Secretary Kathleen Sebelius of the U.S. Department of Health and Human Services advised governors
to consider generating savings through several approaches: like charging higher rates of co-payments for certain services, putting a limit to certain benefits, more efficient management of high-cost patients, putting a stop on improper payments and bringing down the cost of drugs.
Sebelius pointed out that while state Medicaid programs are required to cover doctors’ and hospitals’ services, many other services are deemed optional. These include respiratory care, prescription drugs, physical therapy, dental services, and optometry services and eyeglasses.
The Secretary also suggested states to consider reducing premature births and medically unnecessary Caesarean sections, by reducing hospital admissions and by using proven techniques to improve the care of children with asthma.
Governors think the proposals are not nearly enough, an Associated Press report said. Some requested relief from Congress and waivers on certain federal requirements. Arizona has even come forward and proposed that some groups of individuals be cut from the coverage rolls, the AP said. Gov. Jan Brewer, has asked permission from the federal government to remove 280,000 people from the state’s rolls.
Secretary Sebelius did not directly respond to the proposals, but did say that the legal authority to grant waivers is being reviewed by her office.
Medicaid covers over 50 million low-income Americans mostly seniors and disabled patients in nursing homes. Over the next two years, states are expected to face a deficit of about $175 billion.
In her letter to governors on Thursday, Sebelius promised full effort in helping states find ways to save on their Medicaid budgets. “My team stands ready to come to your state to discuss your priorities and how we can help achieve them,” she said. “We are committed to responsiveness and flexibility, and will expedite review of state proposals.”
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The root problem with the current Medicare/Medicaid Program in the U.S.A. is not complex. The problem is quite simple; it is the unscrupulous Care Providers who bilk the system at every opportunity that is the only problem.
The solution is also simple; investigate the Care Providers with the same technology and vim and vigor used to enforce the so-called “Patriot Act”. Then prosecute offenders to the fullest extent of the law. Revoke their licenses, levy serious fines, and mandatory sentencing to hard time in a federal prison. Problem solved. The ordinary U.S.A. Private Citizen needs to insist that Governmental Officials do what they are hired to do by the people of this great nation! In that way the program will remain solvent. Furthermore the Program can easily be setup to be made self-funding, so do it; effective immediately.
AUTHOR: James Madison, IV
January 2011 A.D.
I was shocked, respiratory care is deemed optional?!?!
Again, another attempt by our Gov’t to cut services to the most vulnerable and needy among us, the elderly and the poor.
I agree with Fonebone above, investigate the care providers and prosecute to the fullest extent of the law.
Instead, as always, the focus is on the recipients and ways to cut services. Another Gov’t abuse of the system.
So…our politicians go from “All American’s deserve healthcare like we’ve got in Washington” to……”Let’s eliminate it for our poor”. This nation’s priorities are too disgusting for words. Our country should quit pretending it places human life at such a high standard.
I read yesterday Fraud within the Medicare/Medicaid system is estimated at 60 Billion per year. The article discussed all the media coverage a bank robber gets compared to fraud of this magnitude. In fairness, this is now said to be a higher priority and being pursued more than ever before.
What else don’t we know?
Grr. Yeh I have my medicaid app still sittin on my kitchen table, best hurry up and sent it in before they cut off any new applicants.
Glasses and eyecare is optional? I have high eye pressure/borderline glaucoma and have to get it checked yearly in case i need drops.
Last year I was forced to get new glasses and contacts: I could no longer see with the ones I have. I was waaay overdue but my COBRA offers limited optometry/eye care so i was putting it off for as long possible till one day I almost drove my car off the road…
Anyhow if you don’t want the trendy chain store frames, ugly as sin teeny squarish things you have to hunt around and find a private (more expensive) optometrist. Finally found a decent pair (non designer) with my script. thinnest material avail and edges rolled and polished they still go over the frame so I had to pay to get the extras or i’d have serious coke bottle eyes, anyhow cost me $400 with 20% insurance discount and a pair of good quality glasses/frames for a high script go for $500 or more easily. They insisted I needed bi-focals but I wasn’t gonna go for that at my age so saved myself another $150.
Contacts lens also cost an arm and a leg for certain scripts, of course they are “cosmetic” but when you’ve almost got coke bottle glasses…
Optional dental care? I’d rather NOT be toothless.
Well the new governor of the state is saying “we ALL have to make sacrifices” they’ve allready said besides tax increases social service programs will be cut, I will end up homeless w/o food or insurance and how will this impact the $100K exec. living in his 1/2 million $ home with his new BMW? Is the governor himself gonna take a pay-cut?
Another plot to get rid of the destitute!
EOTW: Well, actually, hate to say this, but you are sitting much prettier than I am. I have NO Cobra, I have no health insurance, I have no dental and no vision. So, and you know I have always been on your side, but you have much more access to assistance (housing, eye care of any sort, health care of any sort, and dental of any sort) than I do, and I am 20 years + your senior. I do not begrudge you anything you have, or any access you have, but you are sitting much prettier than most of us. I have trifocals, not covered by any insurance of any kind, and I get my glasses at Wal-Mart. The hell with (cosmetic) contact lenses, I need to SEE!, and be able to work on a computer and a monitor screen, and actually, I look pretty sexy in my glasses (without the visible marks), and I have to pay out-of-pocket. And I would also like not to be toothless, but I have no dental or social services care, and I have three broken teeth (thankfully in the back where no one can see), and cannot afford dental care. I have no health insurance, and no social services for medical care, and if I get sick, I am just going to have to die, quite honestly, because I am NOT going to lose my home for medical reasons and jeopardize the only small things I have to leave to my daughter and grandchildren (if I can manage to hold onto it at all), but regardless, will not put myself in the situation where I cannot take care of my own health, and no one else is responsible for my care. Yep, certainly don’t want to be adentulous, but I do consider it (kind of) optional. Respiratory care, however, is NOT optional–whoever heard of living without breathing!!!????!!! Respiratory care is NOT optional.
I absolutely sympathize with your situation, but you are getting help with housing costs, you are getting other assistance, and speaking only for myself, I don’t get any of the assistance you receive. My concern is that there are people out there who might be deprived of LIFE-SAVING assistance–to include respiratory care. Periodontal disease (which I likely have) can actually be a life-threatening disease, not having coke-bottle glasses is not and cosmetics have to be put aside unless they can be paid for out-of-pocket–again, not life-threatening. Do I want to look pretty? Most certainly!–that’s why I pay out-of-pocket for no-line glasses (or glasses of any kind)–but I have to pay out-of-pocket for everything! So though I would like to be more than sympathetic, I am finding it a stretch…and I have always been, and continue to be, your supporter. But understand, there are those of us out here, many of us your seniors by years, who are unemployed, have no social services, have no health insurance, dental or optometric assistance, have no back-up of any sort, and quite honestly, I think you are sitting in much better circumstances than I am…I still have empathy, but have to understand that you are better off than many.
What I am confounded about is respiratory care being optional!!! You know what?–I can see with coke bottle lenses, I can still gum my food to death–I may not look so good, but I cannot survive if I cannot breathe. I have no respiratory illness, but my mom had pulmonary fibrosis and COPD, even WITH 24-hour oxygen she struggled to breathe. She was not on Medicaid; but that is beside the point. What if she had been? She was on Medicare, and believe me, that will be the next of the “social services” to go. Is breathing an OPTION?!? I am horrified!!
I’m sorry EOTW, I don’t mean to be hard or critical or difficult, but there are so many who do not have what you have, who do not have access to the services that you have, and who are so much worse off than you are. And I’m not whining about myself. My mom is gone. But do understand, I still care for people who may be denied access to care which allows them to breathe before I will stand up and fight for contacts or pretty glasses or even dental care unless it is periodontal disease which could affect their overall general health (which is probably what I have, but cannot afford care for).
Again, I apologize, because I feel really bad to “disagree” with you, because I really like you; but I think you are more fortunate in (some) ways than you realize. Again, just saying…..