Damned if You Do and Damned if You Don’t

An important question behind today’s health care issues should be; what are the right screenings and treatments to pursue?   “Right” means those practices established as best by the most unbiased and medically competent practitioners.   But that was before politicians started hijacking the “right answers.”

The key question behind health care issues has become; who should pay?   In the U.S., the answer has become political with emotional, vote-buying, and coercive attributes.  And because they can, politicians have entangled “best treatments” and “who pays.”

Budgetary pressures in states such as Illinois, Tennessee, Iowa and Washington are motivating changes in Medicaid payments.  For Medicaid patients in Washington State, there is a list of 500 diagnoses for which the state will not pay doctors and hospitals.  Some are routine care conditions that should not waste ER resources.  But in some instances, a test needs to be done to establish a diagnosis.

In Washington State, if a Medicaid patient falls down a staircase and arrives with a swollen ankle,  an x-Ray may be needed to establish whether it’s broken (Medicaid will pay) or not (Medicaid will not pay).  Washington State standard takes additional uncompensated care from the doctor and hospital and some will think twice about ordering an x-Ray.  Going forward, a higher percentage of Medicaid patients who need broken ankle treatment will be sent home without it and more physicians will face malpractice suits by major contributors to politicians’ election campaigns.

Normally, when you spot a government-rigged game such as that in Washington State, you can refuse to play.  But that’s not an option for emergency rooms and physicians.  The federal Emergency Medical Treatment and Labor Act requires a hospital to provide a medical screening assessment to anyone who requests it, and if the person has an emergency medical condition the hospital must stabilize it or transfer the patient to another hospital that can.

The medical professions and consumers are being victimized by our politicians.  State-level Medicaid shakedowns are being monitored by the feds for effectiveness – no doubt as part of a cost saving model for all consumers under the Affordable Care Act.

Alan Daley is a retired businessman living in Colorado.  He follows public policy from the consumer’s perspective.

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