Doyal’s pro-government funding of universal health care proclamation raises question why Hospital District spends $5.8 million on indigent care program to cover 440 patients

44th President B. Hussein Obama, like Montgomery County Judge Craig Doyal, is a huge advocate for community health centers which are at the core of the Obamacare legislation. Doyal intends to proclaim August 12 to 18, 2018, as “National Health Center Week” in Montgomery County to celebrate government funding for healthcare.

Conroe, July 23 – At the Tuesday, July 24, 2018, meeting of the Montgomery County Commissioner’s Court, ultra-liberal lame duck County Judge Craig Doyal will introduce and advocate a resolution to celebrate National Health Center Week. Community health centers have become a key component of the Obama/Clinton-era health care system.

The Kaiser Family Foundation released a report:

“Community health centers are a key component of our health care system, providing essential access to comprehensive primary care in underserved communities. The health center program has experienced significant growth over time, particularly since the enactment of the Affordable Care Act (ACA), which expanded coverage options for many low-income health center patients and provided increased funding for health centers through the Community Health Center Fund (CHCF).”

For some odd reason, however, the Lone Star Family Health Center has existed in Montgomery County since 2001, even though this community is hardly an “underserved” community as far as access to healthcare. Now, LSFHC does provide health services to veterans, so they’re not altogether unnecessary. Nevertheless, a community health center does seem a bit out of place in affluent Montgomery County.

These health centers are not purely rosy participants in the healthcare industry. As Modern Healthcare recently wrote, “Community health centers’ transition from being mostly humble clinics to big business was born out of their need to survive in an increasingly complex and expensive healthcare landscape as well as the constant demand for care, Weinman said. Yet as hospitals have learned, competition for patients also leads to competition across service lines. Some community health centers offer the same ancillary services as local hospitals, such as imaging and lab work.”

These healthcare centers receive substantial federal subsidies and then compete against private physicians and hospitals by several undercutting the price of services well below fair market rates. Additionally, the federally-mandated payment structure of these community health centers encourages the doctors to schedule unnecessary visits and treatments, as the Modern Healthcare article explained:

“One criticism of community health centers from physicians is the underlying federal statute, which set in place a fee-for-service Medicaid payment model.

“By law, community health centers receive cost-based prospective payments even if their state uses capped payments for Medicaid. California, for example, reimburses FQHCs for the difference between the managed-care plan’s payment and the federal fee-for-service rate. California manages this wraparound payment through what both state officials and providers call a burdensome reconciliation process at the end of each year.

“Some view the prospective payments as driving poor management of patients’ care. Dr. Michael Hochman, an assistant professor at the USC Keck School of Medicine, wants to see FQHCs embrace a value-based model like AltaMed, where he used to work. “With fee-for-service, it’s all about getting the Medicaid patients,” Hochman said. “If patients are going elsewhere, that’s less money for the FQHC.”

“This can lead to over-scheduling of unnecessary visits for patients. As long as they get reimbursed by Medicaid, these often extraneous appointments can be lucrative for health centers, particularly in managed-care states since at the end of the process they will get the extra boost in payment. Meanwhile, Hochman said, hospitals can’t compete for those Medicaid patients on the same level because their reimbursement rate is much lower without the advantage of the prospective payment system.”

MCHD’s massive waste of health dollars
Doyal’s proclamation raises another major question about Montgomery County healthcare. County taxpayers pay the Montgomery County Hospital District (MCHD) to provide “indigent health care” as mandated under federal law to those American citizens who can’t otherwise receive healthcare through private insurance, their jobs, Medicare, or Medicaid. Prior to the passage of Obamacare, the Hospital District’s primary patients were the “working poor” who couldn’t qualify for Medicaid because their income levels were too high.
Nevertheless, the Obamacare legislation was to close gaps in coverage. It turns out that it largely did so.
The Golden Hammer has confirmed that there are only 440 patients enrolled in the indigent care program, called the Healthcare Assistance Program (HCAP), of MCHD. So how much do Montgomery County taxpayers now pay per year for the HCAP program?
MCHD’s Fiscal Year 2018 budget for the HCAP program is $6,854,323! That’s $15,578.06 per patient!

In other words, MCHD could buy a Cadillac health insurance policy for each enrollee and spend substantially less money that the taxpayers must shoulder.

Ultimately, it’s nice that Doyal and his pro-government spending MCHD buddies are spending all of the citizens’ dollars on healthcare for a very tiny population of needy patients. Since it’s the taxpayers are paying for it, couldn’t we replace National Health Center Week with “National Taxpayer Week” instead?




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