<p>Some hospitals have a triage system. I’ve been triaged from an emergency room to urgent care. (And I would have gone to urgent care first, if I’d known where it was.)</p>
<p>“Did I mention that she was born without an anus? She pooped out of her vagina.”</p>
<p>This discussion is taking us into the twilight zone.</p>
<p>Urgent care isn’t always available – there may not be an urgent care center nearby, or the urgent care center may have limited hours. If a kid is crying in pain at 1 am - you head toward whatever is open. </p>
<p>The nearest urgent care center to me closes at 10pm on weekdays and at 5 pm on weekends.</p>
<p>Urgent care - that’s the word I was looking for last night!</p>
<p>I do think that there is a need to expand this option. It just makes sense to do so. It would bring down the cost of care for minor injuries and would free up resources for when they are truly needed.</p>
<p>Unfortunately, the urgent care situation is the same as the doctor situation. Many, maybe most, do not accept Medicaid. They can’t. They are already bare bones, low-profit operations… And on the consumer side people who don’t pay tend not to care about costs anyway. </p>
<p>When there’s no money involved, cancelled appointments mean nothing, either. And don’t Medicaid recipients even get free taxi rides to medical appointments? </p>
<p>It doesn’t seem right when Medicaid patients get access to quality hospitals that (paying!) others are shut out of because of narrowed networks. </p>
<p>Every time my family uses an ER, it’s a $200 copay. Every time a Medicaid patient uses it, there is no consequence/no cost. </p>
<p>Yes, God forbid Medicaid patients should have access to quality hospitals. They’re so lucky to be poor.</p>
<p>“Unfortunately, the urgent care situation is the same as the doctor situation. Many, maybe most, do not accept Medicaid. They can’t. They are already bare bones, low-profit operations…”</p>
<p>“It doesn’t seem right when Medicaid patients get access to quality hospitals that (paying!) others are shut out of because of narrowed networks.”</p>
<p>Interesting…</p>
<p>Lack of financial liability equals a lack of fiscal responsibility. </p>
<p>Couple that with superior access and you’re eventually going to have to rationally defend the system that produced it, rather than just talk about how mean the questioning of it is.</p>
<p>Or maybe not.
#-o </p>
<p>Beyond stupid…</p>
<p><a href=“Urban Institute/RWJF Report: Reluctant States not Expanding Medicaid Hurt State Budgets, Hospitals and Uninsured – Center For Children and Families”>http://ccf.georgetown.edu/all/urban-instituterwj-report-reluctant-states-not-expanding-medicaid-lose-billions-in-funding-hurting-state-budgets-hospitals-and-uninsured/</a></p>
<p>" 1. Looking at comprehensive state-level fiscal analyses that have been done in 16 different states, the authors found that every single analysis was unequivocal in concluding that Medicaid expansion would only help state budgets. In every case, state savings and new revenues exceeded increased state Medicaid expenses.
2. Hospitals in states not expanding Medicaid are losing billions of dollars. For example, Florida hospitals will lose $22.6 billion over the next ten years, while Texas loses $34.3 billion, Pennsylvania $10.6 billion and North Carolina$11.3 billion.
3. Only once in over 30 years (in 1981) has Congress ever moved to cut the federal matching rate to states for Medicaid because strong bipartisan resistance from Governors has made this option a nonstarter for decades.
4. Overall, non-expanding reluctant states are foregoing over $420 billion in federal funds through 2022, hospitals are losing $167 billion in funding over the same time period, and 6.7 million state residents will remain uninsured next year.</p>
<p>I even hit the link, dstark, but I still couldn’t find anything that guaranteed the feds would keep paying the teaser rate for expansion. Not surprising, because every single one of these “oh, how stupid can Texas or (substitute your own) be?” pieces conveniently forgets to include the part about the budget-busting when the federal dollars dry up.</p>
<p>Seriously, would you take out a mortgage you couldn’t afford, just because the broker was going to make the first year’s payments?</p>
<p>^if we can’t afford to pay our “debt to the unlucky” as Michael Lewis so succinctly put it in a recent speech at Princeton, perhaps we should reconsider our tax code ;)</p>
<p>Well, there’s very little chance of getting majority support for that position which is precisely why this was sold on the false notion that it would be a cost-saver… It’s also always fascinated me when people say this while at the same tapping into every possible loophole or investment strategy or whatever to maximize their personal pocketbook. Go ahead. Pay more. No–one is stopping you… I do agree the tax code is a mess, though.</p>
<p>If a State expanded Medicaid now and the federal funds dried up what would stop that State from changing their Medicaid eligibility rules?</p>
<p>Mean now, mean later, the only difference would be running up the federal debt a few hundred thousand reams of paper. Well, sort of. I think that state administration would find itself proactively taking away a freebie - with the usual political ramifications - and advocating personal responsibility after proving it wasn’t required at all.</p>
<p>Never worked with my teenagers so I’m kind of skeptical, tom.</p>
<p>
I’m fine with the ‘unlucky’ but I suspect the revenue/outflow imbalance is related to all the ‘unwilling’ that have been lumped in with them.</p>
<p>How do you propose to separate the unlucky from the unwilling?</p>
<p>I’d start with a clear definition of what ‘unlucky’ really means. </p>
<p>Whoa, dstark…
… found this while looking for an answer to tom’s question.</p>
<p>Kind of despicable, if you’re inclined to thinking one way, but pretty darn noble according to a lot of ACA supporters.</p>
<p>Definitely not stupid, at any rate.</p>
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</p>
<p>Go for it. Who’s “unlucky” in your book?</p>