“We are looking at a model to save hundreds of millions of dollars by steering Medicaid beneficiaries to the most cost effective settings,” Alexander told about 300 health insurance executives last week at a meeting in Washington. “To reward beneficiaries we would give them some incentive… so if the state saves $1,000 on a medical procedure we may give the beneficiary $100 or $200 as a reward.”
"Advocates for the poor", of course, hate the idea:
“People on Medicaid should be able to go to the doctor or medical provider of their choice,” said Michael Froehlich, an attorney with Community Legal Services in Philadelphia. “We are all in favor of better quality health services but if it comes at the expense of restricted access to neighborhood doctors then I think we would want to take a closer look at it.”All very nice, high-minded liberal buffoonery. Why don't these fine, upstanding idiots have any understanding of human nature? Have they never met the poor?
Ok, libs, here's how it works: If you subsidize something, you get more of it. Demand creates supply, and, by offering people a coupla hundred buck to go to a hospital, they're going to do it. $200 is a lot of cash to some people -- me included! -- and they'll be lining up to go to the hospital now.
As Whitecoat points out:
If Pennsylvania begins paying people to go to “better” hospitals, the cab voucher fiasco will occur in Pennsylvania, only on a much grander scale. Once Pennsylvania Medicaid recipients learn that they will be paid to go to a certain hospital for medical care, those hospitals will be deluged with patients. To those receiving public medical assistance, the medical care is free, the medical testing is free, and the medical procedures are free. Now, with a monetary incentive to have a procedure done at a given facility, what do you expect will happen? Patients get $200 if they get a cardiac catheterization at one hospital versus another? Twelve year olds will go to those emergency departments complaining of crushing chest pain. Patients get $50 if they go to one emergency department that provides “higher quality”? There will be lines out the door.