It’s now a law in Missouri that, if you’re on Medicaid, and you miss your doctor’s appointment without notifying the doctor 24 hours in advance, you can be charged a fine. The charge for the first missed appointment is $5, the second is $10 and the third is $20. Way to go, state legislature: You’ve just added a new poverty crime to the books.

The new law also allows providers in Missouri Health Net [Missouri’s name for Medicaid] to refuse to schedule new appointments until the missed appointment fee is paid.

Those fees may not sound like a lot to someone earning a middle-income paycheck or above, but they count. They’re a way of nickel-and-diming people who can afford it least. And they can be a barrier to healthcare for people who are financially disadvantaged.

Fortunately, the fee is unlikely to win approval from the federal government.

“They’ve consistently told states they cannot impose a missed appointment fee. I’m not sure that will ever be approved,” said St. Louis University School of Law Professor Sidney Watson of the Center for Health Law Studies.

But in Missouri, passing a law that is unconstitutional, or inhumane, or in violation of federal rules typically does not deter the Republican-dominated state legislature. Apparently, in their quest to pander to the worst instincts of their voter base, they like to go on record as being in favor of these extreme measures. Case in point: The Missouri legislature just enacted—over Democratic Governor Jay Nixon’s veto—a law that removes the need for a permit or any training if you want to carry a concealed gun. The law also institutes the “castle doctrine” or “Stand-Your-Ground” principle that allows you to shoot first, and ask questions later, if you feel—in any way—threatened.  That law resulted in national media dubbing Missouri the “Shoot-Me” state.

The new missed-appointment fee is only the latest in the laundry list of poverty crimes that plague low-income people in Missouri, and elsewhere. Around here, you can pile up lots of fees—traffic fines, court costs, appearance costs—then get arrested for non-payment and put behind bars until you bail yourself out for a few hundred dollars. Then you get fired for not showing up to work, and lose your paycheck, which puts you back into the non-payment cycle.

Moral of the story: Don’t be poor in Missouri. But don’t count on your elected officials to help you, either.

The post MO legislature creates a new poverty crime appeared first on Occasional Planet.

The Centers for Medicare and Medicaid Services (CMS) has just released new rules, the first in over a decade, for Medicaid managed programs. These rules “would cap insurer profits, require states to more rigorously supervise the adequacy of plans’ provider networks, encourage states to establish quality rating systems for plans, allow more behavioral healthcare in institutional settings and encourage the growth of managed long-term care.”

Changes also include a new rule that would create a Medical Loss Ratio of 85 percent, similar to regulation imposed on private insurance plans. This requires insurers to spend at least 85 percent of their revenue on medical care—not for administrative costs or profits.

Sounds good, right? Well not exactly!

Under the new rules, Medicaid plans would not be required to rebate the difference if they spend less than 85 percent on patient care. And how many plans currently meet this benchmark? According to the Kaiser Family Foundation, only one in four plans came close to spending 85 percent on actual care.

The new rules would require Medicaid plan provider networks to have time and distance standards. Patients would need to have access to hospitals, primary-care physicians and OB-GYNs. Why should we be concerned? As a Modern HealthCare article states, “The CMS mostly punted the task of overseeing network adequacy to the states, despite their history of lackluster oversight.”

What does this mean for Missouri and for health care advocates? Currently, three managed-care companies provide services to approximately 400,000 Medicaid participants in Missouri. Under the new budget passed by the Missouri legislature, nearly 200,000 additional Medicaid patients will be moved to managed-care plans.

As managed-care plans expand in Missouri, including to our rural communities that already lack sufficient services, it means we need to be vigilant. We need to pressure our Missouri state officials and our legislators to insist that care comes before profits and that quality services are available to patients.

We welcome the new rules, but we must work to see that they are implemented.

The post New rules for Medicaid managed care: What do they mean for Missouri? appeared first on Occasional Planet.

Millions of words have been written about Medicaid, and the failure to expand it, in Missouri. The words have fallen on deaf ears. Maybe we need to buy our legislators hearing aids? Or, maybe instead of words, we need to add lights….cameras….action, as in this two-act morality play about those who have misplaced their morals.

TIME: Spring, 2015

PLACE: Small town in Missouri

ACT I: Our hero is walking down the street carrying a heavy backpack. It is stuffed with money. On the corner he meets a man and woman who are having a bake sale. They are shivering in their threadbare sweaters and look frail and vulnerable.

MAN: “Would you like to buy a cookie? We’re trying to raise money so I can have surgery for my leaky heart valve.”

WOMAN: “We hate to ask for charity; we both work. I’m a home health aide and he’s a stocker at Walmart. We don’t have any health insurance through work and we make too much for Medicaid.”

MAN: “It would be nice to have a doctor so we don’t have to go to the emergency room all the time.”

WOMAN: “How about some pie? This is a new recipe for a pie called ‘humble.’”

Our hero ignores them, although the money is making his backpack very heavy. He goes to another corner, where he sees a man in a Brooks Brothers suit and highly-polished Gucci shoes with a Louis Vuitton briefcase open in front of him.

MAN: “Hey! Would you like to buy some managed care? We have some on sale today! And just for you, we are offering some real deals. Phone apps, to remind our clients of their doctor’s appointments (if they can find a doctor, of course). And exercise videos! And gift cards for celery for our overweight clients! But those phone apps, man! They are a real deal! But first, you may need this:”

The man whips out his checkbook and writes a big check to our hero, who stuffs it in his pocket. He then opens his backpack and dumps the entire contents into the man’s Louis Vuitton briefcase.

INTERMISSION: Audience comments: “We would NEVER do that.” OFFSTAGE VOICE: “But you just did. You elected people to your legislature who just voted to deny medical coverage to 300,000 low-income Missourians and throw thousands more onto the altar of managed care, where one company reported a 90 percent increase in profits last year. Do I need to point out that this is taxpayer money?“

ACT II: Managed care guy takes a bill and wipes a speck of dust off his shoes. To an aide, he says, “Get the jet over here quick. I only made $19.3 million last year; I need to get back to work!”

On the other corner, the bake sale man and wife are packing up their home-baked goods and wiping up the crumbs.

The post Medicaid: A two-act morality play for Missouri voters appeared first on Occasional Planet.

The St. Louis Post-Dispatch correctly identifies problems with the Missouri Medicaid program (“Medicaid missteps,” May 10). But citing the system as “broken” as a reason to deny Echo Garrett the health insurance she deserves is a red herring.

For three years we have talked with legislators, advocating on behalf of the 180,000 low-income Missourians denied coverage because of their refusal to expand Medicaid. The most common response from the deniers has been, “We can’t expand coverage until we fix the broken system.” When we suggested that the legislator meet with his/her caucus and propose legislation to fix the problems, we were told, “I am not a policy person.” In other words, “It’s not my fault, not my responsibility.”

Our Legislature delayed funding for the computer system that processes applications for coverage with the result of a large backlog in applications. To be “more efficient,” our state social services department closed processing centers where clients could meet with counselors. The result has been that clients wait to get called back from counselors and sometimes give up entirely. Our Legislature has a responsibility, a responsibility to fix the system and at the same time provide insurance for Ms. Garrett and the others who are pushed aside while our legislators delay taking action.

[This post originally appeared as a letter to the editor in the St. Louis Post-Dispatch, on May 12, 2015. It is reprinted with the author’s permission.]

The post No excuses: Expand Medicaid appeared first on Occasional Planet.

At the same time that private-insurance enrollment via healthcare.gov is experiencing technical difficulties, the other side of the Affordable Care Act—the side that makes it possible for more people to qualify for Medicaid—is gaining ground.

Under the Affordable Care Act, states are encouraged—and financially incentivized to the tune of hundreds of millions of dollars—to expand Medicaid eligibility to a wider swath of low-income individuals and families. In the enlightened states [those with Democrats in the Governor’s mansion and/or a Democratic majority in their states’ legislatures] that have not blindly rejected Medicaid expansion, new enrollments in Medicaid are trending up and are expected to grow.

Overall, in 24 states (plus Washington, D.C.) that are going ahead with Medicaid expansion, more than 8.7 million people are expected to be newly enrolled, according to the Centers for Medicare and Medicaid Services. Click here for a chart that shows the status of Medicaid expansion state-by-state.

Think Progress  surveyed news reports from the states that have chosen to expand Medicaid under ACA and found that “the program is responsible for thousands and of new enrollments and appears more successful in enrolling uninsured Americans than private insurers operating in the exchanges.”

CONNECTICUT: Of the 3,847 individuals who signed up for coverage, 1,857 qualified for Medicaid, 1,897 signed up for plans with one of the three private insurance carriers, and 93 qualified for the Children’s Health Insurance Plan. Of the individuals who signed up with private carriers, 772 won’t receive a subsidy and 1,125 will receive a federal subsidy to lower their monthly premium.” [CT News Junkie]

MARYLAND: “About 82,500 people had signed up for Maryland’s expanded Medicaid program as of Friday, more than 30 times the 2,300 Marylander’s who managed to enroll through the state’s insurance exchange.” [Politico]

OREGON: “Though Oregon’s health insurance exchange is not yet up and running, the number of uninsured is already dropping thanks to new fast-track enrollment for the Oregon Health Plan. The low-income, Medicaid-funded program has already signed up 56,000 new people, cutting the state’s number of uninsured by 10 percent, according to Oregon Health Authority officials.” [The Oregonian]

ILLINOIS: “The sign-up process apparently hasn’t been as difficult for Illinoisans poor enough to qualify for the health-care law’s federally funded expansion of Medicaid eligibility, which the General Assembly approved this year without a single Republican vote. Those applicants are routed to the state’s ABE website for Medicaid.” [The State-Journal Registrar]

WEST VIRGINIA: “More than 50,000 West Virginians have already enrolled in the state’s Medicaid program that was expanded under the Affordable Care Act….But most new Medicaid signups came through an auto-enrollment program DHHR began in the weeks leading up to the opening of the insurance marketplace.” [Charleston Daily Mail]

ARKANSAS: “After two weeks of enrollment, a total of 56,288 adults have told the Arkansas Department of Human Services (DHS) they want to enroll in the “private option” health insurance program, [the state’s Medicaid expansion] according to data released Tuesday. From Oct. 1 through Oct. 12, DHS received 1,509 applications through its state-run web portal and 1,119 telephone and paper applications. That is in addition to the 53,660* current DHS clients who have already been determined eligible and returned letters saying they wanted coverage.” [Arkansas Department of Human Services]

That’s good news in those states where the interests of all people are priorities. But it’s bad news for the hundreds of thousands of low-income people who are—once again—being left behind, in the 26 states where hating Obama and stopping his programs at any cost is more important than helping citizens gain access to the basic health services that they deserve. Because their states have rejected Medicaid expansion, an estimated 8 million people are expected to remain outside of the expanded healthcare coverage envisioned by the ACA.

Under the terms of the ACA, Medicaid coverage was intended to be expanded to all adults with incomes up to 138 percent above the federal poverty line (which amounts to $15,856 for an individual), money that would be covered by the federal government at 100 percent of cost until 2016, and at 90 percent thereafter.

However, under a U.S. Supreme Court ruling on the ACA in June 2012, the federal government was barred from mandating states to enact Medicaid expansions. As a result, an insurance coverage gap currently exists where millions of people making less than $11,500 per year ($23,500 for a family of four) will have too much income to qualify for Medicaid but not enough to receive federal subsidies when purchasing insurance on a state-run health exchange.

That is a sad commentary on the state of Republican state governance in America. We can only hope that the legislators who rejected Medicaid expansion will see the light–or the color of the federal money that they are turning down because it’s “tainted” by the President’s agenda–and get on board–or get voted out of power by the people they are screwing.

The post ACA [Obamacare]: Doing well–and doing good–in states that expanded Medicaid appeared first on Occasional Planet.

We repeatedly hear that this state or that state is cutting back on Medicaid eligibility and benefits. For most progressives, it’s insulting. For anyone who is poor it’s like a dagger in the heart.

Medicaid was created by the Social Security Amendments of 1965, which added Title XIX to the Social Security Act. Medicaid was created as an entitlement program to help states provide medical coverage for low-income families and other categorically related individuals who meet eligibility requirements. Candidates include the blind, aged, disabled and pregnant women. In essence, Medicaid serves as the nation’s primary source of health insurance coverage for low-income populations. Each state administers its own Medicaid program, establishes their own eligibility standards, determines the scope and types of services they will cover, and sets the rate of payment. Benefits vary from state to state, and because someone qualifies for Medicaid in one state, it does not mean they will qualify in another.^[6] The federal Centers for Medicare and Medicaid Services (CMS) monitors the state-run programs and establishes requirements for service delivery, quality, funding, and eligibility standards.

It’s key to remember that Medicaid was authorized by Congress at President Lyndon Johnson’s request in 1965. It was that same year that he energetically moved forward with his Great Society programs. These programs expanded the federal government’s role relating to a number of domestic issues. The Civil Rights Act of 1964 gave the federal government an expanded role in regulations regarding interstate commerce. A key component  dealt with public accommodations, banning racial discrimination in restaurants, hotels, and a host of other venues where people congregate. The Great Society also brought us new cabinet offices, including the Department of Education, Department of Transportation, and the Department of Housing and Urban Development. The War on Poverty brought the creation of the Office of Economic Opportunity. It coordinated grassroots efforts to address poverty, including extending empowerment to the people who lived in impoverished areas. And let us not forget that Medicare was established in 1965 at the height of the Great Society.

The Great Society, including the establishment of Medicare, moved power from the states to the federal government. All of this lead to the states squawking over being left out of the areas of social change. Indeed ,the balance of power in our system of federalism was shifting dramatically toward the federal government.

The political viability of many members of Congress depended on support from those at home in their state governments. Many members of Congress previously served in state legislatures. Our elected officials in Washington were hearing loud and clear from those serving at the state level that they wanted a piece of this Great Society action.

Congress and President Johnson responded. They established a series of block grants, in which federal monies were transferred directly to the state governments for administration. While there are currently over 700 types of block grants from the federal government to the states, none is as important as the administration of Medicaid. The states wanted increased involvement in health care and the federal government responded in a way in which it did not with Medicare. It sent most of the money for Medicaid to the states and left it up to them to determine eligibility and allocation. Thus we have our current situation in which most states work to weaken Medicaid, even when extra money is provided by the federal government. With health care, as with many other programs, the states prefer to keep taxes low at the expense of providing needed public services for their citizenry.

When money started being transferred from the federal government to the states in large quantities, including with Medicaid, the intent may have been to be fairer to the states and maintain the established and historic balance we had in federalism. However, as domestic needs increased in the last third of the previous century and now into the 21^st Century, we clearly see that states are not up to the job of dealing with basic issues, such as income inequality. The federal government can do this if it wants. A good place to start would be in cutting off the Medicaid block grants to the states and instead running Medicaid itself.

The post Why is Medicaid a state program? appeared first on Occasional Planet.

I went to see the movie The Impossible the other day and have since been thinking about how it relates to our situation here in Missouri.  The film is based on the true story of a family vacationing at a beachfront resort in Thailand in December 2004, when the tsunami sweeps them away from each other and into the maelstrom. The film recreates the struggle of the injured mother Maria, and her 10-year-old son Lucas as they seek medical care and help in a devastated country, not knowing where they are or the language of those around them.   And then there is the father, Henry, searching for his wife and son, leaving the 5- and 7-year-old boys, Simon and Tomas, with strangers as they are moved away from the danger zone.

As the 2013 Missouri legislative session is set to begin, we have had warnings – warnings of a tsunami of bad legislation and of our inability to communicate with our legislators.

Our senators are proposing that we join Kansas in the race to the bottom.  If Kansas can do it, we must do it.   Kansas has a zero tax rate for small businesses.  “What’s our plan?” asks the little girl in an ad running in Kansas City.   Our plan is to mimic Kansas, which now has an $800 million shortfall in its budget next year, and create our very own revenue reduction by halving our corporate tax rate.  I can’t help but see the image of Maria and Lucas being tossed to the ocean floor and struggling to come up for air as I read about this tax plan.  Even as our schools, our bridges and infrastructure crumble in the storm, we want to reduce revenues.

And as we struggle to come out of the muck, let’s make matters even worse by reducing the individual tax rate and increasing the sales tax to make it even more difficult to buy the goods and items we need.

While families struggle to pay for clothes and other goods, our legislators would prevent 260,000 uninsured Missourians from receiving benefits under an expanded Medicaid program as called for in Obamacare. They ignore the studies such as the one from the University of Missouri, showing that 24,000 new jobs would be created. They ignore reports that the savings from other parts of the program, plus the expected new state revenue, would exceed the costs to the state’s general revenue fund.  They ignore the results of a poll conducted by the Missouri Foundation for Health, which finds that 52 percent of Missourians agree that Medicaid should be expanded, and that a majority of us believe the state government bears a responsibility for ensuring access to affordable health care and should act in the legislative session, even if it requires raising taxes. Our communication problems resemble those of Maria and Lucas – our legislators are speaking Thai, while we remain confused and bewildered.

Like the overcrowded, understaffed facilities in The Impossible, our rural clinics and hospitals serve a population away from the busy urban centers.  Our medical facilities are required to give emergency care to all, and our hospitals receive funds to help pay for the care of patients without insurance.   Under Obamacare, it is assumed that there will be fewer uninsured patients due to Medicaid Expansion, and funding for unreimbursed care will be severely reduced. If we do not expand Medicaid, our hospitals, and particularly those in rural areas, will be a risk. and some may have to close their doors.

Jobs created under Medicaid Expansion would include more health care workers – nurses, pharmacists and others. One of the most wrenching scenes in The Impossible is watching Maria being dragged and carried and then cared for by untrained villagers until she could be transported to a rural hospital.  The hospital was, of course, understaffed because of the emergency, and Maria, a physician herself, sent her son searching for antibiotics to prevent infections from her open wounds. I thought later about Maria, wondering what would have happened to her if she was not a wealthy physician, but if she was poor, with a part time job, and living in Missouri. If she was declared disabled because of her wounds, to receive Medicaid without the expansion, she would be unable to go back to work; she would earn too much to qualify.

Several of our legislators have been quoted as saying that expanding Medicaid is the wrong thing to do, that we would be helping able-bodied Missourians at the expense of the rest of us. They maintain the myth that those on Medicaid live on welfare, even though those who would be helped are able-bodied; they are the working poor. Our legislators, like a character in The Impossible who refuses to loan his phone to Henry to call his family in England, seem to have no feeling for those in desperate need.

Our legislators need to learn as Lucas did, Maria’s 10 year old, that empathy and helping others is what makes us truly human.  In the midst of the chaos Lucas rescues a toddler from a tree, carries him to safety and takes pride and pleasure in seeing the boy reunited with his father.  And like Henry, Maria’s husband, after we stop crying we need to struggle against our tsunami and do everything we can to prevent the destruction from the storm and create a prosperous, healthy Missouri where 7 year olds like  Tomas and 5 year old Simon can look forward to a brighter future.

The post Why “The Impossible” makes me think about healthcare appeared first on Occasional Planet.

Dear Governor Nixon: During the debate over the Affordable Care Act (ACA), we learned many things as a country. Chief among them, in my mind, is that a citizenship without medical coverage is a growing problem, both for the health of our people and for our finances. People should never go bankrupt because they or their children get sick or seriously injured, but every day they do. Every day thousands of Missourians go without necessary health care. Some of them lose their livelihoods and, unable to provide for their families, they turn to the state for help.

Health care is widely regarded as a human right in developed nations, Mr. Governor, and every facet of our society reflects that. Our health care professionals take oaths to practice medicine ethically and put the patient first, to aspire to prevention before cure. All of those ideals are acknowledged in the ACA via free preventative care, rescission bans, and coverage for pre-existing conditions, among other things.

We also have laws that require hospitals to provide medical treatment to everyone who needs it, regardless of citizenship or ability to pay. Every single taxpayer chips in to programs like the VA, Medicare, and Medicaid so that the people who need health care the most–but in most cases are least able to afford it–are able to get the care they need. Responsible employers share the cost of employee health care because they know a healthy worker is a productive one. Good health is necessary to a life in the pursuit of happiness, liberty, and the American dream.

The Affordable Care Act is simply an addendum to this societal norm, this very basic right. A right we all recognize and accept, whether we gain from it politically or not, whether we will admit to it publicly or not.

This is why I’m asking you to take the first step in extending Medicaid to cover hard-working Missourians earning up to 133% of the federal poverty line by including it in your budget. Please sign this state on to the Medicaid expansion so that more Missourians in need of something as basic as medical care can live in good health, keep their jobs and their homes, and provide for their families with dignity. Health care is a human right and Missourians are people too.

The post Dear Governor Nixon: Extend Medicaid coverage in Missouri appeared first on Occasional Planet.

What do conservatives mean when they say, “Government should be kept out of health care as much as possible?” as a Missouri State Representative recently stated in an article I just read in my neighborhood newspaper. Does he mean keep government out of my Medicare? Medicare has provided quality services to all of us 65 and older and to those disabled and unable to work.

Does he mean keep government out of Medicaid? Without Medicaid our working poor would have no routine medical care. Without Medicaid many of our nursing homes and care centers would close their doors.

Does he mean keep government from paying for our federally-funded health care centers? Without these centers our low-income neighbors would receive no ongoing care for chronic problems.

Does he mean keep government from helping hospitals by providing funds for uncompensated care?

Does he mean keep government from providing health care for our veterans, those who fought for our country?

Or does he mean he wants no government interference with our private, for-profit insurance companies – companies that until the government “interfered,” denied insurance for pre-existing conditions, denied coverage to women for pregnancy, and have typically spent more than 15 percent of their premiums on salaries and compensation for their executives while increasing premiums without notice?

Or does he mean keep our state government out of the business of requiring a health insurance exchange that would allow small businesses and individuals to compare policies and choose one that meets their needs? With that “solution,” we will now have the federal government plan our insurance exchange.

Who we really need to keep out of health care are legislators who obstruct needed health care reform instead of working and compromising to see that the system works for us all.

The post Why government should be—and is, quite effectively—involved in health care appeared first on Occasional Planet.

If there were any benefits to the sound and fury accompanying the recent controversy about the debt ceiling crisis, one of them was this: it relegated the sturm und drang about the Patient Protection and Affordable Care Act to the back burner. It won’t stay there, though. Almost everyone agrees that we are going to have to grapple with the high cost of health care in our efforts to set this country on a sound fiscal path.

Former Senators Erskine B. Bowles and Alan K. Simpson, two true statesmen who took on the thankless task of co-chairing the National Commission On Fiscal Responsibility and Reform, put it this way: “If we can’t find a way to slow the rapid rise of health care costs, they will drive this country to bankruptcy. We should ask more of health care providers and drug companies through adjustments in payment formulas and increased drug rebates for Medicaid and Medicare, more from beneficiaries through more rational cost-sharing rules that discourage the overutilization of care, and more from lawyers through tort reform.” (New York Times Op-Ed page, Aug. 3, 2011)

If we’re going to ask more from everybody in order to rein in health care costs, I suggest that we start in St. Louis….specifically in Clayton, at the corner of Hanley and Forsyth. This is the headquarters for one of the most successful companies in St. Louis: Centene Corp.

Founded in 1984 as a single health plan, today Centene provides managed care services for Medicaid patients in 14 states. According to a story in the St. Louis Post-Dispatch on Feb. 6, 2011, written by reporter Jim Doyle, company officials say they “specialize in finding health care efficiencies: saving money for the states by lowering medical costs for the poor.”

Centene has been spectacularly successful enriching itself while controlling costs for the poor. In 2010 it reported revenue of $4.4 billion. It recently announced a new contract with the state of Texas that will add between $666 million and $1.1 billion in new revenue, and it won another $1.1 billion contract from the Louisiana Department of Health and Hospitals to serve Medicaid beneficiaries in that state (St. Louis Business Journal, Aug. 2, 2011).

These are taxpayer dollars.

And how has Centene spent those tax dollars accrued by “lowering medical costs for the poor?” By enriching itself, its stockholders, and specifically its CEO, Michael Neidorff. According to St. Louis Post-Dispatch business reporter David Nicklaus, in 2010 Neidorff received a pair of bonuses totaling $2.8 million, which helped boost his pay to $7.9 million for the year. That was 31 percent more than his $6.1 million compensation for 2009.

“The health care firm’s chief executive got a $1.9 million bonus for 2010 performance and an additional $900,000 based on three-year results,” Nicklaus wrote. “His salary rose 10 percent to $1.1 million and he received stock valued at $3.6 million. His perquisites included $154,700 worth of personal use of company planes, plus an unspecified amount of tax-preparation help, financial advisory fees, tickets to entertainment events and security services.”

These are taxpayer dollars.

Based upon the new contracts the company has secured in 2011, Mr. Neidorff and other Centene executives can look forward to hefty bonuses again this year.

These will be taxpayer dollars.

One has to admire the business acumen of the leaders of this company. They have been spectacularly successful in developing products and marketing them to state officials who are trying to control the costs of providing baseline health services for low-income residents. But, if we are going to heed the pleas of Senator Bowles and Senator Simpson and “ask more of health care providers,” perhaps we ought to ask less from Centene. Perhaps they could negotiate a few less lucrative contracts. Perhaps they could pay their executives a little less. Perhaps stockholders, who saw their share price rise 20 percent last year, might be satisfied with a little less. Less for Centene executives and stockholders might mean more services for Medicaid recipients and more savings for U.S. taxpayers.

We’re all concerned about the high cost of health care, and we all worry about the holy trinity of “waste, fraud and abuse” that find their way into the system. But there is another issue that our capitalistic society seems reluctant to face: as long as our country tolerates a for-profit health care system, we are going to have to come to grips with greed.

The post Taxpayer dollars enrich Medicaid cost-cutters appeared first on Occasional Planet.