I know. Health care is a dead horse. But here's an interesting discussion of the inequality among states in Medicaid that is a driving reason for both the need for reform and states' resistance to same. The Arkansas angle:
Jonathan Bates, the president of Arkansas Children’s Hospital, has seen the real-life impact of the Medicaid mishmash. His hospital is a leader in heart transplants and sometimes treats children from out of state. But the lower Medicaid payment rates of other states mean the hospital must navigate bureaucracy before performing such major surgery, or risk not getting paid.
“We have to negotiate that price up front,” Dr. Bates said. “Because if we take the patient and do the transplant and then send the bill, they’ll deny it because it has to be preapproved.”
In the case of some emergencies, Dr. Bates said, hospital officials found themselves “up in the middle of the night trying to find somebody at a state agency who can say yes or no on something like that.”
That does not, however, happen with patients who live in Arkansas. “For what it’s worth,” he said, “we have perhaps one of the more spectacular Medicaid programs in the country.”
Thus he indirectly furthers support for Gov. Mike Beebe's decision to put an expansion of the ARKids program on hold because of the state budget crunch. I'm not saying I support that. But testimony such as this certainly gives it cover. We're already doing better than many.