Wisconsin’s Government Health Care System Running Short

This provides a look at what a government-run system looks like. 

The state may be forced to cut more than $1 billion over the next 18 months from BadgerCare Plus and other health care programs for the disabled, elderly and low-income families.

The shortfall comes at a time when more people are turning to BadgerCare Plus because of the state’s battered economy. About 700,000 people were enrolled in BadgerCare Plus alone on Nov. 30, an increase of more than 70,000 since the start of the year. At the same time, state tax revenues have plummeted because of the economic downturn.

Bear in mind that the increase in enrollment was intentional.  Doyle and the Democrats opened up BadgerCare to people who didn’t previously qualify.  Many of those people have access to other plans, but BadgerCare is cheaper for them. 

So here’s a couple of the things they are looking at doing to “fix” the shortfall.

• Booking $195.4 million in savings - more than a third of the overall savings - through several one-time accounting changes, including delaying payments until just after the new state budget begins in mid-2011, according to the fiscal bureau.

In other words… accounting gimmicks and pushing off the expenditures to the future.  Who is owed those payments?  Doesn’t matter.  They have just been forced to extend a line of credit to the government.

• Increasing the use of generic drugs, potentially saving $71.3 million.

I have no problem with generic drugs, but shouldn’t that be a decision for the patient and his or her doctor?  Not in this case.  The word is coming from on high to use more generic drugs. 

• Pegging the price paid to pharmacies for generic drugs closer to their wholesale costs, potentially saving $50.9 million.

Screwing the pharmacists by looking for cost savings in their net income. 

• Reducing the amount allocated for administrative costs for managed care companies outside of southeastern Wisconsin, potentially saving $32.5 million.

Again, those administrative costs don’t go away.  The government just won’t pay for them.  Who pays?  The rest of us who aren’t in the government system. 

• Cutting reimbursements to certain rural hospitals by 10%, potentially saving $15 million.

This is huge.  As the story states, rural hospitals are actually reimbursed 100% of their costs - unlike most health care providers.  By cutting 10%, their costs won’t be covered.  Two things will happen.  The hospitals will try to shift those costs to people who aren’t in BadgerCare and they will have to cut back staff and/or services.  So much for a government system helping people get access to healthcare. 

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The only reason these government systems are halfway viable is because they are able to shift much of their cost to those of us who are not in the system.  When they don’t pay for the entire cost of a service, the health care provider shifts those costs to the rest of us.  What happens when there isn’t a “rest of us?” 

1. I honestly don’t think they care. They obviously are ignoring all those who are trying to tell them it’s too expensive and not sustainable, but they don’t care.

   Posted by Billiam on December 16, 2009 at 1034 hrs




2. Socialism only works until it runs out of other people’s money.

   Posted by fishaddict on December 16, 2009 at 1053 hrs




3. What happens when their isn’t a “rest of us”? 

   They ration.

   Posted by (JavaScript must be enabled to view this email address) on December 16, 2009 at 1241 hrs




4. The future of ObamaCare on a state scale.

   Posted by (JavaScript must be enabled to view this email address) on December 16, 2009 at 1300 hrs




5. I know better than to wade into something like this. But I do want to point out…

   “I have no problem with generic drugs, but shouldn’t that be a decision for the patient and his or her doctor?  Not in this case.  The word is coming from on high to use more generic drugs.”

   This has happened to me more than once under my current insurance plan. I’ll bet just about everyone reading this has had a prescription changed based on what the insurer will pay for rather than any interaction between a doctor and the patient.

   Posted by (JavaScript must be enabled to view this email address) on December 16, 2009 at 1344 hrs




6. “They ration.”

   We ration today. Lots.

   Posted by (JavaScript must be enabled to view this email address) on December 16, 2009 at 1346 hrs




7. Jim -

   You are correct.  I choose to pay out of pocket for my thyroid meds because I believe they work better than the generic.  My choice, my option.

   Did you know that Medicaid and Badgercare prohibit you from paying cash for uncovered services?

   So while an insurance company (or rather the plan that your employer has with the insurance company) can “ration” certain drugs and such, you still have the option of paying yourself.  With government care they take that away from you.

   Sounds like one helluva deal to me!  Sign me up!!  (sarc)

   Posted by (JavaScript must be enabled to view this email address) on December 16, 2009 at 1443 hrs




8. So while an insurance company (or rather the plan that your employer has with the insurance company) can “ration” certain drugs and such, you still have the option of paying yourself.

   If you can pay for it. But why not let beings die, right mom?

   Posted by (JavaScript must be enabled to view this email address) on December 16, 2009 at 2234 hrs




9. OK, so they’ll only pay them 90% of their “costs” but what are costs anyway?  Are we talking marginal costs or total costs?  Because its not atypical for people to pay vastly different prices for the same service in any market, and the medical services markets is one of the least transparent and least consumer driven that I can think of.  As long as the marginal cost is met and they aren’t forced to take medicaid patients on the occasion that they’re just booked up with other patients then they have nothing to complain about.  And are we assuming that doctors salaries are somehow set in stone?  I mean sure the AMA makes sure there’s a shortage so their salaries stay good and high, but medicaid is a huge program with a fair amount of leverage too.  I don’t have a problem with them using it.  Which brings me to insurance companies - they also have a ton of leverage.  If the hospital trys to shift the “costs” onto the insured patients then the insurance company could tell the hospital to stuff it and drop them from their network.  Bottom line, costs are not fixed - they’re a product of negotiations between labor and suppliers.  Payments aren’t fixed either - they’re a function of the current market for your product and negotiations with insurance companies.  The dollar that one guy manages to get knocked off his bill doesn’t just shift over to another customer’s bill.  Its more complicated than that.

   Posted by (JavaScript must be enabled to view this email address) on December 16, 2009 at 2251 hrs




10. Get a grip Keith…  we were discussing employer-sponsored insurance plans that require generics but how you have the choice to pay for the name brands now.  As opposed to government care which denies the choice of paying for it yourself.

    And death comes from this where?

    Posted by (JavaScript must be enabled to view this email address) on December 17, 2009 at 1958 hrs




11. It’s hard to save $1 billion through nickels and dimes. Wisconsin should cut a percent of the whole thing across the board. Providers are hard to find anyway.

    Posted by mgm on December 18, 2009 at 1230 hrs