The Illusion of Medicaid Expansion - Wyoming lawmakers consider a new health care advisory

by Wyoming Liberty Group

Call it an illusion.

It sounds good, in principle: More healthcare coverage for those who can't afford it. Who wouldn't want that? But as the old saying goes, nothing's really free. That includes Medicaid, the government program aimed at providing health insurance for children and adults with limited resources. For years, powerful interests have made multiple attempts to ram through an expansion of Medicaid in Wyoming—and no doubt, they will try again. But who's going to pay for it? And would it actually do any good—or make things worse?

Keep in mind: A lot of things sound good on paper. And the latest thing on paper was brought to us by the Joint Health, Labor and Social Services Committee, a state legislative body which recently proposed creating a health care advisory group called the Wyoming Healthcare Authority.

That's a lot of wonky words. A committee. An advisory group. How about this: Another illusion?

Well, let's take a closer look.

The idea of this Healthcare Authority, according to those who are pitching it, is to advise and keep an eye on what's going on in healthcare and make recommendations to our lawmakers.

"The mission of this group is to engage in collaborative decision-making for improved health outcomes and economic diversification," said the governor's policy advisor on health and human services.

Collaborative. Outcomes. Diversification. Fine. But what about the fine print?

This advisory group would fall under Gov. Gordon, who apparently would appoint many of its members, which would include doctors, state health officials, lawmakers, citizens and others. Some of the group's recommendations wouldn't need our lawmakers' blessings; rather, the governor would simply have the authority to make it happen. There, of course, would have to be a budget for this advisory body, though how much money isn't clear.

A new expense for taxpayers would be concern enough. So, too, would the idea of another bout of bureaucracy, especially in the field of healthcare, which is rife with administrative mumbo jumbo. But the other concern, which was raised by lawmakers at the recent committee meeting, was that this new advisory body could push the healthcare industry's agenda, potentially another sly attempt to try to expand Medicaid in the Cowboy state.

What, by the way, is the concern with expanding Medicaid? After all, let's be utterly clear: We all want improved healthcare access for all patients. But the problem is, Medicaid doesn't cover the full cost of the care. That is an especially glaring problem for Wyoming hospitals and other healthcare providers who simply couldn't afford to pay for the part not covered by Medicaid. Costs have not surprisingly risen for healthcare providers, whether it's renting office space, hiring staff, or paying for malpractice insurance.

In brief, promising to expand Medicaid but not covering that cost is not a promise.

It's an illusion.

And the fallout is, hospitals and other healthcare providers go under.

Medicaid expansion doesn't even begin to tell the scope of the overall problem. Physicians, grappling with the massive bureaucracy of powerful insurance companies, are increasingly spending more time filling out paperwork than treating patients. One study, for instance, indicated that doctors spend over 3o minutes on electronic health records for each patient. The result? Many physicians are experiencing burnout at such high rates that many are retiring and getting out of the business; this is projected to create a significant doctor shortage by 2034.

The bureaucracy is such a huge problem that it's now the bureaucracy—and not your doctor—who often determines your worth when it comes to treatment options. This can mean life or death as you wait in line for care.

Meanwhile, more patients with more medical needs is a problem putting a greater strain on the healthcare system; six out of 10 people have a chronic disease. The average wait time to see a doctor keeps rising. Add to that the aging of our population. About 17 percent of the population is over 65 years old; by 2040, that number is projected to exceed 20 percent.

How is the creation of an advisory body in Wyoming going to fix all of what ails the healthcare industry?

It's a critical question that needs to be addressed if—or when—a bill is floated to create this Wyoming Healthcare Authority, perhaps as early as this month. Let's also be sure not to be bamboozled by big words signifying nothing more than more bureaucracy.