The Middle-Man Gets His Share Off The Top of Medicaid
By Hugh W. Wyatt
Hugh W. Wyatt
It's high time to get rid of the Middle Man in the Medicaid health care program for the poor, disabled and children.
The term Middle Man refers to a sleazy "street hustler," or some other character of ill-repute who is not really needed, but who works to expedite deals-and takes more than his fair share of the action.
They are akin to the "carpet baggers" who invaded the South after the Civil War. In the Medicaid program, the carpet baggers are the health care insurance companies. They are the HMOs, or health management organizations, and their Middle Man scam is to "manage" Medicaid
They are contracted by states to manage health care for the millions of the Medicaid poor in their state, and are given millions or billions from the state and Washington to administer it.
They manage the money more than the health care. To administer it, these privately owned HMO insurance companies take anywhere from a third to 40 percent off the top. New York State's Medicaid budget is about $52 billion, so one-third for administration would be more than $17 billion for a year-or more. That drives up the cost of health care and reduces care for the patients.
Established July 30, 1965, through Title XIX of the Social Security Act, each state administers its own Medicaid program with 50-50 matching funds from the federal Centers for Medicare and Medicaid Services (CMS), which monitors the programs and establishes requirem...Read More