Friday, April 20, 2018

Not expanding Medicaid biting South Dakota in the ass


The Dakota Progressive likes the idea of rolling the funding for Obamacare, TRICARE, Medicare, the Indian Health Service and the Veterans Administration together then offering Medicaid for all by increasing the estate tax, raising taxes on tobacco and adopting a carbon tax. Reproductive freedoms should be included with conditions just like the military does under TRICARE.
The ongoing payment dispute between the State of South Dakota and the Indian Health Service is not close to resolution. The state has been trying to recover Medicaid dollars spent on IHS eligible patients in non – IHS facilities. Governor Dennis Daugaard says they continue to talk to federal officials about those payments. Daugaard says the tab for the state continues to increase. Daugaard says they tried to get a bill through Congress to make those changes. Daugaard says he is not optimistic of changes anytime soon. [WNAX]
Sanford, Avera and Rapid City Regional enjoy virtual medical industry monopolies in their markets making South Dakota the best state to practice medicine.

During a bipartisan hearing of the Senate Homeland Security and Governmental Affairs Committee Senator Jon Tester (D-MT) said Congress should take a “solid look” at a single-payer health care system. Tester, who has been listening to various options including some intense lobbying from this blog, asked the panel of experts how to finance the health care system while controlling the costs.
Because of the way hospital networks and private insurers independently negotiate prices with each other in most of the country, rural hospitals are often de facto monopolies with massive leverage. As a result, only insurers that are also effectively monopolies can hope to negotiate for decent prices to drive out competition. Even increasing insurer competition in these concentrated hospital markets could actually make the cost problem worse. [The ACA is Failing Because It Didn’t Account For Hospital Monopolies in Rural Areas]
Recall former Montana Sen. Max Baucus threw President Barack Obama's pick for Health and Human Services Secretary, former Senate Majority Leader and fellow Democrat Tom Daschle, under the bus during a pre-confirmation quarrel in 2009.

Daschle was widely expected to push Congress toward a universal health care plan in the weeks before Big Pharma-backed Baucus soundly rejected single-payer medical insurance and guided the passing of what would become the Patient Protection and Affordable Care Act.

Obama later admitted he "screwed up" by pushing Timothy Geithner's confirmation as Treasury Secretary first in a effort to reverse the economic catastrophe left by the previous administration. Daschle withdrew after Obama put off his confirmation hearing and after Baucus stabbed Daschle, the American people and the new president in the back.

In 2013 Obama appointed Baucus, a Democrat who had been a royal pain in the ass, Ambassador to China. Baucus has publicly reversed course and now supports a single payer system.

So, Denny: if these hospitals are monopolies like utilities are, or even oligopolies in their markets, why isn't there a public commission to regulate pricing?

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