Two single-payer advocacy groups, Rhode Island Chapters of Physicians for a National Health Program (PNHP) and HealthCare-Now, have prepared a report that is highly critical of Governor Gina Raimondo’s Reinventing Medicaid initiative.
The PNHP/HCN-RI report identifies five areas of concern and concludes that “Governor Raimondo has made it impossible” to achieve the goal of developing “a plan to improve the quality of care Rhode Islanders receive and reduce the costs for Rhode Island taxpayers.” The areas of concern cited in the analysis are:
1. presenting faulty and misleading data and analyses
2. misidentifying “problems;”
3. requiring unjustified budget cuts within preselected “six major strategies’”
4. not permitting consideration of the actual problem: private health insurance companies generating enormous administrative costs and improperly rationing care
5. not permitting consideration of an effective solution: a comprehensive single payer health care program for all Rhode Island residents such as that proposed by H5387, a single-payer health care bill introduced by Representative Aaron Regunberg.
The report says Raimondo overstates the percentage of the Rhode Island budget spent on Medicaid. She uses 31 percent, but the PNHP/HCN-RI report says the actual number is 22.1 percent. Further, Rhode Island’s expenditures are below the national average of 23.7 percent. And it should not be forgotten that most Medicaid expenses are reimbursed by the federal government dollar for dollar. Every dollar cut from state expenditures is two dollars cut from services.
The PNHP/HCN-RI report also accuses Raimondo of cherry picking data to paint the worst possible picture to create a false Medicaid crisis.
When Raimondo considers the drivers of high Medicaid costs, she ignores key problems. While Raimondo blames “High Utilization,” an “Aging Population” or “fraud, waste and abuse,” the PNHP/HCN-RI analysts note that her supporting data are questionable and we should be looking at the fact that “multiple payers create enormous excessive administrative costs and unfairly ration care.”
The report concludes by making the case for single-payer healthcare. Adopting such a program, says the PNHP, will:
Provide comprehensive health care coverage to all Rhode Island residents with most Rhode Islanders paying less for health care than they are currently paying;
Improve access to health care;
Save approximately $4000 per resident per year by 2024 and put more money into the Rhode Island economy.
Significantly reduce health care dollars spent on administrative costs and shift these dollars to actual provision of health care (providers would save almost $1 billion in administrative costs in the first year);
Decrease administrative burdens on health care providers and allow them to spend more time providing health care;
Eliminate the burden of health insurance costs and administrative obligations on Rhode Island businesses and thereby make them more competitive and profitable. In the first year, payroll contributions to the single payer plan would be over $1.2 billion less than current private health insurance premiums.
Contain health care costs (reduced administration and control over monopolistic pricing) would save 23% of current expenditures in the first year with larger savings in subsequent years.
Create a significant economic stimulus for the state by attracting businesses to and keeping businesses in Rhode Island because of reduced health insurance costs, a particular boon to small businesses and their employees.
Chair of the RI PNHP, J. Mark Ryan, MD., will be presenting some of this data at the next Reinventing Medicaid Town Hall Meeting at the on April 1. You can see my coverage of the Providence Town Hall meeting here. For more on PHNP and single payer, see here.