[MtnClimber]

Manhattan Contrarian ping

[Worldtraveler once upon a time]

---- "....free medical care to the poor and near-poor in the U.S. Who could be against that?"

The Missus and I can be against "that?" Without firm controls of services paid, this is a sieve. When "the poor and near-poor" go to an emergency facility for a head cold or flu, that's an expensive "take to aspirin and go to bed" gambit.

And then, according to the Guttmacher Institute, "...21 states use state funds to cover abortion care through Medicaid."

That's an expensive box of condoms.

[Carry_Okie]

How Much Of It Is Legitimate?

I'm guessing between 70-80% and declining as States learn that Medicaid dollars are a cash infusion.

[butlerweave]

Keeping track of it could be a Real job for AI

[BradyLS]

1%

One-percent of it is legitimate.

[jerod]

There are a myriad of conditions that are beyond diagnosis...

I.E. The government needs to rely on the physician’s honesty and integrity to actually diagnose an individual who is presenting a series of well documented symptoms, which the patient claims they are suffering from. A simple blood test, or x-ray can’t help with the determination of the diagnosis.

For instance... HDHD, PTSD, COD, Depression, etc., etc. The problem being... Offering compensation through tax breaks and handouts to those diagnosed with these undiagnosable disease relies on honesty... And sadly, there a lot of dishonest shysters who take advantage of these programs.

[Red6]

The US government managed to screw things up, royally.

We have managed to create the WORST of two worlds.

You have the government today basically in the background running healthcare through a “standard of care” they get to define. That’s the American approach to rationing health care and controlling costs. This standard of care is defined through the NIH, DEA, and FDA mostly.

BUT, then you have a private store front, businesses trying to maximize their profits, hospitals, big pharma, doctors, insurance companies. That’s where you get the 5 different bills from for a simple outpatient procedure where they try to creatively figure out what they can charge for.

What the US really created and it went absolutely crazy under the Obama era, is a mediocre Western style socialized health care system (it’s rationed care) that’s really expensive.

[Red6]

My point is that fraud surely contributes to the problem, but that’s not the primary cause.

If we take Maine as an example which the article mentions. (((DOUBLE))) what their IG claimed was fraud for the whole state, multiply that times 50 states, and you come up with merely a little more than 1% of our nation healthcare costs.

The problem is the “system.”

It’s a poorly conceived system that never addressed the causes of rapidly rising health care costs in the first place. It merely rationed care and provided a shield/protection against litigation for malpractice. Its socialized health care which made the doctors and insurance companies (people were punished/fined unless they buy this product) happy.

[Jim W N]

The US Constitution delegates no healthcare regulation to the federal gov't.

Healthcare is a states' issue.

NUKE FEDERAL HEALTHCARE!!!!!

[Texas Eagle]

Somewhere between 0 and 1%.

[fruser1]

90% of it goes to fund the government infrastructure along with paying for the salaries and lavish benefits of government employees attempting to manage the monstrosity.

90% of what’s left is fraud.

That leaves about 10 billion making into the hands of the people it was “intended” to serve.

[Jim Noble]

The advent of Medicare and Medicaid in 1965 was meant (by the creators) to initiate a slow (5-7 years) but inevitable transition to a Universal Health Care system.

What has been going on for the past 61 years is a low level political civil war between people who will accept nothing less and people who don’t want it.

All of the battles have been won by the UHC faction (DRGs, EMTALA, HiTech, PPACA) and while all of those things have been meant to destroy what existed before 1965, the end of what’s left of pre-1965 medicine hasn’t been visible - until now.

[Brian Griffin]

“then again in the most recent period of 2020-2024”

I believe that’s because during Covid a rule was set in place that people couldn’t be dropped from the program.

I believe that rule has come to an end.

[Brian Griffin]

Hospital costs can be reduced by splitting most hospitals ~50/50 between two companies.

Medicaid costs can be reduced by gently nudging people away from the program, discouraging ER use and making nursing home care cheaper. Start with $2/month Medicaid premiums and raise them by $2 for each month and each ER use. The time-based Medicaid premium amount to not exceed the monthly Medicare premium.

Premiums to be lowered by $1 for each week you subsequently have private PPACA-scope coverage.

Nursing homes could be two side-by-side eight-bed units primarily staffed by four live-in caregivers assisted by one 10pm-7am staffer and one 11am-7pm staffer for each unit.

[Red6]

Sorry for the machine gun postings.

The third way to look at it:

The primary cost drivers are pharma, hospitals, doctors, medical devices and insurance.

Those were not addressed.

All government did, in its usual fashion of fixing anything, is to “ration care” for the consumer.

Today, the average American, no different than a German or a Brit, gets rationed care THROUGH what is defined as a “standard of care.”

America managed to create a really over priced / expensive socialized health care system that only appears to be private at the consumer interface level, but in the background it’s defined by government more than anything else.

When they came up with this system, they never addressed the actual causes of what are driving the costs!

I assume to get buy in by those that might resist (pharma, insurance, hospitals, doctors), to reduce the resistance, they created this mess which ONLY focuses on you, the patient receiving the care and what they are willing to pay for as well as what recourse you or family have if left crippled, deformed or deceased.

[Lurker]

Constitutionally speaking?

None.

L

[DeplorablePaul]

Waste, fraud and abuse aside Obamacare greatly increased the cost of medicaid through expansion:

ChatGPT

The Medicaid expansion under the Patient Protection and Affordable Care Act — commonly called “Obamacare” — expanded Medicaid eligibility to many lower-income adults who previously did not qualify.

What changed

Before the law, Medicaid was generally limited to specific categories of people such as:

children
pregnant women
some parents
elderly people
people with disabilities

Many low-income adults without children were excluded, even if they had very little income.

The ACA expanded Medicaid to nearly all adults under age 65 with incomes up to about 138% of the federal poverty level.

[ProtectOurFreedom]

Did you notice the deceptive and distorted time (X) axis? The time axis is non-linear / irregularly spaced. Early years (1966–1995) are heavily compressed, but later years (especially ~2015–2024) are significantly stretched out. Note that this is Not logarithmic scaling on the time axis. A true log time axis would compress recent years (the opposite of what’s happening here).

This kind of manipulation is common in misleading charts for a few reasons:

• To downplay explosive recent growth. By squeezing the early decades and expanding the last 10–15 years, the steep upward curve in the 2010s–2020s looks gentler and more "gradual" than it really is. On a uniform axis (as in the corrected version I show below), the acceleration after ~2010–2015 becomes much more visually dramatic.
• To fit more data points in recent years. The chart labels many specific years after 2000 (2001, 2003, 2005, etc.), which requires more horizontal space. Designers sometimes unevenly space the axis instead of using a clean linear scale + fewer labels.
• Visual deception / cherry-picking presentation. People (advocates, government reports, media, etc.) sometimes use this trick to make long-term trends look less alarming. Medicaid spending grew extremely slowly for decades, then accelerated sharply — especially after major policy changes like the Affordable Care Act expansion and post-COVID effects. A uniform axis makes that "hockey stick" shape obvious.

The irony is this article is trying to make the case for the horrific explosive growth of Medicaid. The author should have used a linear time axis to show the explosion of spending:

What really jumps out is that red exponential regression curve fit line. Talk about "unsustainable"!

[UnwashedPeasant]

The hyperinflation from trillions in fraud hurts the truly poor and the working class. The fraud millionaires buy fine real estate, etc., and drive up prices.

Medicaid should be reformed to reduce fraud incentives: A government store provides very basic food to prevent starvation (government cheese, powdered eggs, powdered milk, etc., from USDA surplus programs), and everyone must go to a government medical facility for minimum necessary care from government doctors (who probably could not get a job anywhere else).

Everyone should have to reapply for Medicaid, with multiple approvers to weed out government workers who approve the wrong people. Abusive workers should be arrested for fraud.

[cuz1961]

Citizens covered / legitimate

Illegal Aliens / illegitimate

Do the population math.

We
Are
Being
Robbed
Blind