Issue 435 Medicaid should be used differently. October 8, 2014

So Medicaid in each part of the United States acts like an insurance to cover the costs of the poorer masses health care needs.  Issue is that it is becoming more and more expensive to cover such costs on such a large scale.  So what do we do about it?

The Idea:  Yes this is one of mine.  I freely admit it, but I doubt I thought of this idea first.  The concept is simple, turn Medicaid into a kind of health savings account.  Basically it will act the same way as food stamps does, but for medicine and doctors’ visits.  So if you have a prescription, the card would be used to pay for the cost rather than having to worry about changing numbers on your insurance cards each year due to new numbers.  It can also be used to cover doctor visits as well.  However, it can work like an insurance to specify a co-pay.  To do this it would cover the medicine or doctor’s office cost up a specified amount based on how much income you earn yearly.  So it insures that a $3,000 medicine would be covered, but would make you pay the final dollar if you can afford it.  A doctor’s visit which without insurance would cost around $120 or more would be paid by simply sliding the card through in the same way a food stamps card covers fruits and veggies.  It becomes simple and easy to use.

Why do it this way:  Well, as a person who works in a pharmacy, billing insurance even electronically can be a hassle.  There are glitches in the system which cause the cards to not go through, each State may have their own cards for their own version of Medicaid, and each year these numbers can change causing what is known to people in the pharmacy as hell month (January) where all the insurance cards get new numbers and we have the unfortunate pain of updating any number of our 1,600 patients insurance information.  But this is more complicated by Medicaid.  As not only do we have the numbers changing, but certain drugs and certain brands like Pfizer or Mylan will be covered while others will not.  This can cause a higher copay than necessary or cause a lifesaving medicine to not be covered at all (thanks lobbyists and government death panels, you really kill people).  But by switching to a savings card format, you eliminate this issue with respect to Medicaid.  Literally it simplifies the system to the point that the patient and the pharmacy staff do not have to worry about insurance rejections anymore.  And guess what, if you already have insurance or Medicare, but still need Medicaid, the copays can and should be covered by this savings account.  

How it works:  So every month the State would deposit money into the account to cover the cost of the medications you buy with a little extra just in case.  If the copays are higher than normal that month due to you trying a new medication, or your Medicare is not covering as much, the overdraft component will trigger.  This will add a little extra money next month to cover the cost next time while the difference will still be given to the pharmacy or doctor's office you are paying to insure they are not jipped on payment.  Of course certain doctors’ offices will be part of the plan due to costs being cheaper while being equally as effective as someone else.  So a list will be given to each Medicaid patient to say who is and is not preferred or else they will suffer a larger copayment or even have their money reduced in their account as a way to heard them toward the cheaper option.

Conclusion:  Well I like my own idea obviously.  It avoids the issues of insurances being down or rejecting certain medications.  There will be one less middle man to deal with in respect to companies having to fill out paperwork to get reimbursement money from the Medicaid program.  So this saves costs as well on both the company and State level.  Also, Medicaid recipients can see the real cost of their drugs in relation to their accounts and they can be allowed to take initiatives to look for cheaper alternatives as well to preserve extra money in their health care accounts.  We can make it cheap and effective to the point that more doctors may even start accepting more Medicaid patients again (the reimbursement process was a hassle and some doctors were losing major amounts of money taking these patients in which forced them to stop taking them on as patients).  As such, if my idea has merit, then please if you have power, push it through.  If not, then well at least I contributed to the overall conversation.