Is subscription model healthcare a real alternative?
Mississippians have, like citizens in many Southern states, argued for a long time over the question of Medicaid expansion. The arguments run the gamut from financial to moral to philosophical to purely political and usually intensely partisan.
The debate continues in 2023, a courthouse-to-statehouse election year in the state. In the wake of the Dobbs abortion case decision by the Supreme Court, the current debate has focused on increasing postpartum Medicaid care for mothers from the present 60 days to one year. In the state with the highest rate of infant mortality in the country and as the originating state for the Dobbs anti-abortion decision, an expansion of Medicaid for this purpose more than makes sense.
But the politics of Medicaid expansion in
The bright line explanation for cheaper medical care in the subscription model is that they claim to remove the insurance companies from between the doctor and the patient.
For those with the means to afford private insurance of some kind, the subscription model may well be worth exploring. But as a substitute for Medicaid, serving some of the poorest people in America, the subscription model has many failures and shortcomings.
The subscription model requires a monthly, quarterly or annual payment, usually between
Because of the lack of traditional health insurance, experts say subscription primary care customers need a health savings account (HSA) or a high deductible health insurance plan (HDHP) in case a car accident or cancer battle occurs.
To make those monthly primary care subscription payments, HSA contributions and HDHP premiums, there must be a steady stream of income. Perhaps subscription primary care works as a substitute for traditional fee-for-service health insurance. But as a substitute for Medicaid, the more likely outcome is that the Mississippian in poverty will remain uninsured.
As I've written before, regardless of one's politics, taxpayers have and will continue to bear the brunt of healthcare costs for the poor. Two federal laws virtually dictate unreimbursed spending.
Many of the government-owned community hospitals in
The uninsured primarily receive uncompensated care. Nationally, uncompensated care in the
Second, there is the 1986 Emergency Medical Treatment Act (EMTALA) which was enacted by
Also applicable under EMTALA is the requirement that every
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