Winter Sucks - Healthcare Spending

[Jared]

A topic that has interested me since I returned to school this year to pursue a career in the healthcare industry:

In 2009 (most recent data available), Minnesota spent $7 billion dollars on medical assistance for people who were not able to afford their own healthcare coverage.  For reference, the state's entire population was around 5.2 million that year, so that's $1300 per capita spent on MA.

In order to qualify for MA, individuals must show a case worker that they are not able to afford coverage for themselves and family members and have no other reasonable means of securing coverage.  Once that threshold is met, healthcare is free or extremely low cost for them, provided they continue to show a financial need.

Outside of that, there are no other requirements that need to be satisfied in order to receive MA.  Clearly, a person's ability to consume anything without financial impact to themselves leads to excess.  How many motorcycles would you own if you didn't have to pay for them?  If going to urgent care was free every time you went, do you think you'd go more often or for less serious situations?  How about medications:  If you don't pay for them, do you care if there's a lower cost alternative available? 

Beyond that, individuals of low income have higher rates of smoking, diabetes, heart disease, and asthma than do people of higher income, leading to further excess.

My question: Is is reasonable to require people on MA to participate in state mandated wellness programs in order to qualify for coverage?  Think of things like smoking cessation programs, training on how to eat in a healthy manner, mandatory vaccinations, medication evaluations etc.

[Yul]

This forum is not for "Winter Sucks" or "I'm bored" posts.
Please take your politically charged topic to one of the other forums.

[flyinlow]

My wife worked in the medical field and dealt with alot of MA at her most recent job. The company she worked for dealt with alot of MA patients and they lost alot of money because the state would not pay if you made a mistake on a form. You had to then re-submit and there was a time limit for doing this, after the limit they simply said "sorry, you didn't submit in time, you lose". On top of that there are something like 52 MA programs for the state, so once you dropped off of one, you could then get on another. And it also depended on where you lived in the state as to which programs you could be on.

You could make the argument that people on these programs should have to do wellness programs. But then you get into the whole cost thing. There are many studies that show that it is actually cheaper to eat poorly than to eat healthy. These are low or no income people and generally not that well educated. They also argue that it should be the food stamp programs responsiblity to make sure people are only buying healthy foods with their food stamps. Then there are the people themselves who would argue that you are imposing something on them that is not imposed on the general public.

I'm not making arguments for them, I think they should be required to do whatever if they are going to be on MA, but as usual its politics and its messy.

[gdawgs]

it is difficult to mandate a wellness program as it can include different levels of success.  you may just end up spending more to roll out and police the program than the actual benefit. 

it is difficult to come up with the right balance of accountability and not cross the line of "free hand out". 

i fall on both sides of the equation and it really is conflicting.  unfortunately, i don't have a good solution. 

congrats on the medical/health field.  it has a strong future. 

[Greg]

This forum is not for "Winter Sucks" or "I'm bored" posts.
Please take your politically charged topic to one of the other forums.

lol, this guy cracks me up. Come on Yul, grow some seeds and give your real identity.

anyway ....
The ACLU will never go for what you're suggesting, Jared ..... though I agree wholeheartedly with your sentiment. One thing we could do as society is bring back the element of "shame". Public discussion about healthy life styles, discussing how grotesque America has become.

One thing I would take a little exception with is this. It doesn't cost more to eat healthier, it does cost more effort though. Cub foods has a brilliant commercial running right now where a mother & daughter show how many meals they can prepare for $20 of food purchased at Cub.

Several years ago (over 15) I started to take my own lunch to work. I save a lot of cash over a years time by doing this, as well as calorie savings too.

(Google "How many Americans are pre-diabetic or diabetic" ... the answer will stun you. Or Google, "How many Americans are morbidly obese")

[Ray916MN]

Have to look at what is really going on with the people on MA.

How many end up on because they have a medical problem from an accident or are crime victims or simple loss of job.

I'm all for people understanding how to take better care of their health and taking better care of their health, but spending money to get people to take care of themselves is a tough sell for me. The administration of such a program is tough and ultimately this kind of stuff tends to make government bigger. I would prefer to see taxes on unhealthy foods and the tax revenues used to make healthcare more affordable, make access to preventive care more affordable or make access to fitness centers more affordable. Less administrative cost and a carrot and stick approach to motivate change, as opposed to the typical carrot only approach.

The stats on diabetes, and obesity are out of control. It drives me crazy that we complain about healthcare costs yet do little to disincent people from leading unhealthy lifestyles. It is time recognize the societal costs associated with this type of behavior and address it with penalties and rewards.

[Chris]

I don't think there should be a state or federal health insurance payer in anyway, but instead a state could give voutures (not the feds) for you to go to a Health Insurance Company to get the coverage, the the insurance company can say what they expect from you. Mine insurance company currently does tell me what they expect, we have to get tobacco tests every year, we also can get a break the next year if we join a health club and go 12 times a month. Are there issues with doing a vouture system yep, will it piss people off yep, will it save tax payer money yep, will it shrink government yep. will it reduce heath care cost nope (medical companies not getting paid are not the reason for high cost of heath care.

RANT off... have a nice day good luck with your new career move

[Deplorable, thank you!]

 Hey how about we get big corporations to pay their "fair" share of federal taxes.....why is it many huge earners pay less than 10% federal tax when I pay over 35% federal tax?

 Cut the bulk of the financial aid crap programs too. It is all on you, the way it should be. Or your own family, friends etc... can help if they chose.
 Why should I be forced to pay to subsidize someone elses health or food stamps or whatthefuckever--if I feel generous that should be my choice, it shouldn't be government stealing my money to give to someone else. I would love to only have to pay 10% or less--you know what I could do with keeping 25% more of my hard earned income in my pocket........

Oh yeah, I forgot for a second we are talking about the government, screw the little guy and offer up huge incentives for the big guy to get bigger, then regulate the shit out of everything to create an even bigger government and an even bigger problem....Government is and will continue to be the biggest problem---How about the government consists of volunteers--no pay! Of course then you would have mass corruption, as apposed to the mass corruption there is now...

[RCKT GRL]

working for a large healthcare company AND working directly with patients that are on MA, I see patients like this day in and day out... They are on MA, but yet have designer clothing, Coach purses, fake nails, blinged out cell phones, and much more.   Saving money on healthcare, but spending it frivously elsewhere!  Sickening! 

[Jared]

I would prefer to see taxes on unhealthy foods and the tax revenues used to make healthcare more affordable, make access to preventive care more affordable or make access to fitness centers more affordable. Less administrative cost and a carrot and stick approach to motivate change, as opposed to the typical carrot only approach.

I like this idea a lot but it would be DOA with the ultra-liberal characterizing it as an attack on the poor, not to mention food industry lobbyists. 

While I am amused more than anything by the dirty hippies of occupy wall street and the tea party fundamentalists, I can identify with the sentiment that something needs to change and we don't have a government willing to man up and do anything productive.

it is difficult to mandate a wellness program as it can include different levels of success.  you may just end up spending more to roll out and police the program than the actual benefit. 

This is probably true, especially with the lack of efficiency that you see with government, but you would be shocked at what it costs to treat just one person who is diabetic.

working for a large healthcare company AND working directly with patients that are on MA, I see patients like this day in and day out... They are on MA, but yet have designer clothing, Coach purses, fake nails, blinged out cell phones, and much more.

Yup.  I have similar experiences in my job almost daily.  People who pull up in new cars who are there for taxpayer funded healthcare.

[carlson_mn]

I'm also in healthcare. One problem is that those on the system don't have to pay anything so there is no accountability for themselves. I had a friend on MA and it drove crazy he had money for beer all the time but didn't pay anything for his daughter's birth.

The occupy people are the biggest collection of idiots I've ever seen.

[Chris]

The occupy people are the biggest collection of idiots I've ever seen.

+1

[pkpk]

Triumph The Insult Comic @ Occupy Wall Street

[Jared]

Now that's funny.  The drum circle rimshot guy is classic.

[nOOky]

I'm sure I'll get flogged for this, but people on MA should get major medical only. If your arm is missing, come on in. If you think you have the flu, tough it out like an old farmer would do 
One of my favorite quotes "the problem with socialism is that pretty soon you run out of other people's money to spend".
I have no problem helping people that deserve help. I have a problem helping worthless aholes that think because their mommy and daddy bumped uglies and made them the country owes them something.