WV Gubernatorial Candidate Fights Medicaid Abuse

I will start off by saying that I’m not endorsing any particular gubernatorial candidate here, but it was interesting to find an article in the Register-Herald this morning about Republican gubernatorial candidate Russ Weeks, who is on a crusade to bring accountability to Medicaid expenditures.

Let me tell you the biggest problem I see with Medicaid, especially in West Virginia. Since people who actually create jobs and support small-town economies (i.e., self employed or run their own business) cannot actually afford [good] health insurance, they actually care what medical services cost them when they are needed.

Say your sister needs to get an MRI or a CT-scan. She goes to the local facility/hospital that has the equipment. The scan takes about 5 minutes. They charge her upwards of $2,000.00. She later finds out that the fair market value of that scan is about $300.00. She complains, but she is told by the hospital that they just use the price as set by Medicaid. In other words, that is what Medicaid pays, so that must be the value of the procedure. The end result is that she is royally ripped off by the hospital. But this also means that the taxpayers are royally ripped off every single day when Medicaid pays inflated prices for medical procedures – prices that would never survive in a free market.

I see this all the time with clients who have been injured in car accidents. They incur a massive debt of medical bills, and they are out of work for a long period of time. Their life is barreling towards bankruptcy. Usually the insurance companies will only cover about $10,000.00 worth of initial medical bills. Then the hospital and doctors want to be paid. Sometimes they are willing to wait for a settlement, sometimes they are not. Between the greedy insurance companies, the greedy hospitals, and the sometimes-indifferent doctors, these poor folks can be backed into a corner. And many times, the true value of the medical services rendered is 1/8 of the debt that is accumulated.

The point is, that there has got to be a better way. And I would start with cleaning up this Medicaid mess, which is nothing but a government-sponsered ponzi scheme designed to enrich hospitals and health care companies at our expense.

– John H. Bryan, West Virginia Attorney.

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