Medical providers have asked the question of whether offering cash discounts for certain health services jeopardizes their insurance contracts- especially regarding Medicare/Medicaid, as they have the most complex rules and regulations. Unfortunately, after reviewing various documents on the matter, there are no clear and absolute answers; but certainly there are prevailing opinions and recommendations. A pertinent review of the issues and opinions for health facilities offering discounts to uninsured patients can be found at this link.
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Experts say California might have to go solo on extending healthcare coverage to the millions of uninsured Californians because “the future of federal overhaul efforts appears uncertain,” reports California Healthline. Nearly 7 million people are uninsured in California, and about the same amount of people are enrolled in the state’s Medicaid program, Medi-Cal. “Although federal health care reform could extend coverage to more Californians, it also could burden the cash-strapped state with additional Medi-Cal costs,” states California Healthline.
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The Washington Post reports that, “Last year, Obama used his budget to lay the groundwork for comprehensive health-care reform, proposing a 10-year $634 billion reserve fund as a “down payment” on universal coverage. This year’s blueprint does not include that money,” but administration sources say the new budget presumes a healthcare bill will be passed and lead to a $150 billion deficit reduction over the next 10 years.
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A while ago Congress came up with a solution to control Medicare spending; however, the solution only solves the problem temporarily. “It sets spending targets. If they’re not met, fees paid to doctors, hospitals and nursing homes automatically are cut,” reports the Houston Chronicle. If targets aren’t met, these fees are supposed to be cut, but a majority of the time “those cuts have been triggered, Congress has stepped in at the last minute to soften or repeal them — usually with the provision that even larger cuts would take effect at some undetermined future date,” states the Houston Chronicle.
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St. Vincent’s Hospital Manhattan has been helping people for over 150 years, and has “treated victims of calamities, from the cholera epidemic of 1849 to the sinking of the Titanic, the 9/11 terrorist attack and, just last year, the Hudson River landing of US Airways Flight 1549,” reports Anemona Hartocollis from The New York Times. However, the hospital is now struggling to stay alive, and a big chain of hospitals has “proposed to take over St. Vincent’s, shut down its inpatient beds and most of its emergency room services, and convert it into an outpatient center tied into the chain’s own hospitals uptown and across town to the east,” states Hartocollis. If St. Vincent’s were to be taken over, it could be the end of the last Roman Catholic general hospital in New York City.
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Millions of Americans are uninsured; however the state of California has the largest number of people without insurance, and this number continues to grow. 6.6 million Californians are uninsured, and California has “a lower percentage of individuals with employer-sponsored coverage,” reports Paul Fronstin from the Employee Benefit Research Institute. Employer-sponsored coverage decreased 9% between 1987 and 2008, and “although Medicaid and individually purchased coverage partially offset this decline, more than 20% of Californians remain uninsured,” states Fronstin.
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State lawmakers, especially California, are worried about the increased costs of the proposed expansion of Medicaid.
WebMD reports that, “California’s budget crisis already is hindering Medi-Cal, California’s Medicaid program, in its current state. Adding 1.6 million new enrollees to the program would be extremely difficult if not impossible.”
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