Numbers for Medicaid expansion don’t add up
Obamacare supporters want to talk numbers when it comes to expanding Medicaid in Georgia. OK, let’s talk numbers:
When they returned last month, Georgia’s legislators already faced a $774 million hole for Medicaid through June 2014. That was before any expansion, and even after assuming renewal of the “bed tax” that brings in some $700 million a year for the program.
Medicaid is already the fastest-growing part of Georgia’s budget. Including PeachCare for kids, it will consume $1 of every $7 in state funds in fiscal 2014, up from $1 per $9 a decade ago.
That increased ratio means almost $616 million will go to Medicaid next year instead of transportation, tax cuts, whatever. State lawmakers can do precious little to arrest the trend.
Still, Obamacare supporters want Medicaid to grow faster.
Pressure is mounting on Nathan Deal to follow the path taken by some other Republican governors — Florida’s Rick Scott and New Jersey’s Chris Christie joined the list in the past eight days — and accept the expansion included in Obamacare.
At first, they note, Washington will pick up the tab. Only after three years will the feds begin reducing their share of the expansion, to 90 percent by 2020. How long that rate sticks, I note, will depend on the generosity — or profligacy — of future Congresses.
But today I want to address two other arguments the expansionists are pushing.
Scott made one argument last week when he announced support for expanding in Florida: “[O]ur options are either having Floridians pay to fund this program in other states while denying health care to our citizens,” he said, or taking federal money to expand Medicaid.
The same claim is made here. We’re going to pay for it, so why not benefit from it?
The arrangement might make sense if it were Washington whose budget was balanced and the state whose finances were in shambles, not the other way around.
The notion taxpayers are already funding the Medicaid expansion requires one to ignore the serially large deficits Washington is running — as well as lawmakers’ reluctance to accept the relatively small cuts of sequestration, due to hit Friday.
Spending that rises while huge deficits persist is not “paid for” in any meaningful sense. Scott, Christie and the others are wrong about the responsible course.
And persist deficits will. Just this month, the Congressional Budget Office projected only two years out of the next 11 in which the deficit will be smaller than the very largest deficit (adjusted for inflation) between 1940 and 2008. That’s probably an optimistic take: CBO’s belief the deficit will soon fall to “only” $430 billion in 2015, before rising in each subsequent year, rests on the hope our sluggish economy is about to achieve and maintain a growth rate not seen in a decade and a half.
Speaking of rosy forecasts, another new argument is that expanding Medicaid in Georgia by $4 billion a year over 10 years (the federal share) would create thousands of jobs and boost our economy by more than $8.1 billion a year, a 103 percent return on “investment.”
A review of federal jobs data and state health expenditures makes me skeptical. Using the most recent figures available for both, and adjusting them for inflation, a five-year average for both Georgia and the entire nation showed there was one direct health-care job for roughly every $200,000 spent on health care annually. That $8.1 billion economic boost assumes one direct health-care job would be created for every $110,000 spent.
It’s possible newer jobs would be created more efficiently. But if the earlier average of $200,000 per job held up, and even if we accept the study’s other multipliers, the return on “investment” may be closer to 20 percent — $4 billion in new spending creating $5 billion of activity — than 103 percent. That’s not worth raising state taxes to fund our share of the cost.
The bases for weighing the Medicaid expansion are whether the state can afford its portion, whether we can count on the feds to deliver on their promises, and whether we should expand Medicaid before reforming it. All three answers remain “No.”
– By Kyle Wingfield
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354 comments Add your comment
Politico
February 28th, 2013
6:19 pm
Awww
Little Tiberius humped my leg when I was directing a post to md and now he is attempting to change it around
bless his short self and heart…….. little guy is as lonely as he can be
MarkV
February 28th, 2013
6:20 pm
If Tiberius want to maintain his ignorance, it is a free country even for that..
Politico
February 28th, 2013
6:21 pm
Kyle
Let your self appointed blog sheriff and welcoming committee spokesman (Tiberius) now that unless you have an issue with my postings, I will not be going anywhere.
He can cry and email you all he likes.. Maybe threaten to sue, but it wont change anything.
Maybe give him some attention so he thinks he is your star pet. That makes him happy.
Good night
JDW
February 28th, 2013
6:24 pm
@Aesop…”No, what we are actually saying is that blacks die at a disproportionate rate to whites, mostly because of the living conditions the democrats have forced them into. Normal people would be ashamed with themselves but not a lib, they use the statistics that they created to hate on the United States, mostly so they can kill the rest of us.”
You know when I was a kid your fables were so much better…this drivel is just mean.
Tiberius - pulling the tail of the left AND right when needed
February 28th, 2013
6:28 pm
If MarkV refuses to debate an alternative view, well, it’s a free country for him to remain ignorant of the facts.
Tiberius - pulling the tail of the left AND right when needed
February 28th, 2013
6:29 pm
You always know when Politico has lost his argument.
Simply read his last three or four posts to me.
Catches him with his pants down every time (and believe me, that’s not a visual I want to have in my brain).
JDW
February 28th, 2013
6:32 pm
@Tiberius…”“when we could pay them ZERO and still rank #1 in spending. Dumbest post of the day – bar none. Thanks for the laugh, JDW.”
Still math challenged I see. It works like this… according to the OECD, you know that link I gave you earlier that you obviously distaining viewing ’cause as well all know YOU KNOW EVERYTHING
we spend $8233 per year per person. Doctors account for about 1/5 or $1646 of that total…if we paid them ZERO our costs would STILL BE $6586 per person which is more than the number two nation on the hit parade Norway at $5388 per person.
Keep laughing…though it is a bit sad.
JDW
February 28th, 2013
6:35 pm
@Tiberius…”Obviously someone doesn’t know the difference between the freedoms afforded us and all those other countries”
O’ JEEEEESSSSSH our freedoms are killing us faster than everyone else
…only guns dufus and if you took em all out it doesn’t impact overall expectancy that much…just ruins lots of lives needlessly.
Aesop's Fables and other Lib Economic Theories
February 28th, 2013
6:36 pm
jdw – Obviously you don’t have a reasoned rebuttal to what I say so the inbred “if I babble it then it must be true” syndrome was all you had to suffice.
JDW
February 28th, 2013
6:37 pm
@md…”We choose everything we do jdw.”
You got it…in this country we choose not to provide health care and it hurts lots of folks…kind of nasty don’t you think?
JDW
February 28th, 2013
6:39 pm
@Aesop…”Obviously you don’t have a reasoned rebuttal to what I say so the inbred “if I babble it then it must be true” syndrome was all you had to suffice”
There is no reasoned rebuttal to pure trash…all you can do is kick it to the curb
indigo
February 28th, 2013
6:39 pm
Tiberius – 5:45
Read my post again.
I said the Govt. is in complete charge of our Military.
Also, I said, and still say, that if our healthcare system was run, by the Govt. the same way they run the military, you and the cons here would be yelling “socialized medicine”.
You can’t have it both ways.
If the Govt. running of our Military does not meet the strict “socialist” definition, then that same kind of healthcare managing cannot be called “socialized medicine”.
And, I DID serve in the Military, US Navy, something I seriously doubt you’ll ever do.
MarkV
February 28th, 2013
6:39 pm
Since Tiberius is too lazy to get the correct information:
Karl Marx was not “father of Socialism.” The idea of socialism, and that term, existed long before Karl Marx.
“From each according to his ability, to each according to his need” is not the motto of Socialism; it is the motto of Communism. The motto of Socialism is “From each according to his ability, to each according to his contribution.”
JDW
February 28th, 2013
6:41 pm
@MarkV…”Can’t Tiberius google something like the socialist motto to get the right one?”
Why would Tiberius Google…he already knows everything…
MarkV
February 28th, 2013
6:41 pm
For those few who care about what they write:
“Socialized” does not mean “Socialistic.” It simply means that the subject, whatever it is, is spread over the whole society. For instance in the expression “Socialized Risks, Private Rewards” not even the most ardent socialism-fighter can find anything about Socialism.
True “socialized medicine” means that the society, through the government, PROVIDES health care, i.e., providers are state employees. “Universal Health Care” may but does not have to mean “socialized medicine.” It is quite often used for systems where only the insurance costs are “socialized,” as in the tax-based “single payer” systems or “Medicare for all,” or in any private insurance systems with compulsory insurance.
Politico
February 28th, 2013
6:45 pm
Speaking of losing arguments, I never demanded or suggested anyone leave the blog, threaten to sue the AJC, wrote emails crying like a baby…………
But we all know who has done that……..
don’t fall little guy
indigo
February 28th, 2013
6:46 pm
MarkV – 6:39
Tiberius knows all, sees all and is never wrong.
If you doubt this, why, just ask him.
Aesop's Fables and other Lib Economic Theories
February 28th, 2013
6:51 pm
If it walks like a duck and talks like a duck, it’s a duck.
Can I get a duh?
Michael H. Smith
February 28th, 2013
6:52 pm
We [Cons] have been yelling socialism and socialized medicine long before obumercare was past. You need to study history instead of trying to rewrite it with your half baked phony rhetoric.
Quotes by Roosevelt
I pledge you, I pledge myself, to a new deal for the American people. Franklin D. Roosevelt, accepting the Democratic nomination for President – July 2, 1932.
[Some People]…will try to give you new and strange names for what we are doing. Sometimes they will call it ‘Fascism,’ sometimes ‘Communism,’ sometimes ‘Regimentation,’ sometimes ‘Socialism.’ But, in so doing, they are trying to make very complex and theoretical something that is really very simple and very practical…. Plausible self-seekers and theoretical die-hards will tell you of the loss of individual liberty. Answer this question out of the facts of your own life. Have you lost any of your rights or liberty or constitutional freedom of action and choice?
http://en.wikiquote.org/wiki/New_Deal
And, yes Franklin we lost a great number of rights liberties and freedom of action and choice!
Politico
February 28th, 2013
6:54 pm
Tiberius
Get you last word in so you can feel good about yourself.
Don’t be so lonely and catch you next time little fella
Aesop's Fables and other Lib Economic Theories
February 28th, 2013
6:54 pm
Will Rogers said, “Be thankful we’re not getting all the government we’re paying for.” Today we are not paying for all the government we are getting, and the political class benefiting from this practice should be thankful for the Fed’s low interest rate policy, which makes running deficits inexpensive. In addition to making big government cheap, this causes a flight of investors from interest-paying assets into equities — the rising stock market primarily benefits the wealthy — and commodities, rather than job-creating investments.
Any idiot can understand this, er, I mean, “most” idiots. But not our idiot president.
md
February 28th, 2013
6:56 pm
“You got it…in this country we choose not to provide health care and it hurts lots of folks…kind of nasty don’t you think? ”
No, because when we choose everything we do, many are where they are because of those choices. And it isn’t up to others to make up the difference just because.
I say make health insurance just like car insurance and those that want to participate will make the necessary choices to do so…….and the hospitals are always there as a last reort by law.
Why do you have the right jdw to dictate what others should earn because of your perceived right?
What do you do for a living? Should others demand of you that you get paid a max amount because they feel they have a right to your goods or services?
Last I checked, a right can not exist if one has to infringe on another to provide that right…..
Michael H. Smith
February 28th, 2013
6:57 pm
Anyhow Kyle, the socialist have nothing less than a single payer healthcare system.
Which as we know is everything but, “really very simple and very practical” in FDR speak.
JDW
February 28th, 2013
7:03 pm
@md…I say make health insurance just like car insurance and those that want to participate will make the necessary choices to do so
Did you know that if you drive you must have car insurance? The equitable solution is that if you breathe you should have health insurance…I think we passed a law about that.
md
February 28th, 2013
7:10 pm
“Did you know that if you drive you must have car insurance? The equitable solution is that if you breathe you should have health insurance…I think we passed a law about that.”
As I said, if one chooses to participate (electing to drive) then one may make the choices to buy the insurance, and one that chooses to participate in hc may buy the insurance……otherwise, one may walk or take the bus and one may choose to go to the hospital for care.
It gets back down to wants vs needs….that carton of cigarettes or heath insurance.
And I’m on record for providing a safety net, so these folks that choose to remain poor by not making the necessary choices to better themselves are extended a helping hand, but if they choose to not move forward then it isn’t up to others to fix that.
Just like the homeless guy in NY that was given a pair of boots, he said it was his choice to live on the street although his family always has the door open.
Choices jdw…..choices.
Michael H. Smith
February 28th, 2013
7:12 pm
obumercare was found constitutional based on the ability of Congress to tax not on the equitable solution is that if you breathe you should have health insurance.
Michael H. Smith
February 28th, 2013
7:16 pm
Goodnight to all.
Stephenson Billings
February 28th, 2013
7:41 pm
Shortage of family doctors leaves health care in crisis
The NHS is facing a chronic shortage of family doctors after official figures showed some GPs were responsible for 9,000 patients.
“More than a million people were registered with a GP who served more than 3,000 patients, almost twice the average list size of 1,600.
Experts warned that doctors with vast numbers of patients might not be providing the best service, with their practices seeing poorer care and longer waiting times.
The figures show the worst surgeries for securing a doctor’s appointment within two days have 50 per cent more patients per GP than the average practice.”
http://www.telegraph.co.uk/health/healthnews/8978509/Shortage-of-family-doctors-leaves-health-care-in-crisis.html
Stephenson Billings
February 28th, 2013
7:44 pm
Patients’ lives at risk in NHS hospital wards ‘on brink of collapse’
Patients’ lives are at risk in NHS hospital wards that are “on the brink of collapse” due to a critical shortage of out-of-hours doctors and growing numbers of the elderly.
“Some hospitals narrowly avoid “catastrophe” every weekend, research by the Royal College of Physicians has found, because doctors’ shifts are limited by the European Working Time Directive and they do not want to work anti-social hours.
Some are “struggling to cope” with the volume of older patients. Many are discharged in the middle of the night or shunted around “like parcels” to free beds for new arrivals.”
http://www.telegraph.co.uk/health/healthnews/9539872/Patients-lives-at-risk-in-NHS-hospital-wards-on-brink-of-collapse.html
Stephenson Billings
February 28th, 2013
7:47 pm
NHS boss ’steps aside’ over fears high death rates were masked
The head of an NHS trust has “stepped aside” amid fears that staff tried to mask high mortality rates by recording the wrong cause of death for patients.
“In 2011, Bolton NHS Foundation Trust recorded a large spike in septicaemia deaths – which are not included in official mortality figures – at the Royal Bolton Hospital in Greater Manchester.
During the same year, it also recorded a significant improvement in death rates and was given an award for the “most improved” trust.
But a recent audit demanded by local doctors has unearthed evidence that these improvements may have been fictional.”
http://www.telegraph.co.uk/health/put-patients-first/9898427/NHS-boss-steps-aside-over-fears-high-death-rates-were-masked.html
Stephenson Billings
February 28th, 2013
7:49 pm
Road crash victims face rehab ‘lottery’
Road crash victims face a ‘postcode lottery’ when it comes to rehabilitation, that is hampering their recovery and costing the NHS £120 million a year, claims a report.
http://www.telegraph.co.uk/health/healthnews/9895110/Road-crash-victims-face-rehab-lottery.html
Stephenson Billings
February 28th, 2013
7:55 pm
Rising health demands to cost £34bn more
“Britain’s ageing population, salary pressures and drug price rises could cost the NHS a further £34bn by the start of the next decade, according to a major new study of the health service.
This report from the Nuffield Trust sets out the political predicament that the next government will face. It will struggle to avoid cuts to the NHS, which now costs £106bn, if it is still fighting to cut the fiscal deficit in the next parliament.”
http://www.ft.com/intl/cms/s/0/f8145e84-3cae-11e2-a6b2-00144feabdc0.html
Stephenson Billings
February 28th, 2013
8:00 pm
Canada’s doctor shortage will only worsen in the coming decade
“When stacked up against countries with similar health care goals, namely universal coverage, it quickly becomes apparent that Canada’s health care system is not worth emulating. While we’re a top spender, we have among the longest waiting lists, low levels of medical technologies and perhaps the problem that hits closest to home, a short supply of doctors.
If you think it’s bad now, just wait. Over the next decade, the physician shortage will become more severe. Even if government imposed restrictions on the number of doctors being trained in Canada are immediately removed, it won’t have an impact for much of the next decade given the time it takes to train a new doctor. The only short-term solution is to recruit more foreign-trained doctors.”
http://www.fraserinstitute.org/publicationdisplay.aspx?id=17360
Stephenson Billings
February 28th, 2013
8:05 pm
Report: Canadian health care spending unsustainable
“Single-payer Health Care, once lauded by President Barack Obama for its ability to keep health care expenditures down by rationing care, has become prohibitively expensive and inefficient in Canada, according to a new study.
A 2011 report by the Fraser Institute concluded that Canada’s health care system is spending at an unsustainable rate. Six of ten Canadian provinces are on track to spend half of their revenues on health care, according to the institute.
“We conclude that Canada’s health system produces rates of growth in health spending that are not sustainable solely through redistributive public financing,” the report concluded.
In 2011, health care spending consumed 50 percent of revenues in Canada’s two largest provinces, Ontario and Quebec.
By 2017, four more provinces — Saskatchewan, Alberta, British Columbia and New Brunswick — will spend half of their revenues on health care, according to the institute.
Total federal, provincial and territorial government health spending has grown by 8.1 percent annually, while the national GDP in Canada rose by only 6.7 percent during the same period.
In response to the rapidly rising costs, provincial governments have raised taxes and rationed care, increasing patient wait times. Provincial drug plans have also more often refused to pay for most of the drugs that are certified as “safe and effective” by Health Canada.”
http://dailycaller.com/2012/07/24/report-canadian-health-care-spending-unsustainable/
Stephenson Billings
February 28th, 2013
8:10 pm
Health-care costs could downgrade Canada’s credit
“Standard & Poor’s is warning that Canada and other G20 countries could face credit downgrades if they don’t control expected increases in health-care costs as the average age of their population rises.
The ratings agency, in a report issued Thursday, says governments in advanced economies have missed the importance of health-care cost increases linked to aging populations.”
http://www.cbc.ca/news/business/story/2012/01/31/standard-poors-health-care-costs.html
Tiberius - pulling the tail of the left AND right when needed
February 28th, 2013
8:25 pm
Losers (and sore ones at that) like JDW, Politico and MarkV just can’t seem to hack the logical arguments presented on this blog.
Politico attacks the posters, but contributes nothing else. And repeats the same things more often than AmVet ever did. Too bad Politico won’t take the same path and self banish himself.
JDW keeps moving goal posts so frequently that he can’t even see the stadium any longer, and only tells the side of the argument he agrees with – never the whole story.
And what to say about MarkV that hasn’t already been said? If it’s not worded precisely in his personal dictionary, it can’t possibly be true. And when caught in his falsehoods, he constantly complains that “he never said that” (simply because someone didn’t quote him EXACTLY).
All-in-all, a fools gallery the liberal establishment can be proud of.
Tiberius - pulling the tail of the left AND right when needed
February 28th, 2013
8:30 pm
And Indigo, your fractured “logic” of a socialized military proves you didn’t learn anything about the military if you actually did serve, which I doubt.
Of course, you could be one of those rare few who served and turned against the very Constitution you swore to defend, simply because you never read or understood the words of that document in the first place. Oaths don’t mean much to people who are liberal.
Rafe Hollister preparing for an Obamanist America
February 28th, 2013
8:34 pm
And there are those who think our heart disease and obesity rates would decline, if everyone had the ability to see a Doc in the box for 10 minutes once a year, for free. I’ll bet a double cheese whooper, that it will not make one bit of difference.
Those same folks believed that Obama was going to cut the deficit in half in his first term, not sign a bill that added one dime to the deficit, close Gitmo, have the most transparent administration ever, not allow lobbyist in his administration, and be a healer that worked across the aisle.
Rafe Hollister preparing for an Obamanist America
February 28th, 2013
8:35 pm
whopper not whooper— boy that makes me hungry!
Rafe Hollister preparing for an Obamanist America
February 28th, 2013
8:38 pm
Indigo says a socialized military is working just fine and so would socialized medicine. Wrong analogy, Indie, we already have socialized medicine and it is not working fine, i.e. The Veterans Administration. I’m afraid that any socialized medicine we get from the Dems would more closely resemble the VA than the military.
Lil' Barry Bailout - OBAMAPHONE!!!
February 28th, 2013
8:38 pm
Four years of Obozo, and ain’t nothing been fixed.
Tiberius - pulling the tail of the left AND right when needed
February 28th, 2013
8:42 pm
Rafe, like everything in life, VA medicine has its good and bad points. There are some holes in the system (mental health services in particular), and there are some pretty bad hospitals in certain areas of the country, but there are also some very good ones as well.
They could always do better, but they sure could do worse.
JDW
February 28th, 2013
8:52 pm
@Tiberius…8:25 may be the perfect Tiberius post…
It has ZERO substance…not a fact, not a link, not a hypothesis, not an argument. There is no position and nothing with which to debate.
It does have insults…
“Losers (and sore ones at that) like JDW, Politico and MarkV just can’t seem to hack the logical arguments presented on this blog.”
“Politico attacks the posters, but contributes nothing else.”
“And what to say about MarkV that hasn’t already been said ”
“All-in-all, a fools gallery the liberal establishment can be proud of.”
Then he follows with this bit of drivel at 8:30 (guess it took 5 minutes to come up with it)
“Of course, you could be one of those rare few who served and turned against the very Constitution you swore to defend, simply because you never read or understood the words of that document in the first place. Oaths don’t mean much to people who are liberal”
More pontificating from our self appointed “Constitutional Authority”…speaking of which never did hear back from you on those Constitutional budget requirements you spouted off on the other day…where were those again?
JDW
February 28th, 2013
8:56 pm
You know Tiberius, I have found the perfect political party for you…
http://en.wikipedia.org/wiki/Nullifier_Party
You are the perfect person to carry that banner…most everything you say seems to follow the vein of selective adherence…it is perfect for you.
Lil' Barry Bailout - OBAMAPHONE!!!
February 28th, 2013
8:57 pm
Obozo got everything he wanted in the grand bargain with Our Speaker Boehner, and then he moved the goalposts and walked away from the deal. Just like Yasser Arafat did in the negotiations brokered by Clintax back in the nineties.
Arafat and Obozo: America-hating Muslim terrorists.
Bruno
February 28th, 2013
9:17 pm
At first, they note, Washington will pick up the tab. Only after three years will the feds begin reducing their share of the expansion, to 90 percent by 2020. How long that rate sticks, I note, will depend on the generosity — or profligacy — of future Congresses.
I’m not sure why this shell game of shuffling money around is generating so much excitement here among the Libs. It’s this simple: our health care delivery system is too expensive. With more than 50% of our health care dollars wasted, the focus should be on reining in costs, not on pretending that monies coming from the federal government are somehow different from state monies. It all comes from the pockets of the taxpayers (us).
Dusty
February 28th, 2013
9:21 pm
Well, Stephenson Billings has given us some good info on the healthcare in Canada. The results there are exactly what would be expected by anyone with the slightest inkling about the providers and the costs.
But healthcare in America as an issue was pushed more for the votes than for the health of citizens. ObamaCare’s 900 pages was thrown together for those who think government is there to supply everything from birth to death. The naive only think of what they will get, not what it will cost. So they vote for whomever will give them more.. Now the ugly figures of cost rise up like ghosts in the graveyard and they won’t go away.
The rude, the ugly and the uninformed are the first to demand what they see as their share. Unfortunately, it spreads over this blog like a London fog, a blight that touches everything they post. It is a liberal exhibition of nihilism in hopes of ruining anything conservative.
I only wish the best for Kyle. He stay honorable above it all and that we can appreciate..
Dusty
February 28th, 2013
9:32 pm
Shhh BRUNO
Don’t mention that federal money and state money come from the taxpayers pockets!!!
Everybody knows it comes from the money tree!!.
Bruno
February 28th, 2013
9:32 pm
The rude, the ugly and the uninformed are the first to demand what they see as their share. Unfortunately, it spreads over this blog like a London fog, a blight that touches everything they post. It is a liberal exhibition of nihilism in hopes of ruining anything conservative.
Dusty–I think the reality is that liberals start from a very different set of assumptions about people and life than conservatives do. One common assumption liberals seem to make is that people are basically incompetent and incapable of self-control, such that we shouldn’t hold them responsible for any bad habits they may pick up along the way. JDW advanced a theory along those lines earlier today when he attempted to shift responsibility for good health choices from the individual to our health care system. We’re just not offering enough “free” services, and doctors just aren’t hounding their patients enough. As one who has worked in health care for nearly 27 years, I can assure JDW that doctor input has minimal impact on patient’s choices.
Lil' Barry Bailout - OBAMAPHONE!!!
February 28th, 2013
9:34 pm
Health care is just another example of something ruined by a bunch of parasites looking for someone else to pay their bills for them. Higher education is another prime example.
Pay your bills, losers.