So I came across this op-ed about Medicaid by Betsy McCaughey, a long-time foe of, well, any healthcare insurance improvements (and who also thinks we can combat the antibiotic resistance problem with hospital choice), and, surprisingly, it started off well (boldface mine):
Nationwide, one-third of nursing-home residents suffer serious, often permanent injuries due to neglect, according to a federal inspector general report…
The deadliest problem is infection. A staggering 380,000 nursing-home patients a year die from infections, according to federal estimates. Not all are preventable. But nursing homes are infection cauldrons. The routine precautions taken in hospitals to limit infections — such as testing patients for superbugs on admission, disinfecting rooms and equipment and keeping infected patients away from others — are ignored in nursing homes.
Patients with staph infections are rolled into communal dining rooms and seated next to other patients. Superbugs contaminate bedrails, curtains and rehab equipment. Caregivers tasked with bathing and grooming patients go from one bed to the next, without using disposable gowns and gloves, spreading bacteria from patient to patient.
Because even rudimentary infection prevention is lacking, one-quarter of patients pick up dangerous, drug-resistant bacteria, according to new research by Columbia University School of Nursing. Columbia’s Carolyn Herzig warns infection rates are increasing across the board and action is urgently needed.
Medicaid recently adopted new standards calling for more infection precautions but delayed the start date to November 2019. Why delay, when hundreds of thousands of elderly patients will die from infection in the meantime?
I agree! We need better infection control in nursing homes. And too often, what passes for a healthcare discussion is actually a healthcare insurance discussion.
But this is Betsy McCaughey. There are shoes. And gravity. Dropping:
Here’s the truth: There are no “cuts.” Medicaid spending will continue to increase every year, though at a slower rate.
The real threat to seniors isn’t Medicaid funding levels. It’s that Medicaid officials tolerate substandard nursing-home care, when they could use the program’s market clout to demand better conditions. About 66 percent of long-term patients are paid for by Medicaid.
The derp is strong in this one.
Even if we shut down the bad nursing homes, the patients will simply have to be housed at other (or new) nursing homes. This will save very little money. Of course, McCaughey also repeats the long-time conservative talking point, recently resurrected for this round of the debate, that below-cost increases aren’t cuts, but that’s par for the course. Dean Baker explains (boldface mine):
In the case of Medicaid, the Congressional Budget Office (CBO) uses the best information available to project the eligible population and also the cost of providing services to this population. This is the baseline that the Republicans are working from with their health care plan. They are proposing to spend roughly $800 billion less over the 10-year budget horizon than the baseline spending level projected by CBO. This is equal to approximately 17.0 percent of projected spending over this period and 25.6 percent of spending in 2026, the last year for which CBO made projections for the Republican plan. (The reduction from baseline is even larger after the end of the 10-year horizon.)
This means that unless the Republicans have some way to reduce the cost of services that they have not told anyone about (e.g. paying drug companies and medical equipment companies less for their products or doctors less for their services), Medicaid will not be able to provide the services offered under current law. Given the size of the reductions relative to the baseline, by year 10 this will likely mean hugely reducing the number of people getting coverage and quite likely throwing people out of nursing homes.
This is the meaning of “cuts.” This is, in fact, a rather simple point and not a question of semantics. The Republicans do not have a plan for Medicaid to provide the level of services promised under current law, they are proposing to radically reduce the level of services. This is not ambiguous, just like it is not ambiguous that President Obama was not born in Kenya.
Though this what one would expected from a former member of the Manhattan Institute (yes, that Manhattan Institute).
It would be funny, except for all of the people who would suffer.