Comments on: On that pesky federal Medicaid waiver http://www.pioneerinstitute.org/blog/news/on-that-pesky-federal-medicaid-waiver Public Policy Research Fri, 09 Jan 2009 14:08:14 +0000 http://wordpress.org/?v=2.5.1 By: mischievous blogger http://www.pioneerinstitute.org/blog/news/on-that-pesky-federal-medicaid-waiver#comment-1355 mischievous blogger Thu, 02 Oct 2008 20:05:46 +0000 http://www.pioneerinstitute.org/blog/?p=656#comment-1355 why would mr.keefe reply defensively if, as he's suggesting, there's nothing to defend. transference doesn't make it any less transparent. makes it more so. it is not personal. why would mr.keefe reply defensively if, as he’s suggesting, there’s nothing to defend.
transference doesn’t make it any less transparent. makes it more so.
it is not personal.

]]> By: Jim Stergios http://www.pioneerinstitute.org/blog/news/on-that-pesky-federal-medicaid-waiver#comment-1351 Jim Stergios Wed, 01 Oct 2008 18:52:02 +0000 http://www.pioneerinstitute.org/blog/?p=656#comment-1351 Dennis: Thanks for your comment. No ideology here at all, but you know that and that is why thou protesteth so much. I state clearly in my post that what I have heard is altogether hearsay -- so I may very well be wrong. And I may be very wrong. I always admit this when I do not have a piece of paper or data in front of me that I can rely on. I'll glide over the self-serving suggestion that you have provided all sorts of data to undermine my original argument. I suggested to you an exchange on the issue and you suggested back that you have been having this argument for a long time and that in fact data would not help come to a general agreement on the facts. In regard to your closing: "Ironically, we could actually support your ultimate idea to distribute special payments to all hospitals serving the poor based on the data. We don’t believe, however, it would have the result you envision and would unduly harm some very good health care facilities." Let me say again very clearly -- if the data takes us to the place where BMC and CHA merit more support and the other urban hospitals serving the same poor populations deserve less, as you seem to imply, then I would follow the data. If you are implying that BMC and CHA and all the other urban hospitals deserve money, that is a different argument, and I would suggest that you stop investing in medical technology and start investing in buying some old machinery from the Mint. Dennis: Thanks for your comment. No ideology here at all, but you know that and that is why thou protesteth so much. I state clearly in my post that what I have heard is altogether hearsay — so I may very well be wrong. And I may be very wrong. I always admit this when I do not have a piece of paper or data in front of me that I can rely on.

I’ll glide over the self-serving suggestion that you have provided all sorts of data to undermine my original argument. I suggested to you an exchange on the issue and you suggested back that you have been having this argument for a long time and that in fact data would not help come to a general agreement on the facts.

In regard to your closing: “Ironically, we could actually support your ultimate idea to distribute special payments to all hospitals serving the poor based on the data. We don’t believe, however, it would have the result you envision and would unduly harm some very good health care facilities.” Let me say again very clearly — if the data takes us to the place where BMC and CHA merit more support and the other urban hospitals serving the same poor populations deserve less, as you seem to imply, then I would follow the data.

If you are implying that BMC and CHA and all the other urban hospitals deserve money, that is a different argument, and I would suggest that you stop investing in medical technology and start investing in buying some old machinery from the Mint.

]]> By: Dennis D. Keefe http://www.pioneerinstitute.org/blog/news/on-that-pesky-federal-medicaid-waiver#comment-1349 Dennis D. Keefe Wed, 01 Oct 2008 17:11:56 +0000 http://www.pioneerinstitute.org/blog/?p=656#comment-1349 Jim, in the words of Ronald Reagan “there you go again.” We have previously pointed out the errors in your analysis and how several Massachusetts safety net health care systems stand apart from the rest of the hospital sector for their role in caring for low-income and uninsured government health care dependent populations. Now we are confronted with the limited value of hearsay and the fact you don’t want to be held accountable for the things you publish here. That speaks volumes about the lack of substance broadcast recently by you and the Pioneer Institute. It is a troubling trend and is more suggestive of ideological banter than of the standards expected from a public policy institute. You are simply wrong on the facts about payments for Cambridge Health Alliance and Boston Medical Center and you impugn Secretary Bigby’s integrity and credibility. We are unaware of any new agreement on our future funding levels and the figures reported are not accurate (nor adequate for that matter) – according to the sources directly involved in the state-federal negotiations and whose information has been entirely consistent throughout this process. A few facts are worth repeating. Based on the last available full year of data (2007), Cambridge Health Alliance provided 34 times the health care to the uninsured compared to the community hospital average (based on Uncompensated Care Pool costs) and 14 times the health care to Medicaid/Commonwealth Care patients compared to the community hospital average. Cambridge Health Alliance provided nearly one-third of the inpatient mental health care in the state to the uninsured or 23 times the average hospital in Massachusetts. These are but a few of the reasons that CHA stands apart and has required additional financial support to maintain a large volume of essential but poorly reimbursed health care services like the growing demands for primary care and mental health care under health care reform. Ironically, we could actually support your ultimate idea to distribute special payments to all hospitals serving the poor based on the data. We don’t believe, however, it would have the result you envision and would unduly harm some very good health care facilities. Jim, in the words of Ronald Reagan “there you go again.”
We have previously pointed out the errors in your analysis and how several Massachusetts safety net health care systems stand apart from the rest of the hospital sector for their role in caring for low-income and uninsured government health care dependent populations.
Now we are confronted with the limited value of hearsay and the fact you don’t want to be held accountable for the things you publish here. That speaks volumes about the lack of substance broadcast recently by you and the Pioneer Institute. It is a troubling trend and is more suggestive of ideological banter than of the standards expected from a public policy institute.
You are simply wrong on the facts about payments for Cambridge Health Alliance and Boston Medical Center and you impugn Secretary Bigby’s integrity and credibility. We are unaware of any new agreement on our future funding levels and the figures reported are not accurate (nor adequate for that matter) – according to the sources directly involved in the state-federal negotiations and whose information has been entirely consistent throughout this process.
A few facts are worth repeating. Based on the last available full year of data (2007), Cambridge Health Alliance provided 34 times the health care to the uninsured compared to the community hospital average (based on Uncompensated Care Pool costs) and 14 times the health care to Medicaid/Commonwealth Care patients compared to the community hospital average. Cambridge Health Alliance provided nearly one-third of the inpatient mental health care in the state to the uninsured or 23 times the average hospital in Massachusetts. These are but a few of the reasons that CHA stands apart and has required additional financial support to maintain a large volume of essential but poorly reimbursed health care services like the growing demands for primary care and mental health care under health care reform.
Ironically, we could actually support your ultimate idea to distribute special payments to all hospitals serving the poor based on the data. We don’t believe, however, it would have the result you envision and would unduly harm some very good health care facilities.

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