Hal Scherz

All across the country, state governors are under tremendous pressure to accept federal funds for expansion of their state Medicaid programs. Most of this originates in Washington and the Obama administration, but much is local and comes from special interests such as hospitals, which stand to profit from an expected increase in business with more patients covered under this healthcare plan.

Twenty one states have decided (for now) not to expand their Medicaid programs. Four are still debating this issue. 25 states will accept the money and expand their Medicaid programs. The latest state to succumb was Michigan, where centrist Republican Governor Rick Snyder has pushed hard to get this pot of money. He, like many of the GOP Governors who initially decided not to participate in this expansion, but later flip flopped, believed that they could not afford to let this money dangled before them slip through their fingers unclaimed. This short term gain where the federal government picks up the tab for the expansion through 2017, will turn into long term pain for the states when Washington pays for 90% of the expansion, and the states are on the hook for the balance. Governors need to look at the “long game” and resist the urge to grab the cash.

The Medicaid expansion is a Trojan horse, to get more people covered by a Federal health program. This is a necessary step in order to achieve the ultimate goal as stated by President Obama, Sen. Harry Reid, Minority Leader Nancy Pelosi, and others, which would be the creation of a single payer, government controlled healthcare system.

Unfortunately, achieving this goal will be at the expense of the patients that these individuals claim to be trying to help. Medicaid, as it currently exists, is a failed system. Each day, an increasing number of physicians are refusing to see these patients. All that the Medicaid card does is to give an increasing number of patients, an opportunity to wait on an ever increasing line to receive care. A number of studies have reported that Medicaid patients have worse health care outcomes and higher death rates than patients who have no health insurance coverage at all.

As businesses decide that the only way to survive the financial pressures on them caused by Obamacare is to lay off workers, or to cut their hours and make them part time employees, the Medicaid rolls will swell as these people lose their insurance coverage.

Hal Scherz

Dr. Hal Scherz is the Chief of Urology at Scottish Rite Children's Hospital in Atlanta and Secretary of the Docs 4 Patient Care Foundation.