs attempts to do it into a wall of red tape.
I’d not heard of the subscription model. That sounds very intriguing.
What I have noticed locally is walk in clinics popping up in CVS and Walgreens. Potentially good free market solutions to meet the need for non urgent care.
there is a difference between "no insurance" and "no care"....
the people that don't get insurance, for whatever reason, and sometimes people just are too cheap to give up their fancy cellphones and their daily Starbucks, but for whatever reason, they DO use urgent cares and emergency rooms more frequently and that is very expensive....
I don't care how poor anybody is, everybody needs to have skin in the game..everybody should have to pay SOMETHING each time they run to the doctor...
I really dislike this kind of thinking. The medical profession is already focused on trying to keep people well. Vaccines are probably the biggest medical breakthrough in history on that front; measures like encouraging people to eat a healthy diet (NOT vegetarian or some other politically correct fad diet, but a balanced, healthy diet), exercise, and so on help, too.
Yet, despite the billions that are spent to keep people well, dolts like the one quoted above promote the myth that the healthcare system is all about profiting from illness, not keeping people well.
And let's face it - those tobacco funds are LONG gone. They probably spent that within 6 months of receiving the check. They're just using the imaginary tobacco fund as a screen to spend more money without riling the taxpayers.
That works out to $666 per person for a year. How much health care can that really provide ?????
Hmmmm... 666
Where have I seen that number before???
There needs to be a separation between insurance (betting against your self the someday you’ll need it) and the pre-existing ill (already lost the best).
The pre-existing ill should have Tri-care like insurance or no insurance at all. Bring back HIGHLY REGULATED AND CONSTANTLY INSPECTED USPHS hospitals for those.
there is a difference between “no insurance” and “no care”....
the people that don’t get insurance, for whatever reason, and sometimes people just are too cheap to give up their fancy cellphones and their daily Starbucks, but for whatever reason, they DO use urgent cares and emergency rooms more frequently and that is very expensive....
I don’t care how poor anybody is, everybody needs to have skin in the game..everybody should have to pay SOMETHING each time they run to the doctor...
You are misreading the situation. The difference is between reasonable premium insurance and Obamacare style catastrophic insurance in all but name. The choice for many isn’t “starbucks or insurance”. The choice is no insurance or spending $5,000+ in premiums while still paying out of pocket for all medical care up to an outrageous deducible of $5,000 or more. The biggest problem now isn’t the uninsured, IMO. It’s the uselessly insured. Government demanding folks spend 30%+ of their income on “insurance” that will almost certainly be of no use for them is criminal.
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