Wednesday, October 23, 2013

How Can Obama Run A Country Like Ours?

So today we have this report from Dick Durbin, via The Hill.

A top Senate Democrat said that a leading House Republican told President Obama that they could not 'even stand to look at you' during negotiations over the government shutdown.

And a Kos diarist explains what happens when the Republicans in charge of particular states and localities decide to stab their constitutents and the ACA in the back:

My wife is an obstetrician/gynecologist working in North Carolina so I know the difficulties of delivering health care to pregnant women here. When the great recession hit, the state cut and delayed Medicaid payments, causing financial problems. She closed her practice and found a job in a larger town. Doctors and hospitals delivering care to lower middle class and working class women have been hit hard by the recession, just like their patients. That's why infant mortality is rising. Rural and community hospitals in North Carolina are struggling to survive. Big city hospital systems bring in high revenues from insured patients for specialized procedures. Urban hospital centers put the profits back into improving their facilities and investing in new equipment. Rural and community hospitals are struggling to replace obsolete equipment at present revenue levels. I interviewed the CEO of Onslow Memorial Hospital, Ed Piper, about the need for Medicaid expansion to learn the details.
Ed explained to me that hospitals made a deal with the federal government to accept an end to federal payments for unreimbursed care because the Affordable Care Act would expand Medicaid coverage for the working poor and provide subsidized insurance coverage for lower middle class Americans who weren't covered by employer provided insurance plans. His hospital's revenues are now running barely above costs, a 3.5% margin, barely enough to replace failing old equipment. But, because McCrory is rejecting Medicaid expansion, his hospital will be in trouble next year when the federal reimbursements for unreimbursed care cease. Onslow county has one of the best infant mortality rates in rural eastern North Carolina. Smaller hospitals in poor counties with out military bases will be in deep trouble. And these counties already have third-world-level infant mortality rates as high as 20 deaths per 1000 births.

1 comment:

  1. There was a story on NPR about the states that are rejecting medicaid expansion (thanks SC!) and how there will be X number of people who neither qualify for medicaid nor the exchanges. It was actually being painted as an unintended consequence of ACA. At no point did the report mention that the states rejecting the medicaid expansion are doing so for purely spiteful reasons. We can only hope that voters in those states will exert enough pressure to help egg along their recalcitrant "leaders".