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    Physicians must fight to save Medicaid expansion

    Editor's Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Lori E. Rousche, MD, a family physician in Souderton, Pennsylvania. She is also the hospice medical director for Grand View Health in Sellersville, Pennsylvania. The views expressed in these blogs are those of their respective contributors and do not represent the views of Medical Economics or UBM Medica.


    Politicians are at it again—trying to save the healthcare system.


    Further reading: Front-line physiciansn respond to AHCA vote


    Although there is no easy answer, eventually changes will be made that conceivably will ensure the stability of insurance companies and Medicare, hopefully allowing access to care for most, if not all, Americans. 

    After receiving feedback on my previous blog, Medicaid expansion must remain safe in healthcare reform, I must continue to encourage that Medicaid, a joint federal and state program that funds healthcare for the poor, be protected.Lori Rousche, MD

    Our most vulnerable neighbors need medical care. The Medicaid expansion as enacted under Obamacare helped to cover the working poor, young mothers, young adults and early retirees. Waiters and waitresses, sales clerks and fast food cooks are just some of the workers that might lose coverage with the new American Health Care Act (AHCA). The Medicaid expansion also protected some of our alcoholic, schizophrenic and otherwise disabled neighbors. If we live in an advanced civilization, which we presumably do, how can we not take care of those less fortunate?


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    The House of Representatives passed legislation to repeal and replace Obamacare. It has many flaws, and we all know premiums continued to rise with this program. But, the new-and-improved version, Trumpcare, cuts off federal funding for the Medicaid expansion.

    Next: "There will always be scoundrels to take advantage"


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    • [email protected]
      Dr Rousche is confusing the issue. Her concern for making sure that at least basic medical care is afforded by our society to those who either cannot or will not provide for themselves is shared by the overwhelming majority of our citizens. The issue which she is not appreciating is whether the Medicaid system as it presently exists is the best way to do it, and it clearly is not. Medicaid is at the same time grossly wasteful and grossly underfunded, the epitome of bureaucratic ineptitude. The idea of extending this program even further to more participants is folly. The prevailing Republican idea is not to stop helping the poor but to allow the individual states to tailor the available funds more appropriately to their own needs, and perhaps at the same time to come up with more effective alternative approaches that others could copy.
    • Anonymous
      I live in one of those "flyover" states. There is another segment of the population served by the Medicaid expansion that no one is talking about--farm families that feed the rest of us. A fairly large proportion of the farm families I serve obtain insurance for their children through the insurance exchanges and the Medicaid expansion. These people are self-employed. They are not eligible for insurance through employment, though they work more hours a day than any of us and never get a paid vacation or a weekend off. Many of our farm families are the "working poor". Many people I talk to think that all the farms are corporations now, but that's not true in the heartland.
    • Anonymous
      medicaid pays at about 75% of overhead. it costs most practices to look after medicaid patients. as a consequence,many practices will either not accept medicaid patients or limit the number they will serve. to give incentive to practices for accepting medicaid patients. the fees collected should be tax free. tax forgiveness is used in multiple other government supported endeavors, why not medicaid patients?
    • Anonymous
      The term" Scoundrel" was the hospitals under Obama care. we have large share of medicaid patients in our state we do provide and proud to take care for whatever cents worth. The following things have changed during Obama care. 1-Hospitals started hiring the PCP/ Hospitalist and Specialist under federal program added enormous stress to the practice who are solo practiones and even private small group bearing the cost. The cost of simple EKG at the office whould cost less now but under hospital corporation the same EKG cost 10 folds. How can you even think we saved the cost of care under Obama care. 2- All the mature nurses were fired and bought in young ones dont have a clue what is going on in refer to patient care and in the name of cost cutting due to Obama care by the hospitals "Big Farce". 3- MD Anesthelogist who have been providing care to the hospital since the inception of the hospitals were all replaced with CRNA in the name of cost cutting "Obama care" big Farce again providing substandard care. 4-They hired the ER / Hospitalist as a team care, every pt under minimal issues admitted for the benift of hospitals. 5- Primary care physcians who have been serving in the community do not take any more calls at the hospital since the hospital hired hospitalist, therein the patients who get admitted has complete disconnect with PCP and Hospitalist. How do we say its for the betterment for the patient These are some of the back lash of Obama care in the small community in the name of affordable care act. Apart from high premium all that jazz the media talks about. All the mature nurses and

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