United States Healthcare: A Medical Death Wish

America's Medicaid program provides medical assistance for individuals and families with low incomes and/or few resources. The program began in 1965 and is now the largest source of funding for medical and health-related services for people with limited income. Today, the program covers 53 million people, nearly one in every six Americans, and costs $300 billion a year in federal and state funds. In fact, Medicaid in some states accounts for more than one-third of the overall budget (Galt, 2005, 1). The program undoubtedly has a major impact on America, but overall it is more damaging to patients and medical providers than it is beneficial. Yes, medical assistance for those with limited incomes is important; however, Medicaid is not effectively providing medical assistance where it is absolutely essential.

The Medicaid program can, at times, significantly help individuals in need of medical assistance. With medications often costing upwards of one hundred dollars for a single months supply, Medicaid's maximum co-payment of three dollars can literally be a lifesaver to those without a job and/or insurance. Unfortunately, it can also be as a means to obtain unnecessary medication at taxpayer's expense. More often than not, people being placed on Medicaid greatly increase their number of monthly prescriptions (Galt, 2005, 1). In a recent glimpse of five randomly selected patients, four added three or more medications per month when they began their coverage. By working as a pharmacy technician for over a year, I have seen many patients being dispensed ten or more medications every month for medically debatable diagnoses. People, who in the past had to pay out of pocket, could very easily perceive the ability to obtain unlimited medication virtually free of charge as something to take advantage of.

By far, the worst monetary aspect of Medicaid deals with payment to medical providers. While the program offers inexpensive medication to patients, it does so in part by underpaying medical facilities. Often times, it actually pays companies under their actual acquisition cost (NCPA, 2001, 3). Just like all other retail stores, a pharmacy marks up medication to make a profit. For example, a medication that actually cost $5.50 for a pharmacy to receive might be sold for $10.00 as a means to make revenue. Medicaid, unlike any other insurance group, on the same medication could pay as little as $4.00 to $7.00 depending on the patient. This leads directly to cost shifting. Cost shifting occurs when one group of patients pays less than the actual cost of their medical care. Providers must in turn cover the losses by overcharging everyone else. The Congressional Budget Office's study on cost shifting showed $78 billion dollars were burdened onto patients without Medicaid in 1994 to make up for the medical field's lost profits (NCPA, 2001, 2).

Medicaid does not have a single incentive program encouraging individuals to attempt to end their medical assistance. Originally enacted to provide short term aid, Medicaid has become heavily used as a means to receive unnecessary medication for years on end (Galt, 2005, 1). Without any limits on time, medical aid, or type of medication there is nothing preventing the program from being used simply a source for governmental handouts. Even