Can New Jersey Hospitals Really Take on More Cuts?

In an article on FierceHealthcare.com they talk about how New Jersey seeking a waiver for huge cuts in their Medicaid rolls.  By doing this, the article points out that this would cause hospitals to pick up more charity cases.  If  a parent working half-time for minimum wage would not even qualify, this means that the hospitals will be footing the $300 million they are looking to cut from Medicaid.  An article from NJ.com, reported that New Jersey's hospitals profit margins were 0.2 in 2008.  They saw a slight increase in 2009 to 1.7 but in order to do this, "half the hospitals had to eliminate jobs, one-third put off giving raises, and one-quarter cut back on programs and services for patients."
Now with the state trying to fix their budget, the cost are being shifted back to the hospitals that are already trying to keep their heads above water.

How do we reduce cost in Medicaid without hurting the hospitals that are serving patients?  New Jersey is not the only state looking at dropping Medicaid patients either. This means that our state or your state may be next.
The out of control spending can not be fixed by making cuts, the healthcare system as a whole has to be reevaluated.  We have to look at why the cost are so high.  To get a better picture we need to be asking hospitals and physicians their opinions because they are the people on the front lines.  I am sure if you ask any hospital, they can tell you where the cost are coming from.
A few years ago I was talking to someone that worked in the billing department of the hospital I was working at and she said that they see a lot of people coming into the ER for things like diaper rash or a cough.  "Why would anyone go to the ER for diaper rash?" I said. "Because they can't afford to pick up medicine at the local drug store and they know if they go into the ER they will at least get medication to help them get by".

Okay so that is just one piece of the puzzle, but it sure would be a lot cheaper if we had clinics open 24 hours a day that were staffed by NP's to see patients with minor problems.  The states could put in their own clinics and could save money on reimbursement because they are paying for the clinic.

Another problem with Medicaid is the patients do not know the impact of the cost when they choose to go to the ER for things like a diaper rash.  If they had a healthcare spending account with so much money in it, they would be more cautious about how they spend their healthcare benefits.  Of course you would need to have a plan for those that fall into a certain criteria that protect patients that need treatment for cancer or have a major accident....but for the regular everyday medical issues that patients are going to their physicians or hospitals for, put a limit on them!

My mom falls into this category of low income and has a multitude of health issues.  I know the burden it has put onto not only her but my family as well.  She only brings home $600 a month and has been denied Medicaid more times than I can count.  The point is, we have found other ways to help get her medication cheaper, find ways to save money with healthcare providers by "shopping" around, and are more aware of the impact the cost has on our pocketbooks.  Although we have been cautious to try to save money with her healthcare, there have been things out of our control, like when she had chest pain.  The hospital had to write off the cost of her bill because she did not have healthcare insurance.  So because Medicaid would not insure her, the thousands of dollars it cost for her to have care fell back onto the hospital.

I know the other argument is....if she were on Medicaid it would be the tax payers picking up the cost.  What some people don't understand is that we pick up the cost anyway.  When people do not have insurance, the hospital takes on the cost, then the hospital raises their rates, the private insurers then pick up the cost, then they raise their rates to those of us who do pay for health insurance and ultimately we pick up the cost in the end anyway because our premiums go up.

Really in the end, cutting Medicaid will not only hurt the hospitals but it will hurt the tax payers as well.  People with no health insurance going to the hospitals and the hospital footing the bill for care causes a chain reaction back to all of us and increases our health insurance rates.  Cutting care is not the answer.  It is an easy solution to a big problem.  I guess people who are not affected will not care until they are able to see the big picture and realize it IS and will affect all of us.
--The Catalyst