By Melissa Daniels | PA Independent
HARRISBURG — If members of Congress were on Medicaid, the program would perhaps look very different.
“In about two weeks, you’d see Medicaid drastically change,” said Dr. Donald Palmisano.
Palmisano is lead spokesman for the Coalition to Protect Patients’ Rights, which opposes the federal Patient Protection and Affordable Care Act reforms, and he has a background as a surgeon and former American Medical Association president.
He spoke Thursday at a panel discussion, moderated by state Rep. Stephen Bloom, R-Cumberland, on how ACA could make it tougher for people to get medical care.
One common theme was that ACA’s regulations will drive up insurance costs and drive out doctors. But these points are debated between ACA supporters and critics.
Palmisano said that because high rates of doctors don’t accept Medicaid, expanding the low-income, health-care plan would force out doctors, resulting in patients not getting needed care.
Palmisano said the “right diagnosis” was reforming “health financing.” Health-care costs could be driven down with free competition, he said, comparing how the price has dropped for computer tablets in recent years.
“I paid top dollar for (a Kindle) when it first came out, it was like $359. Now you can get that same Kindle, basically the same one for $79. Is that because of the benevolence of Amazon? I don’t think so,” he said. “It’s because Apple came out with something called the iPad, and Barnes and Noble came out with the Nook. That’s what we need in medicine.”
Other panelists noted cost drivers ACA could trigger.
Nathan Benefield, director of policy analysis with free market think tank Commonwealth Foundation, said the insurance company regulation on pre-existing conditions helps drive up private insurance premiums. It’s akin to buying car insurance after an accident, he said.
Rick Dreyfuss, a senior fellow with the Commonwealth Foundation, said a planned $500 billion cut to Medicare means less reimbursement for hospitals. That $500 billion would’ve been spent on Medicare during the next 10 years without ACA, slowing the program’s rate of growth.
“When you cut reimbursements to hospitals and doctors, they respond by either shifting that to private insurance, which makes health-care costs even more unaffordable, but it also services as a disincentive for providers to stay in practice,” Dreyfuss said.
Some say the Medicaid expansion could help ease the effects of cuts that hospitals face because of the federal funding structure.
Neal Bisno is the executive director of SEIU Healthcare PA, a union representing 20,000 health-care workers in the commonwealth. Bisno said the group will work with legislators to try to enact the Medicaid expansion, as the effect on hospitals would be positive because of other cuts to reimbursements.
“Hospitals and other health-care providers that are facing federal and state payment cuts are really counting on the Medicaid expansion to help them provide quality care,” he said to PA Independent. “Frankly it’s fiscally irresponsible to not implement the Medicaid expansion. The funding of the Medicaid expansion is heavily subsided by the federal government.”