When I was growing up I was taught that having cash in hand enabled you to, in essence, wheel and deal. In those days if you had the cash in hand you could go to an equipment dealer or an auto dealership and get a better deal than someone who had to take the time to get a loan approved. I have always believed that when you can buy or sell anything quick all parties benefit. Life is much simpler when you don’t have to mess with all of the paperwork and loan applications; likewise an auto dealer could sell you a car and simply take the cash to the bank and avoid taking time to help someone get a loan. Over time the allure of cash has lost some of its sparkle, especially when it comes to paying for medical care. Recently I read an article about Medicaid reimbursements here in the state of Oklahoma.
The Oklahoma Health Care Authority warned providers that the rate cut of 9% would take effect December 1stunless the Legislature restores $70 million to the agency lost when the Supreme Court struck down an unconstitutional cigarette fee. According to their projections, physicians would only be reimbursed at about 79 percent of the federal Medicare fee schedule instead of the 86.57 percent they get now. Any physician who takes care of Medicaid patients knows the paperwork involved is horrendous and they have to employ people just to take care of the additional requirements. Logic would make us believe that the people paying cash would be cherished and sought out. It might surprise most people to know that the people paying cash are often penalized for doing so.
For years I have known that private pay patients in nursing homes are paying a higher rate per day than the patients who are on Medicaid. Recently a nursing home advocate made the comment concerning the practice of charging private pay patients to offset the reimbursement rates, “We’re able to make up some of that through a small percentage of people who privately pay and a small percentage of Medicare,” I can remember when my grandparents and mother in-law were in nursing homes, they were all self pay and they were charged more because they saved their money and looked out for their future. They did not receive any additional care or any preferential treatment in any way. While my heart goes out to our elderly citizens and all need to be cared for, we need to address the feelings of the people paying their way.
When we talk about any government program we need to remember that the money used comes from the taxpayer. The people paying cash are the ones who have paid their taxes but now they are they are being penalized with higher rates even though they helped fund the program in the first place. I have always had a problem with the idea of having a two tiered system where one group is forced to pay more than someone else for the same service. To put it into perspective, how would you feel if you went to a restaurant where the meal was normally $10 dollars but when you went to the cashier if you wanted to pay with cash the cost would be $12 dollars? I bet you would not eat at that restaurant in the future. Whether you know it or not that is what has been happening in our healthcare system for years. I guess it proves that the power of cash isn’t what it used to be.
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