By Gerald Friedman
America’s broken health-care system suffers from what appear to be two separate problems. From the right, a chorus warns of the dangers of rising costs; those on the left focus on the growing number of people going without health care because they lack adequate insurance. This division of labor allows the right to dismiss attempts to extend coverage while crying crocodile tears for the 40 million uninsured. But the division between the problem of cost and the problem of coverage is misguided. It is founded on the assumption, common among neoclassical economists, that the current market system is efficient. Instead, however, the current system is inherently inefficient; it is the very source of the rising cost pressures. In fact, the only way we can control health-care costs and avoid fiscal and economic catastrophe is to establish a single-payer system with universal coverage.
By Bruce Bartlett
At the root of much of the dispute between Democrats and Republicans over the so-called fiscal cliff is a deep disagreement over the welfare state. Republicans continue to fight a long-running war against Social Security, Medicare, Medicaid and many other social-welfare programs that most Americans support overwhelmingly and oppose cutting.
By Bernard Lown, MD
Reflecting back on early days, the first overtreatment I encountered was not related to technology. It involved keeping patients with acute MI’s at strict bed rest for 4 to 6 weeks. This was a form of medieval torture. It promoted depression, bed sores, intractable constipation, phlebitis, lethal pulmonary embolism and much else. Worse it augmented cardiac ischemia and predisposed to malignant arrhythmias. Physicians were aware of what was transpiring but felt it was necessary to protect patients against cardiac rupture which activity may provoke.
By Donald W. Light
Synopsis: Conservatives in every other industrialized country support universal access to needed medical services. An emphasis on individual freedom and responsibility strongly supports this position, and only in the United States do conservatives believe this is not the case.
Examining MaineCare’s Coverage Options Under the Affordable Care Act
By Erika Ziller PhD and Trish Riley, Muskie School of Public Service
The Affordable Care Act (ACA) was designed to achieve nearly universal access to health coverage in the United States—in part by standardizing Medicaid eligibility across the country so that each state’s program would cover individuals with incomes below 138% of the federal poverty level (FPL), or $15,856 for an individual and $32,499 for a family of four in 2013 (see Figure 1).i However, in June 2012, the U.S. Supreme Court determined that states could not be required to broaden Medicaid and retained the decision as a state option. States that choose to participate may do so by amending their state Medicaid plans, and there is no explicit deadline for this decision. Should a participating state choose to discontinue its participation in the future, it may do so without penalty through another state plan amendment.
The Medicaid program is a shared responsibility of the federal and state governments. Currently, in Maine, for every $38 the state spends, the federal government matches that contribution with $62. This is known as the match rate or FMAP.