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    Physicians must fight to save Medicaid expansion


    Federal spending on Medicaid is expected to decrease by $880 billion over approximately the next 10 years. We all know someone, or are related to someone, who works in a profession that may be adversely affected by this change. With decreased access to care, there will be less preventative health exams, less prenatal services and less treatment of acute and chronic illness. It is projected that 14 million Americans will lose or drop health insurance in 2018 under the ACHA. Our most vulnerable patients will be denied care because it is not affordable. This is not a step forward.


    Related: House Obamacare bill won't fix healthcare system, doctors say


    A study from Cornell and Harvard showed that children with access to healthcare (Medicaid and CHIP) had more success in school than kids that had no healthcare. The Medicaid expansion helped decrease income and race-based coverage disparities. Ultimately, the Medicaid expansion saves Medicare money down the road. The states that had the expansion under Obamacare offered coverage to people who were then able to get care for chronic conditions. Conditions such as hypertension, high cholesterol and diabetes are often untreated in patients who can’t afford health care, making the complications of these diseases more severe as the patient ages.

    As with any free program, there will always be scoundrels to take advantage. But certainly not everyone who received coverage under the expansion was a bum. Most of the patients that I took care of at a free clinic who were able to get  Medicaid with the expansion in Pennsylvania were hard working laborers. Some were addicts or alcoholics and thereby unable to hold down full-time work and did not make enough money to buy insurance on the exchange. Others had physical disabilities, such as chronic back pain, that prohibited full-time employment, and these patients qualified for health insurance under the expansion. This segment of the population needs and deserves medical care.


    Blog: Cost, not access, is underlying problem facing American healthcare


    The current battle over Obamacare’s overhaul is off the back burner and in the news again. We await the Senate’s input on Trumpcare. Let’s hope that the offered replacement includes a humane proposal that includes ongoing Medicaid for our most vulnerable patients. Let’s protect those that need it. As a society, those that have need to help those that have-not when it comes to healthcare. Period.


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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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