By: Brian Sikma
Avik Roy, a leading healthcare expert who has done extensive work showing that expanding Medicaid is not a good fiscal deal for states, has also concluded that the program results in lower levels of quality healthcare. Roy, who has written extensively about Ohio and other states poised to expand Medicaid with ObamaCare money, has noted some disturbing trends in healthcare quality. According to his data, individuals on Medicaid receive worse care than those without private insurance or those on Medicare, the federal healthcare entitlement predominately focused on the elderly.
In a policy piece for the Manhattan Institute last year, Roy summarized the findings of a study conducted by academics at the University of Virginia:
The in-hospital death rate for surgical patients with private insurance was 1.3 percent. Medicare, uninsured, and Medicaid patients were 54 percent, 74 percent, and 97 percent, respectively, more likely to die than those with private insurance.
Those are shocking numbers. Perhaps one of the biggest surprises is that, according to those numbers, it is better to be uninsured and have surgery than to be on Medicaid and have surgery. But it’s not just in-hospital death rates that show a huge disparity between those on Medicaid and those not on Medicaid.
In summary: Medicaid patients were almost twice as likely to die as those with private insurance; their hospital stays were 42 percent longer and cost 26 percent more. Compared with those without health insurance, Medicaid patients were 13 percent more likely to die, stayed in the hospital for 50 percent longer, and cost 20 percent more.
Roy goes on to cite other studies that have shown similar results. He says that the reason Medicaid recipients repeatedly rank near or at the absolutely bottom of the healthcare quality ladder is partially because of the low medical reimbursement rates the program pays physicians who treat Medicaid enrollees. “The key reason is that Medicaid pays physicians far below market rates to care for Medicaid beneficiaries,” Roy writes.
Wisconsin ranks among the bottom 15 of states in terms of how little physicians are reimbursed for their work treating Medicaid patients.
Democratic state lawmakers calling for the state to expand its Medicaid program have completely ignored the human and fiscal costs of the program. State Rep. Sandy Pasch (D), who was defeated in her bid to move up to the state Senate in 2011 after an ethics controversy involving allegations of bribing for votes broke, declared Tuesday, “It’s time to stop playing games with the health of our communities and make a bold effort to strengthen healthcare for our everyday citizens.”
But according to the data, it is the Medicaid system itself that is responsible for delivering poor quality healthcare to its enrollees.
State Rep. John Richards (D) embraced even more of the myths surrounding the debate in a statement also released on Tuesday.
“We can provide health care to 175,000 people, save state taxpayers $66 million in the first three years and create 10,000 jobs. It’s a good deal for Wisconsin. It’s a good deal for the health of our state.”
Unfortunately, the data doesn’t support such Pollyanna conclusions. Wisconsin will not save money from the expansion, it will cost $725 million over the first 9 years alone, and the quality of healthcare delivered by the program is lacking.