Government Price Controls Strike Again

The Happy Hospitalist links to a scary article about how much Medicaid pays for ER visits compared to other sources of payment. Here’s the most horrifying datum:

Researchers at the University of California San Francisco and Stanford University found that the uninsured patients paid 35 percent of their overall emergency room bills in 2004, versus 33 percent for Medicaid.

In other words, hospitals receive less from Medicaid for ER care than they get from any other source of payment, including people with no coverage at all. It goes without saying that this level of reimbursement fails to cover costs.

Does one really need to ask, as GruntDoc suggests, “why EDs are closing”? The below-cost-reimbursement hospitals receive for the stampede of Medicaid patients they are required to treat forces many to shut down their EDs:

Financial woes have forced hundreds of emergency rooms around the country to close. As a result, emergency rooms are treating more people than ever and getting paid less to do it.

This is what happens when the government implements artificial prices ceilings. If you want to know how government-run health care will work for the whole country, this is an excellent case study. 

[via Kevin, MD]

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Comments 6

  1. drmatt wrote:

    First, medicaide is state funded and mandated which means this represnts 1/50th of the potential information. Second,as a practicing doctor, many of the private insurances didn’t pay much better and some worse, so the private sector’s record on paying for heath care over all is no better, finally, payment fixing isn’t price fixing, price fixing is when an industry (such as the phone companies, or the oil industry) collude to set a price, thus the term price fixing, when the payor choosed what they are going to pay (which all the insurance companies do) it is payment or reimbursement control, you really should work on your terminology before you title your pieces, or is it just for the “support my point shock value”?

    Posted 09 Nov 2007 at 4:05 pm
  2. Rich wrote:

    DrMatt -

    Are you sure? There are private payers that pay LESS than medicaid?

    Less than Medicare I have seen. None less than medicaid.

    But the point of the piece answers your own question - in that state, medicaid was the lowest payer of any plan, including “No plan”.

    Posted 09 Nov 2007 at 8:08 pm
  3. drmatt wrote:

    Yes I am sure. There are things that medicaide pays for that some private insurance companies don’t, not paying at all is less than medicaide. Also, medicaide is impossible to talk about, you talk about NJ medicaide, the article is about CA medicaide, I talk about NH medicaide, they are vastly different………vastly. They have evolved in the politacal atmosphere and tax structure of each individual state, sufice to say it is not good insurance but after that we can’t really discuss it at all as a whole.

    Posted 12 Nov 2007 at 7:00 am
  4. drmatt wrote:

    oops, and my point was this. You can’t call it “price control” nobody controls the “price” except the provider, you can charge what ever you want, you can charge a million dollars to remove a toenail. It is payment control, and all insurance companies do payment control, so painting the govt insurance as terrible for it’s “price” control is wholly inaccurate and again pushes us all to argue and debate unreal points and positions. Say it like it is, not how it will support your arguement.

    Posted 12 Nov 2007 at 7:03 am
  5. Rich wrote:

    Well, Ok, medicaid pays for tylenol and condoms, so strictly speaking, you are correct, it is better than all commercial insurance.

    Posted 12 Nov 2007 at 8:31 am
  6. drmatt wrote:

    Never said it was better than “all” commercial insurance. What I am saying is Catron alleges that Govt insurance is bad all by itself, it is but not worse than all other private insurance as he alleges. This a platform for an arguement that govt run insurance can’t work, but if you use that platform than you have to say that private insurance doesn’t work either. Broad generalizations wont move us forward and dont represent the problems.

    Posted 13 Nov 2007 at 6:30 am

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