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Caller's Day Made by Telling Host Something He Didn't Know About MedicaidMarch 04, 2013
RUSH: This is Barney in Tucson. Barney, I'm glad you waited, sir. Great to have you on the program. Hi.
CALLER: Rush, there's another hidden reason why the problem with nobody having any money is gonna get much worse under this Medicaid expansion. There's an additional Trojan horse in this legislation where the government will seize as much of the estates of Medicaid recipients when they die as it takes to reimburse the government for the services it provided. And nothing's gonna be off-limits, including homes which have been in families for generations. It's not a brand-new thing. It goes back to the Omnibus Budget Reconciliation Act of 1993, and it's called estate recovery and it mandates --
RUSH: Under what auspices can they seize a home? Under what auspices can they seize a home from somebody's estate?
CALLER: They already have the provision set up, but states have not pursued it aggressively. There is an accounting procedure there where they track what benefits have gone to recipients, and a spouse is living in the house, there are provisions for them, but if it's the only asset, nobody's living there, they will be able to seize it when they die.
RUSH: Okay, hang on. I gotta take a break here. I want to explore this further with you, and I don't have time to do it right now. So be patient.
RUSH: I did some quick searching here during the break; I may have a little bit on this. I want to go back here to Barney in Tucson, Arizona. You say this goes back to budget reconciliation 1993, did you say?
CALLER: Yes. That was when the original provision was put in, but it stands to be greatly expanded under Obamacare --
RUSH: Right. So --
CALLER: -- because there's a multiplier for, you know, the federal poverty level, which is going to get a great deal more individuals enrolled in Medicaid's program, but with the federal government essentially being able to do a reverse block grant of Medicaid funding, it can force the states to exhaust a state recovery before reimbursing the states for their Medicare cost. It's just another Trojan horse in here. But if I may, Rush, there is an elegant solution for all of this that we've been pushing in Arizona.
RUSH: Elegant solution?
CALLER: It's a beauty. It consists of volunteer doctors treating Medicaid patients at no cost to the state in exchange for complete med-mal coverage under the state's existing policy, which it has -- all states have them for university hospitals and clinics. And there's been a model clinic in operation in New Jersey for over a decade that has taken the cost of a Medicare encounter down from 150 bucks a pop to $15.
CALLER: And -- you bet.
RUSH: That is elegant.
CALLER: It's a beauty. Trade doctors, it's been figured that it --
RUSH: Okay. I want to go back to the government, to a state being able to seize your house --
RUSH: -- when you die to satisfy Medicare expenses. Now, I did some research here. Didn't have much time. It was only a three and a half minute break here at the bottom of the hour. I found a Christian Science Monitor story from 2006, and the headline: "A Flap Over Recouping Costs of Medicaid". Folks, I have to tell you, I'm ashamed to admit that I didn't know this existed. I knew it did for drug dealers.
RUSH: I knew they could seize the assets of any drug dealer any -- boat, yacht, airplane, homes, whatever.
CALLER: Well, Rush, it's a rare privilege to be able to tell you something you don't already know.
RUSH: I can imagine. Probably made your day.
RUSH: But here it is: " States try harder to recover their losses from providing healthcare to the poor -- even seizing homes.... In the face of soaring Medicaid" -- remember, folks, now, this is seven years old now. States try harder, "[i]n the face of soaring Medicaid costs, Tennessee and every other state are required to set up a Medicaid estate-recovery program. Many have been launched only recently, and some -- like Tennessee's -- are becoming more aggressive. Often, they target the home because it's all that's left after beneficiaries have spent their assets to pay for nursing-home care."
Now, from the article: "States base their programs" -- like what you said -- "on a 1993 federal law mandating that they recover what Medicaid spends on a beneficiary's long-term care. Congress approved the law to prevent states from forcing the sale of beneficiaries' homes while they were still living, in case their conditions improve and they can return home".
So the way I'm reading this, somebody's not living there. They're either in a convalescent home, or they die, and if nobody's in the home and the state calculates that it's gone bankrupt or gone -- not bankrupt -- if the states calculated that the amount of money they have spent treating this person has resulted in a net loss, they can try to recoup what they've spent by seizing the person's house.
CALLER: That's exactly right.
RUSH: Well, the death panels are gonna take care of this.
CALLER: Well --
RUSH: They won't be treating these people ad infinitum like --
CALLER: Well that's just means they'll be able to get their homes sooner. A lot of states have not been pursuing this aggressively and they've made provisions for individuals and surviving spouses to be able to keep the homes permanently, but the pressures put on by this legislation is likely to force states to recover costs wherever they can.
RUSH: Yeah. Exactly. And you're right, it's a Bill Clinton law, it's a budget reconciliation, 1993. It's his first year in orifice. And so, in a nutshell, I hate to tell you here, folks, but old Barney's right. States can seize houses for money they say they are still owed for their Medicaid treatment costs after somebody dies.
CALLER: -- about this solution because it's the opposite of greater government involvement. It's where doctors can connect better with patients, treat them directly at no cost to the state, it's --
RUSH: Okay, well, where does the Medicaid patient get the 150 bucks?
CALLER: They don't. The 150 was the prior cost of the Medicaid --
RUSH: Okay, whatever it cost the Medicaid patient, the government's paying that they're no longer paying because the patient's dealing directly with the doctor. Where do they get the money to pay for it?
CALLER: There is no money to pay for it because the doctors are treating these patients under this provision. We have a bill proposed, but it's not getting any traction in Arizona, called the "Arizona Volunteer Physicians Protection Act", and doctors donate four hours a week of their time in exchange for complete med-mal coverage, which can run into the six figures. So it's a great way -- for doctors --
RUSH: Wait a minute. You're talking about -- you're saying "med-mal", you're talking about malpractice. You're saying that states can exchange Medicaid charges for the state covering malpractice coverage?
CALLER: Well, actually the Medicaid charges will disappear because the Medicaid patient will now go to clinics set up by volunteer doctors at no charge, and the doctors are amply compensated for their services --
RUSH: By who? That's what I -- by who?
CALLER: The state will put these doctors under the state's existing medical malpractice coverage, which is very cheap for the state, and they have it in place for their university hospitals and clinics, and the payouts under that are minuscule. The state will -- the problem is, in Arizona, there's huge opposition from health insurance industry lobbyists.
RUSH: Well, of course there is. And of course there would be.
CALLER: But, Rush, this solution could solve Medicaid nationally.
RUSH: Well, Medicaid would become a charity run by the state, then?
RUSH: That's the way your system works.
CALLER: Yep. Everybody wins. Almost everybody.
RUSH: No, everybody doesn't win.
CALLER: Nope. The insurance industry lobbyists lose. The health care administrators --
RUSH: The people that count are losing. (Laughing) The big enemies of this, the insurance companies, governments, they -- the problem here is... Look it. I don't want to be negative. I don't doubt that your program works. Here's the thing. What government, especially an Obama-type guy, what government official can allow for Medicaid to appear to be this inexpensive versus what it is now?
CALLER: Well, the fact is they're showing it in New Jersey, and they've done it for the last 11 years. It's called the Zarephath Clinic --
RUSH: The Arafat Clinic?
CALLER: -- they've been operating it for more than a decade.
RUSH: Arafat Clinic?
CALLER: It's with a Z. It's a tough spell. But the doctors are -- have the last name "Eck" -- E-C-K -- so if somebody Googles them, they'll find the clinic.
RUSH: Look, we've already lost 90% of the people in the audience with this. I'm just exploring in my own curiosity.
CALLER: Rush, the more you think about it, the more you're gonna realize this could solve our Medicaid problem nationally. It's the cure for Obamacare --
RUSH: Well, I'll tell you what I'm gonna do. I'll go home and think about it. I got nothing else to do to do today. I'll go home and think about this, and you may be right.
CALLER: Rush, thank you so much for all the time. I wanted to --
RUSH: Barney, it's --
CALLER: -- get on this --
RUSH: -- my pleasure.
CALLER: -- for about a year and a half.
RUSH: Well, I'm glad you made it, I'm glad you got through. By the way, his original point that he was discussing -- the seizing of your home business -- would apply even now to the states taking $300 billion from the federal government for Medicaid, they can still take your home even after taking the $300 billion from the Feds. He's calling it a Trojan horse, only because you don't know it's there. Anyway, I'm glad he got through, and I made his day: he told me something I didn't know. Let me ask you: Mr. Snerdley, now that you know this, are you glad that you've learned this? Was it worthwhile? (interruption) Says it's worthwhile, but he's not glad. Okay. I appreciate it, Barney. Thanks much.
A brief, obscene profit time-out. Just think of it, folks, as Medicaid becoming a charity as far as the doctor-patient relationship is concerned. That's what he was saying, Medicaid becomes a charity, and medical malpractice insurance fees end up being directed somehow to compensate the doctors for their charity work at no loss to the doctors, but not nearly as expensive as straight Medicaid -- Medicare.