11/13/13, "Tattering the Safety Net," John Goodman's Health Policy blog
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11/14/13, "More Obamacare "Social justice": cutting subsidies for charity medical care," mdredux.blogspot.com. Retired Doc's Thoughts
"Dr John Goodman's website explains what is happening. See here. Less money will be paid by the government to hospitals that provide medical care to indigent patients
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A number of well known hospitals (e.g. Parkland in Dallas, Grady in Atlanta, etc) provide much medical care to indigent patients. The federal government through the Centers for Medicare and Medicaid have provided significant subsidies under a program referred to disproportionate share payments.
One of the mechanisms devised to fund the health care transformation known as ACA is to make significant cuts in this program.
Quoting from a recent ( see here) NYT article:
“We were so thrilled when the law passed, but it has backfired,” said Lindsay Caulfield, senior vice president for planning and marketing at Grady Health in Atlanta, the largest safety-net hospital in Georgia.
As Obamacare unfolds we are seeing more than a little backfiring.
And this quote from my favorite Louisiana economist, Dr. Don Boudreaux writing in his blog "Cafe Hayek"
"In the 18th century, Adam Smith launched the discipline of economics by explaining that intentions are not results, and that the complexity of a real-world economy nearly always overwhelms and confounds the hubris-intoxicated “man of system” who aims to improve matters through government intervention."
The most generous interpretation of the comments from spokespeople from AMA and ACP when they lauded ACA as a fountainhead of social justice is that they were enamored with the purported intentions of ACA and naively believed that intentions equaled results."
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11/8/13, "Cuts in Hospital Subsidies Threaten Safety-Net Care," NY Times, Sabrina Tavernise
"A spokeswoman for the Centers for Medicaid and Medicare Services said
that some of the reductions in the subsidy should not hurt safety-net
hospitals because states have discretion over how the money is
distributed and should be focusing on hospitals with the most
uncompensated care. And while there is no special exception for states
that did not expand Medicaid, federal officials have said they will
revisit that in 2016....
Some experts say the cuts in hospital subsidies are part of a larger
problem: government programs like Medicaid do not pay enough to cover
the actual costs of care.
.
The cheapest private insurance on the new
health care exchanges, the Bronze Plan, covers just 60 percent of costs,
leaving low-income people who buy it with a lot of out-of-pocket costs
that hospitals worry the patients will not be able to pay."....
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