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Thursday, August 30, 2012

Their View: A Simple Solution to an Urgent Problem

Following is an Op-Ed by Rep. Moe Maestas, the op-ed was seen in the Las Cruces Sun-News today.

Moe maestasAntonio "Moe" Maestas represents District 16 in the New Mexico House of Representatives.

Every now and then we are presented with an easy opportunity to solve a problem. When a simple solution presents itself the choice is easy. It's typically called a "no-brainer." Governor Susana Martinez has been presented with just that.

The problem to be solved: an ever growing number of New Mexicans, many of them working full-time, cannot afford health insurance. Our uninsured population ranks second-highest in the nation, making this one of our state's most urgent and critical problems. Tens of thousands of New Mexicans do not have access to decent affordable health care.

A recent Families USA report entitled "Dying for Coverage: The Deadly Consequences of Being Uninsured," used methodology developed by the Institute of Medicine to calculate that between 2005 and 2010, over 1,400 New Mexicans died prematurely because they did not have health insurance. Many others hold on desperately by turning to our crowded emergency rooms, and subsequently, health insurance rates continue to rise for everyone else as hospitals and insurance companies pass on those costs. The broken system of expensive and unpaid emergency room visits translates into $2,300 per year tacked on in higher premiums charged by private insurance companies to those who do have insurance.

Expanding Medicaid would enable over 150,000 hard-working New Mexicans to access preventative doctor visits and allow doctors to focus on health care outcomes rather than reactive treatment. In addition, infusing hundreds of thousands of families in our state would no longer have to live just one healthcare crisis away from financial ruin and dropping out of the middle class.

The U.S. Supreme Court's healthcare decision that gives states the option to expand Medicaid to low- income adults has handed Gov. Martinez a tremendous opportunity and a real solution. This opportunity is the best bang for the buck for New Mexico. The federal government has taken on the responsibility of paying the entire cost of the newly covered for the first three years (2014-16) and gradually reducing its share to 90 percent for 2020 and beyond. According to a recent study by N.M. Voices for Children, this infusion of millions of federal dollars will create an estimated 17,000 jobs in New Mexico by 2015. It's hard to see how anyone can call that a bad deal.

Unfortunately, Gov. Martinez appears to be turning what should be a no-brainer into an agonizing political dilemma. By taking the Medicaid opportunity path, she can choose to save lives, save money, and create jobs in New Mexico. It's simply the right thing to do.

But the alternative path that seems to pressure Gov. Martinez is one paved with politics at its worst. Out of a misplaced sense of partisan ambition or steered by ideological handlers, she might choose to march in lockstep with governors such as Wisconsin's Scott Walker, Florida's Rick Scott, and Louisiana's Bobby Jindal. In rejecting the Medicaid opportunity, those governors have abdicated their responsibility and have thrown their most vulnerable populations under the bus — merely to score partisan political debating points.

It's a disgrace that our state has not done more to bring up the most vulnerable among us. The rejection of this opportunity would mean a stomach punch to our state's potential and the continued decline of our state's healthcare outcomes.

This is too important to allow national politics to dictate policy in New Mexico. Let's hope Governor Martinez is committed to solving problems and does the right thing by expanding health care coverage in New Mexico.

August 30, 2012 at 05:00 PM in Children and Families, Medicaid | Permalink


I bet she'll wait until Mittens is defeated to make up her mind.

Posted by: Ellen Wedum | Aug 31, 2012 6:18:14 AM

This is a big part of the problem and it is beyond political partisanship. Ask your doctor, specialist or med tech what the cost of a test, procedure, diagnosis, surgery etc. will be so you can try to "plan" or at least see what kind of financial hit you are going to have to absorb. No one has the slightest clue. The "free market" does not apply to health care.
The problem with health care: What it costs versus what insurance companies have to pay +

"It frustrates people because there's no correlation between what things cost and what is charged," said Paul Keckley, executive director of the Deloitte Center for Health Solutions.
"A thousand percent increase in the cost of a treatment versus what a patient and insurance company ends up paying for it happens. It might be greater or less depending on your hospital and your insurance company. Which is insane. It is no way run a health care system."
"Which again leads to the basic premise here: A single payer health care system that makes price-setting for procedures uniform, that takes out the vagaries of insurance billing and all the overhead involved in managing that billing for all the possible permutations of coverage, is the only rational option for controlling health care costs for everybody."
"To be a health care consumer (i.e., someone who lives in the US) is to be a general contractor managing subcontractors who continually change what they do for you and what they charge you and bicker constantly with your banker/bursar over the appropriate fee. Imagine hiring a general contractor who (at best) figured out how to build your house by googling "home building." That's about how I feel about my healthcare."

Posted by: qofdisks | Aug 31, 2012 11:16:25 AM

"I had a defibrillator replaced in December The original billed cost for just the unit, a piece of hardware about the size of a cell phone was $65K, the insurance negotiated it at $35K.
So for this small device, the original price was about the same as a Chevrolet Corvette Z06, but the insurance company only paid enough to pay for a Ford Mustang Premium GT.
by God loves goats "

"I had a clot in my leg and it would have been high comedy if it wasn't sad.
First, the treatment for a blood clot in my leg is about as obvious as it gets. You get shots for the first few days, then you get put on Coumadin. So I go to my Doctor, he has an MRI taken. Off I go to the hospital - to the ER.
I wait for 6 hours.
It's a teaching Hospital - I see 4 Doctors. This is a good thing, I know, but they all say the same thing. They want another MRI. How much is that going to cost, I ask (I have a 10% co-insurance payment)? You would have thought I were praising Luther in a Catholic Church. WHAT??? Finally I see someone who tells me she can't tell me how much it costs, it is too complicated. I say no - find the fax of the MRI that was taken 4 hours earlier. They find this about 15 minutes after I ask - and shocking I know - the Doctor I saw 5 minutes earlier says she doesn't need another one now.
I see the attending Doctor in the ER. I see him for 3 minutes, of which 90 seconds are me talking to his back as he tries to leave. I get a bill from him later: $550. This makes his hourly rate about $11,000 an hour (but who is counting).
They decide to admit me for 5 days. I ask how much that is going to cost. They can't tell me (it is too complicated). But about 30 minutes after I ask they decide I only need to stay one day instead of 5.
The Bill runs to $4,600 for less than 24 hours. Somehow my health insurance company says that their price is only $2,400 making my share $240. At several points in the process I asked how much things cost, and at each point no one can tell me.
Now I am all for single payer. Tomorrow. But before it arrives there has got to be a way to force cost transparency in the health care system. My guess is if you could get a simple price and compare it, costs would decline dramatically.
But way more effective than the ACA Because with cost transparency, there can follow cost controls, as is the case with Japan.
The whole point of co-insurance is to make the insured more cost sensitive. If you don't know what anything costs,co-insurance is just another way to get money from the insured. by fladem"

Posted by: qofdisks | Aug 31, 2012 1:22:08 PM


The True Cost of Healthcare in 10 Minutes

Forget everything you ever thought you knew about healthcare costs.
From the website:http://truecostofhealthcare.org

This video contains 10 minutes of excerpts from a talk I gave about actual health care costs on July 31,2012. Among the subjects discussed:

1) Most generic medications are less expensive if you don't use your insurance to buy them.
2) Most doctors really don't know how much they're paid for an office visit.
3) Hospitals routinely bill 10 times what they expect to be paid for hospitalizations and outpatient procedures

Posted by: qofdisks | Aug 31, 2012 3:42:13 PM

Well, I didn't give the talk, the Dr. did. LOL.

Posted by: qofdisks | Aug 31, 2012 7:41:23 PM

Here is another one.

"I was ushered into an office where I was presented and asked to sign, unread, 3 pages of consent and authorization clauses.

Most of these clauses were unexceptional except for one that required that I would be "financially responsible for all charges not covered by my insurance...". This I refused to sign because it was equivalent to signing a blank check for an unknown amount. Unknown and unexpected medical charges have been a major source of bankruptcy in this country.

On my return visit to Dr. W's office I had amended his consent form with my agreement to pay any additional charges not covered by my insurance but ONLY after I was informed as to the need and cost of these unknown medical costs. My position is that before being responsible for any costs, I had to know what they were; no blank check, thank you. I was curtly told that "my terms were unacceptable"."

Posted by: qofdisks | Sep 1, 2012 2:05:08 PM

In any case, the Libertarian position that smarter consumers shopping for bargains in the free market are the key to controlling health care costs cannot work for the provision of health care.
We can't have a health care system that revolves around some kind of bargaining contest between providers and patients. People in need of medical care don't have the access, or the time, or the expertise to go doctor shopping. They're old and frail, or sick and weak and in pain. People need care, and they shouldn't be financially exploited because of it.

"The real problem with our health care system is that it is seen as a series of fee-for-service transactions in the first place. This creates the wrong incentives for both providers (more unnecessary procedures = more revenue) and patients (avoiding necessary care = saving money). That being the case, we're not likely to greatly improve the system by tweaking bargaining strategies for each fee-for-service transaction."
by DBunn

Posted by: qofdisks | Sep 1, 2012 2:35:29 PM