Reforming health care

Wednesday, March 17, 2010 | 2:01 a.m.

Medicaid, the health insurance safety net for the nation’s poor, is struggling under budget cuts that are leaving those who most need the help with few options.

The New York Times reported Monday on the serious problems with the program, which is jointly funded by the federal government and the states. Many doctors are declining to take new patients with Medicaid because of substandard reimbursements. In 2008, Medicaid reimbursements averaged 72 percent of the rates paid by Medicare, which usually pays less than what private insurance does.

For example, Dr. Saed Sahouri, a primary care physician in Flint, Mich., stopped taking patients with Medicaid after the state cut reimbursements 8 percent to deal with a budget deficit. The cut came on top of previous cuts, and Sahouri would often receive no more than $25 for an office visit.

“My office manager was telling me to do this for a long time, and I resisted,” Sahouri said. “But after awhile you realize that we’re really losing money on seeing those patients, not even breaking even. We were starting to lose more and more money, month after month.”

In Michigan, patients on Medicaid sometimes have to travel for hours to find a doctor who will accept the coverage. It’s not a situation limited to Michigan. States across the country, including Nevada, have trimmed Medicaid payments to doctors for years and, as a result, doctors have quit taking patients. That puts the health of the 53 million people in America on Medicaid, including 242,000 in Nevada, in jeopardy.

A group of Nevada anesthesiologists said Tuesday that they expect many doctors in their specialty to not accept Medicaid patients, as Cy Ryan reported on the Las Vegas Sun’s Web site. The Legislature cut the reimbursement rate to anesthesiologists in its special session this year, cutting their base reimbursement rate from $37 to $21. Dr. Elliot Klain said the rate hadn’t gone up since 1980, when it was set. “Medicaid is a charity rate,” Klain said. “We can’t give that much charity to the state.”

The system obviously needs to be changed. In a letter to congressional leaders after his health care summit, President Barack Obama agreed to consider raising reimbursement rates for Medicaid as part of broader health care reform legislation. Even though they tend to agree with increasing reimbursement rates, Republicans have continued to try to kill the current health care reform legislation in Congress. If they succeed, it would be a terrible blow to the country. History has shown that if the legislation fails, health care reform will be politically dead for years to come.

In a report issued Monday, the nonpartisan Urban Institute said if the health care reform legislation fails, Americans can expect major consequences in the next decade. For example, the report says that by 2020:

• The percent of middle- to higher-income families without insurance would rise to 56 percent.

• Premiums would more than double for both single and family health insurance policies, and many small- and medium-size companies would quit offering health care plans.

• Public spending on Medicaid and children’s health programs would increase by as much as 108 percent, and taxpayers would see an increase in the cost of care for the uninsured.

As the problems with Medicaid and the Urban Institute report show, the current situation is unacceptable, and dropping health care reform will only cause more problems and cost taxpayers billions of dollars more over the next decade. Congress should push ahead and make the changes America needs.