In an article by Noam Levey of the Tribune, Washington Bureau, Dr. Scott Gottlieb, a Romney advisor says,”..Medicaid is worse than no coverage at all.”  Sounds like Dr. Gottlieb is a follower of Dr. Jane Orient, whose succinct evaluation of the Unaffordable Care Act goes like this:  ”coverage does not mean care.”  

Would he agree that 32 million newly insured folks might be worse off than prior to receiving Obama’s gift?  If a Medicaid card doesn’t grant access to care, why would anyone think that an Obamacare card would?  And why is it that Medicaid patients have trouble getting care?

My apologies to followers of this blog, as you already know the answers.  I point this out as a rare glimpse into the real world of the policy wonks.  This physician, Dr. Gottlieb has hit the nail on the head.  My guess is that this is a bit too blunt for Mr. Romney.  Not so for Rep. Jim Jordan, OH.  Later in the same article, Jordan puts his own party (GOP) on notice, saying, “..if we win there are no more excuses.”  He would cut 2 trillion from Medicaid in ten years and block grant (punt) this entitlement to the states for them to unwind.  

Governor Bob McDonnell of Virginia, said basically, these cuts were not a problem.  Ok.  So far so good.  Now who do you think is opposed to these cuts?  If you guessed the “not show a profit hospitals,” you go to the head of the class!

Dr. Bruce Siegel, president of the National Association of Public Hospitals and Health Systems, threw down the quality card.  He said people with Medicaid are healthier.  But Dr. Gottlieb says people with Medicaid have less access than those without.  Siegel said that Medicaid makes folks more financially secure.  I think he means that they are less likely to be medically bankrupted by the hospitals in his association.  I suppose if they didn’t charge patients 10 times what we do at our facility for the same medical care, patients might not need to fear bankruptcy from medical care as intensely.  

Expect to hear more and more of this stuff.  As the topic of the lack of access continues to raise its head and the talk of what medical care really should cost raises its head, you will hear the “not show a profit” hospitals scream.  If the hospitals have to justify their pricing and why they are unnecessarily bankrupting the poor and sick by overcharging them, they will switch gears and go on to their next tactic:  they will “poor mouth” it.  They will attempt to convince everyone that without giant Medicaid spending, they will go bankrupt! The truth is that they won’t be rich and happy until the entire country goes bankrupt on their behalf!  

G. Keith Smith, M.D.