Cutting payments

The administration has approved California's petition to cut Medicaid payments.  Not cutting the rolls, of course, or getting rid of those who abuse the system,  just cutting the amount they'll pay the provider. So everyone in California who cares for Medicaid patients in any form will take a cut in reimbursement.  When it already costs more to treat many of them then is covered by the DRG. (DRG is the payment schedule, a fee per service paid by Medicaid and Medicare.) Of course, that's just California.  Because they're broke.  And no other state will ask for the same privilege, since they are most of them facing budget shortfalls, and why should California be the only one with cheap medical care for the indigent?

I wrote about EMTALA in the past and the burden it placed on providers (leading to some ER closings) and how some of my friends are forced to do a full third of their work without getting paid. In what other business does the government mandate that you work for free ?

Now the Administration is cutting the amount they'll pay for services for Medicaid in California, and for Medicare all over the country, while still expecting the same (and likely increasing) levels of service.  How many more providers do they wish to run out of business?  How many hospitals closing will be enough?  This has been threatened for a long time, and each time our loyal reps have delayed it.  Not made it go away, just delayed it.  Last time it took so long for them to approve the delay that several people I know took themselves off the rolls of Medicare providers, thereby diminishing the ability of Medicare patients to receive proper care in a timely manner.

But a person has to make a living.  As much as we would love to be able to do our jobs without worrying about the cost or getting paid, that's not the way the world works. If this is part of some dastardly plot to help force Medicare and Medicaid patients into Obamacare as a single provider, what will they do with all those patients and no medical personnel left to care for them?  We can't hold out forever, we have families to care for and mortgages to pay, too. And working for the government, getting paid with a two bedroom apartment for our extended families and a chit for potatoes and vodka won't get it.