The Virginia GOP: Opposing Medicaid Without Good Reason

Next month the entire Virginia General Assembly is up for reelection - or preferably, replacement in the case of many of its Republican members.  In the noise machine that is the run up to the 2016 presidential election, including the ongoing GOP clown car circus, many Virginians seem oblivious to the election on November 3, 2015, and may fail to vote - something that favors the Republicans whose base, while crazy, tends to always go to the polls.  Among the issue to be addressed in the 2016 session of the General Assembly is the issue of Medicaid expansion, something opposed by Republicans largely because it is part of the Affordable Health Care Act championed by Barack Obama.  These individuals - who pretend to be the party of faith - happily throw 400,000 some Virginians in the gutter rather than had Obama a success.  The Virginian Pilot blasts these modern day Pharisees in a main editorial today.  Here are highlights:

REPUBLICAN state lawmakers' refusal to accept billions in Virginians' federal taxes to subsidize insurance for some 400,000 uninsured people has repeatedly been exposed as the partisan political ploy that it is.

The expansion of Virginia's managed-care Medicaid program, the most efficient of two divisions of Medicaid in Virginia, is a prime objective of Democratic President Barack Obama's signature domestic achievement, the Affordable Care Act.

The 2012 U.S. Supreme Court ruling that upheld the constitutionality of that federal law, however, left to the respective states a decision whether to accept the return of federal tax revenue for Medicaid expansion. In Virginia, where Republicans control both chambers of the legislature, GOP delegates and senators dug in their heels and refused.

The effects of that fiscally irresponsible position extend far beyond the health care of lower-income, uninsured Virginians.

Republicans have chosen to bleed hospitals in their own districts of necessary revenue, diminishing access to quality health care while undermining local and statewide economic development efforts. All so they can politically oppose a lame duck president over a law twice declared constitutional and which the GOP doesn't have the votes in Washington to overturn.

State data show one-third of Virginia's acute-care hospitals lost money operating in 2013, as the Virginia Hospital & Healthcare Association pointed out in a statewide public-awareness campaign. Roughly half of rural Virginia's acute-care hospitals lost money that year.

Those figures are unsustainable, and they portend a looming crisis for health care - and for the economy - in Virginia. That crisis could be averted simply by expanding Medicaid and returning Virginians' federal tax dollars to the commonwealth.

The health care industry is the top employer in the vast majority of Virginia's rural counties, providing critical jobs and tax revenue.  It's worth noting many of those areas are represented by Republican legislators, who seem intent on punishing their constituents in order to score a political victory. Gov. Terry McAuliffe, who has focused heavily on economic development, campaigned in 2013 on a pledge to increase health insurance coverage.

Under the law, federal funds would cover 100 percent of costs for expanding Medicaid coverage through 2016, and then gradually phase down to a floor of 90 percent in 2020.
There is no business case for refusing the return of billions in tax dollars already paid by residents to improve health care for Virginia's working poor, shore up Virginia hospitals' ailing financial conditions and strengthen an industry critical to Virginia's economy.

America's Out of Control Health Care Costs: A Single Stitch Tops $500

This blog often looks at America's broken health care system which is the most costly in the world and least efficient in delivery of services of any developed nation.  Yet the Republican Party would repeal the Affordable Health Care Act and condemn Americans to remain victims of this broken system.  How bad has America's system become?  A piece in the New York Times looks at the soaring costs where a single stitch for a cut can cost $500.00.  It's beyond ridiculous, yet that's the system preferred by the GOP, especially those in the House of Representatives.  Here are story excerpts:

SAN FRANCISCO — With blood oozing from deep lacerations, the two patients arrived at California Pacific Medical Center’s tidy emergency room. Deepika Singh, 26, had gashed her knee at a backyard barbecue. Orla Roche, a rambunctious toddler on vacation with her family, had tumbled from a couch, splitting open her forehead on a table.

On a quiet Saturday in May, nurses in blue scrubs quickly ushered the two patients into treatment rooms. The wounds were cleaned, numbed and mended in under an hour. “It was great — they had good DVDs, the staff couldn’t have been nicer,” said Emer Duffy, Orla’s mother. 

Then the bills arrived. Ms. Singh’s three stitches cost $2,229.11. Orla’s forehead was sealed with a dab of skin glue for $1,696. “When I first saw the charge, I said, ‘What could possibly have cost that much?’ ” recalled Ms. Singh. “They billed for everything, every pill.” 

In a medical system notorious for opaque finances and inflated bills, nothing is more convoluted than hospital pricing, economists say. Hospital charges represent about a third of the $2.7 trillion annual United States health care bill, the biggest single segment, according to government statistics, and are the largest driver of medical inflation, a new study in The Journal of the American Medical Association found.

A day spent as an inpatient at an American hospital costs on average more than $4,000, five times the charge in many other developed countries, according to the International Federation of Health Plans, a global network of health insurance industries. The most expensive hospitals charge more than $12,500 a day. And at many of them, including California Pacific Medical Center, emergency rooms are profit centers. That is why one of the simplest and oldest medical procedures — closing a wound with a needle and thread — typically leads to bills of at least $1,500 and often much more. 

At Lenox Hill Hospital in New York City, Daniel Diaz, 29, a public relations executive, was billed $3,355.96 for five stitches on his finger after cutting himself while peeling an avocado. At a hospital in Jacksonville, Fla., Arch Roberts Jr., 56, a former government employee, was charged more than $2,000 for three stitches after being bitten by a dog. At Mercy Hospital in Port Huron, Mich., Chelsea Manning, 22, a student, received bills for close to $3,000 for six stitches after she tripped running up a path. Insurers and patients negotiated lower prices, but those charges were a starting point. 

In other countries, the price of a day in the hospital often includes many basic services. Not here. The “chargemaster,” the price list created by each hospital, typically has more than ten thousand entries, and almost nothing — even an aspirin, a bag of IV fluid, or a visit from a physical therapist to help a patient get out of bed — is free. Those lists are usually secret, but California requires them to be filed with health regulators and disclosed.