Politicians, government bureaucrats, and the growing class of largely nonprofit corporate types who live off revenues siphoned from government entitlement spending make many a bizarre argument and manage to do it with a straight face. It’s a rare moment when you can catch them chortling over the idea of pulling the wool over the citizens’ eyes.
As Linda noted at the beginning of her Medicaid series, Nebraska politicians and the “stakeholders” who stand to receive bundles of cash if Medicaid is expanded would have you believe that expansion will . . . SAVE MONEY. The argument goes like this:
“Part of the theory for extending the program is that uninsured people are most likely to use high cost emergency rooms for health care and wait until health crises before seeking help. Ultimately taxpayers and insurance premium payers pick up the tab anyway, but for high cost and inefficient care. The goal is to get them some kind of coverage and, if possible, preventive and regular health care to reduce costs.”
Now, in “LB577: Nebraska’s Unaffordable Care Act“, Linda disproved every assumption behind this “savings” argument, calling it “wishful thinking.”
- It is Medicaid patients, not the uninsured, who are the most “frequent flyers” in hospital emergency rooms, seeking care for non-emergency problems.
- There are not enough primary care physicians to serve the needs of an expanded Medicaid population, so the newly-eligible will seek routine treatment in emergency rooms even with Medicaid coverage.
- Because they do not bear the additional cost of “inefficient” care, Medicaid patients have no incentive to change their behavior with regard to using ERs for routine care.
But, after he read an early draft of the “wishful thinking” piece, it was Norlyn who really cut to the bottom line when he posed the following question:
“Are these senators pushing this rationale seriously asking us to believe that either health insurance premiums or taxes are going down as a result of shifting an ever-growing number of enrollees from emergency room care to other tax-funded options? Putting aside the evidence that shift is simply not going to happen, where is the commitment from these wishful thinkers that taxes will be cut and insurance premiums will go down in Nebraska? All I hear are crickets.”
Norlyn may be hearing crickets, but Linda heard LAUGHTER when this topic came up at the committee hearing re LB577. Apparently, attendees at that hearing on Feb. 28th, think the idea of passing savings on to citizens in the form of lower taxes or reduced health insurance premiums is – chuckle worthy.
Linda’s notes and observations from the LB577 hearing on this whole sorry subject:
Mary Borgeson, Douglas County Commissioner, testified as the representative for the Nebraska Association of County Officials, asserting a list of “savings” totaling in the millions to be realized by counties if LB577 were to pass. One reason given by Borgeson was that the counties would be discontinuing their medical assistance programs.
One Senator inquired whether that meant the counties would be reducing their citizens’ property taxes. Ms. Borgeson said, “Well . . . NO.”
The crowd, comprised mostly of government employees or people employed by nonprofit corporations that thrive by sucking up as many taxpayer dollars as they can, apparently found the question and Borgeson’s response amusing. Their snickering provided the backdrop for the remainder of her remarks.
Borgeson commented that Governor Heineman raised the same question. When she and her fellow county representatives met with Governor Heineman, she explained, he told them he would consider withdrawing his opposition to LB577 if they would put dollar for dollar cuts in property taxes on the table. But the counties refused. Borgeson unequivocally stated, as if it was a foregone conclusion, that the “savings” from LB577 would be “freed up” and spent by the counties to cover other things the counties want to do.
There was tittering in the gallery during this entire exchange.
We don’t know about anyone else, but we’re not remotely amused.
A person with the last name Jurvevich from Region IV Behavioral Health Center later testified on behalf of all of the regional behavioral health centers. Jurvevich, like Borgeson, listed millions in purported “savings” for the health centers if LB577 were to pass. But, like Borgeson, the testifier reported that the “savings” would be “re-invested”.
The Nebraska Medicaid Director, Vivian Chaumont, who testified in opposition to LB577, reported that she hasn’t heard any insurer announcing that it would lower its rates if LB577 were to be enacted. In fact, she reported that premiums are rising.
Obviously, Vivian Chaumont stands out from the others mentioned. She was very cool under a lot of pressure from a Committee filled almost entirely with a bunch of Senators who are just foaming at the mouths to expand Nebraska Medicaid AGAIN, this time on steroids.
Besides Ms. Chaumont, Linda’s observations on this whole subject seem spot on:
Heroes used to live by the motto “Death Before Dishonor.” Modern-day bureaucrats live by the motto “You’ll take even the smallest part of my department or agency’s budget from my cold, dead hand.” It’s the sequester mentality writ large for Nebraskans to see.
In the meantime, the peanut gallery who attended the LB577 hearing is busy getting ready to party like it’s Friday night — on our dime, no less — and laughing in anticipation at even the suggestion that our money should remain just that — ours.
Author’s Note: This is the eleventh in a series of articles about Nebraska’s Medicaid program, the Unicameral’s apparent intent to expand it, and the many reasons why expansion is an uncommonly bad idea. Although they don’t have to be read in order, here are links to the previously-published articles in the series:
- NE Medicaid Expansion: The Race is On
- Let’s See What Condition Our Condition is In
- People Don’t Walk Away From a Fool and His Money
- Sending Granny (and Gramps) to the Home
- Congratulations! She’s Having His Baby . . . And You’re Paying for It!
- Families Need Medicaid Like Fish Need Bicycles
- Money for Nothing and Health Care for Free
- Projections re Cost of Medicaid Expansion: Too Good to Be True
- LB577: Nebraska’s Unaffordable Care Act
- Pelosian Economics: Medicaid Expansion as Fiscal Stimulus
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