Tuesday, June 11, 2013

Medicaid: a plea to rich people

Mississippi is facing a Medicaid battle.  Not only is it in danger of not being expanded, it's in danger of being CUT.  Please don't think I'm about to make a plea for the poor - I'm not.  No, this one's for the rich people*.  Don't even read this if you're lower than solidly middle class.  Hey rich people.  Are we alone yet?  Let's talk about how this will affect us.

Let's start with me, actually, like we rich people tend to do.  Mississippi has two pediatric neurologists.  TWO.  In the ENTIRE STATE.  Ace sees one of them for his cerebral palsy and I have to block out at least 3 hours in my schedule to see him because he's so overbooked.  I just found out Friday that he is leaving the state because of underfunded Medicaid - he's just not getting paid.  Now I either have to see the ONLY pediatric neurologist in the state and heaven knows how long I'll have to wait for an appointment with her or I have to take Ace out of state for his appointments. Since there still remains one pediatric neurologist in the state, my insurance won't pay for an out-of-state doctor.  There goes the lawn man.  DAMN IT.

"So?  Quite frankly, Stacey, I'm glad you'll be inconvenienced because your car is newer than mine and I hate you for it.  I'm richer than God and my kid doesn't have special needs; how will this affect ME?"

Hang on to your French tips, girl.  Have you ever complained that despite the fact that we take naps on our fat stacks of cash that it STILL takes an hour or two to get in to see your gyno?  That's because he/she is overbooked, too.  If Medicaid is cut, doctors WILL leave the state of Mississippi because Mississippi is not dominated by people like us, it's dominated by people who depend on Medicaid to pay their doctors.  That means your doctor will become MORE overbooked - or will leave the state too.  And you KNOW how much it sucks to find a doctor who makes you comfortable enough to allow him/her to stick things in your vagina.  It's not just doctors who will leave the state - nurses, EMTs, physical therapists, occupational therapists, speech therapists, counselors, social workers, midwives, et cetera, et cetera.  And you can forget about the friend who gives you Xanax at book (wine) club, she's gonna be hoarding that shit.

Listen, fellow Fidelity and Ameritrade members, if our healthcare providers leave the state, our healthcare will decline, which means EVERYTHING will decline.  Mississippi has a low cost of living (making your six figures much more cushy) because the industries that employ the majority of our state don't have to pay their workers much or give them good benefits.  That leaves three options: a) they only employ super healthy people who don't need good insurance, b) they are forced to increase their costs to pay their employees more and give them better benefits, or c) their employees supplement with Medicaid.  Does your employer employ *whisper* lower classes?  Which option do you think they'd want?  Which option do you think would keep them here?  Which option do you think would bring MORE industry here?

This thought makes my Discover card tingle though - if I have to go to Birmingham, Memphis, or New Orleans to see a pediatric specialist, I'll be spending quite a bit of money there.  Will certainly be visiting the restaurants and I don't eat fast food.  Might check out a few local attractions.  May even get a hotel room depending on what time the appointment is, and I don't sleep in anything without a free breakfast and 4 pillows per bed.  And you KNOW I'm not peeing in a shady, cheap gas station.  Think of all the tax dollars I'll be giving those states.  Think of all my money that's going to their roads and education - Ace sees a LOT of specialists.  I know your kids go to St. Andrew's and you don't really care about the state of our public education, but on your way to St. Andrew's, enjoy tightening every muscle of your body while you drag your $200 limited edition Lexus LS wheels down the Fondren side of Lakeland to get there.

How much do you pay your cleaning lady?  Mine doesn't charge me much, considering she spends 3 hours spit-shining my hardwood and she has a ton of medical issues she likes to overshare with me.  I'm not great at math, but I'm fairly certain the amount I pay her x the amount of houses she cleans per day = she's on Medicaid.  Fine with me!  If she had to pay for self-employed insurance, I'd have to pay her a WHOLE lot more or (FOR THE LOVE OF GOD) scrub my own toilets.  And actually, if you have a cleaning SERVICE, refer back to the paragraph about industry, thanks, smooches.

So please, contact Phil Bryant and tell him you want better Medicaid for our state.  Contact that senator you went to Prep with or that representative whose wife is in your book (wine) club.  And share this post with your rich friends.

Not the poor ones*.

*Please know that this is all tongue-in-cheek and I'm not THAT elitist or rich.  I do have a cleaning lady and a lawn man though. And, on a personal note, I WILL move out of Mississippi if I can't get my son good health care.  And I don't wanna.  SO MAKE SOME NOISE FOR ME.


SelenaFaye said...

Love this post. We also see lots of specialist at UMC in Jackson for my son Liam and I can't imagine having to travel out of state for all of those appointments.

Bourg Family said...

Don't move to Louisiana though. Sucks here too! :(

JustBeingMichael said...

This was funny and I love it. As someone who works for CMS (Medicare and Medicaid)... you are pretty spot on with your assessments of payment.

As a person of means, you are VERY spot on with your assessment of how we really only vote for things that affect us, and sometimes it has to be spelled out.

ConcernedAboutHealthcare said...

The debate going on has nothing to do with making medicaid better. It is a debate about expanding the current medicaid coverage to include more individuals. No physician reimbursements have changed recently or will change from the state. Reimbursments have always been poor. It is the democtratic lawmakeers that have blocked the state reauthorization and funding for this next year. I would be all for an open debate about expansion but not keeping the current patients hostage to do so.

As altruistic as physicians are they still need to make a living. Most of the time they try to balance out Medicare/Medicaid patients with private insurance. More and more physicians are refusing new Medicare/Medicaid patients due to the rate of reimbursement. Expanding the Medicaid patients will propbably not help the physicians stay in Mississippi.

The only proposed cuts recently are federal and they relate to the DSH payments that a hospital receives for indigent care. The federal mandate was to expand Medicaid to try to offset this DSH cut. This would only apply to hospitals and not the physicians.

I would agree that a healthy debate is needed about healthcare. I would just say call ALL lawakers and tell them to pass current level funding for next year.

Crawdaddy79 said...

Lots of good doctors here in the DC area. I guarantee they won't be leaving here any time soon.

Just sayin'.