Is Signing a Petition Pleading McCrory to Expand Medicaid Prudent? (Or Just Great Propaganda?)

Despite, Governor McCrory’s hint a few days ago toward Medicaid reform, not Medicaid expansion, today, on Facebook, I noticed a virtual Petition circulating.  The Petition is asking Governor McCrory to please expand Medicaid.  I’ve copied the Petition’s language below, as well as, provided you a link in case you want to sign the Petition. For ease of reading this blog, I have italicized the actual Petition.

Tell McCrory: Expand Medicaid in NC

By Action NC (Contact)

To be delivered to: Pat McCrory, Governor

As a North Carolinian, I urge you to implement the Medicaid Expansion for low-income individuals under the Affordable Care Act.

Petition Background

Gov. McCrory, the power to fundamentally change the health care system in our state is in your hands. By expanding Medicaid, low-income North Carolinians will have access to health coverage, and there is potential to undo the profound health disparities in our state.

As it stands, North Carolinians who are uninsured are likelier to develop serious health complications or die younger from diseases that are all too often preventable. By gaining health insurance through Medicaid, we would add health coverage for more than half-a-million North Carolinians within five years who otherwise would remain under insured.

We urge Gov. McCrory to implement the Medicaid Expansion for low-income individuals under the Affordable Care Act so that all of our state can remain healthy and strong.

End of Petition.

Period. That’s it. The end.  That’s the extent of background information provided before the Petition expects, or the authors of the Petition, expect people to electronically sign their names. And people have.  4512 people have signed the Petition….and climbing.

Shoot, if that was all the research I did (merely reading the Petition Background) I would probably sign it too.  I mean, who doesn’t want “half-a-million North Carolinians” to get health care coverage? Who wouldn’t want “all of our state to remain healthy and strong?” I want half-a-million of North Carolinians to have health care coverage!! The difference is that I want the health care coverage to be as good as private insurance.  So, sadly, we need to be realistic.

Readers: BEWARE! Expanding Medicaid will not make our state healthy and strong. Expanding Medicaid will not provide half-a-million NC residents quality health care (Note, I said quality health care, not health insurance….HUGE difference).

I think what upsets me so much about this Petition is that it is propaganda.  It appeals to emotion, not facts.  Reading the Petition incites emotion. Most humans, I hope, want to help other humans.  If all I did was read the Petition, the Petition would bear my name.  So, in a way, the Petition is only disclosing partial facts. Hence the definition of propaganda.

Propaganda is defined as:

  1. Information, esp. of a biased or misleading nature, used to promote or publicize a particular political cause or point of view.
  2. The dissemination of such information as a political strategy.

Historically, the Nazis were the best with propaganda. TThe Nazi’s used propaganda to incite anger toward Jews and create a feeling of superiority in whites.  As you can see, propaganda is not always a good thing.  To me (maybe not the Webster’s definition), propaganda is any misleading political information that incites emotion with zero basis in fact.

According to the Petition, “there is potential to undo the profound health disparities in our state.” (If we expand.) Wrong.

If North Carolina accepted the expansion of Medicaid, yes, approximately 700,00 more North Carolinainas would have health care coverage under Medicaid. However, the “profound health disparites in our state” will be exacerbated.

Let me explain:

Already today, approximately 60% of physicians and health care providers in North Carolina do not accept Medicaid. What does that mean? Why is that important? If you have Medicaid and cannot find a physician to provide care to you, what good is the Medicaid card?

If a health care provider does accept Medicaid, that health care provider is being compensated at a severely lower rate than what a Blue Cross would compensate.  Just thinking logically, do you think that health care provider is providing equal service to the person with Blue Cross versus the person with Medicaid?

Fact: Some Medicaid recipients are unable to locate any health care provider to provide health care to them unless they drive hours to a non-rural county.

Question: Logically, if we add 700,000 more North Carolinians on Medicaid, do you think that the Medicaid recipients will have an easier time or a harder time locating physicians or health care providers?

The fact of the matter is that the Petition SHOULD have stated, something to this effect, sign here if you want more people to be eligible for Medicaid, but less Medicaid recipients to receive quality health care. My question is doesn’t Medicaid recipients deserve quality care?

If you agree, sign here:


About kemanuel

Medicare and Medicaid Regulatory Compliance Litigator

Posted on February 5, 2013, in Division of Medical Assistance, Medicaid Expansion, Medicaid Recipients, Medicaid Reform, Medicaid Reimbursement, NC DHHS and tagged , , , , , , , . Bookmark the permalink. 9 Comments.

  1. Hmmm. Propaganda. So how would you characterize the statements being made by Republican legislators about Health Reform? Reasoned? Well-informed? I think not.

  2. Yes I would love to see medicaid in NC expand for others and myself . I am disabled because I have spinal degeneration disease, spinal stenosis, the thoracic area at T7 & T8 has compressed on the nerve causing severe pain every day. I am on Morphine, Flexirel, and Depression medications. I do recieve disability from the US treasury, after a pay my House payment, utilities, medications, my pain management doctor and groc. I am broke. I filed for medicaid but they said I make more than the limit, which is $961.00. My monthly disability check is $1684.00. The also told me there would be a deductible of $8000.00 through a 6 month window. I can’t afford that I am already paying on other medical bills from the past. There should be some care when any person of any ethnic group needs medical attention if suffer from any illness, life or death. Thats included in the oath that doctors swear to.

    • Chris,

      Thanks for your comment. I am sincerely sympathetic to your situation. However, I did not understand why ethnicity is even a factor. Notwithstanding, I think you represent the common misconception most people have regarding Medicaid expansion. Currently, 60% of primary care physicians refuse to accept Medicaid. This means that all the Medicaid recipients in North Carolina must go to only 40% of primary physicians. When you get into specialized care, such as what you need with your spinal degeneration disease, the percentage is even higher (for physicians refusing Medicaid). Some specialties have zero doctors willing to see Medicaid recipients. Therefore, had North Carolina expanded Medicaid without, first, fixing Medicaid, you would have been the holder of a bright, shiny, Medicaid card without being able to find health care. I believe it is imperative that all Medicaid recipients receive quality health care. That is not case at the moment. Instead of throwing more North Carolinians into a system in which they would not receive quality health care, we need to figure out how to get more health care providers to participate in the Medicaid program.

      • Well my orthopedic surgeon and pain management doctors accept medicaid. From what I read Doctors and Hospitals are for the expansion of medicaid.Doctors, nurses urge NC General Assembly to support Medicaid expansion, for health, jobs. A doctor quoted
        Without the expansion, North Carolina hospitals will continue to have pay for charity care in emergency rooms, the cost of which will keep getting passed along to patients with private insurance, he said. Go to this link which is a drop in the bucket compared to all the other news journals of NC medicaid.

  3. Sorry didn’t attach link but thats ok here it is

  4. That’s great that your ortho and pain management doctors accept Medicaid. My guess is that they are affiliated with a hospital otherwise they would not.

    Hospitals, most likely, are for expansion because, as you said, they are unable to turn anyone away. So, of course, expansion would help the hospitals. The doctors for Medicaid expansion, again, are most likely affiliated with a hospital.

    The job increase you mention is patently bad for our state ONLY BECAUSE (believe me, I am for adding jobs) of this: The DMA audit a couple weeks ago showed that DMA spends 648.8 million yearly in administrative costs. How cow!! Wouldn’t it be great if that 648.8 million actually went to Medicaid recipients? The jobs that would be needed if Medicaid expanded would be in DMA or consulting firms affiliated with DMA. We do not need to add more administrative costs. We need to provide better care.

    You are correct that hospitals have costs due to uninsured patients (thats why most hospitals want the expansion). But the amount of frivolous malpractice claims is more of a reason that health care costs continue to rise, than uninsured. I’m sure there are a million other contributors.

    Also, just because NC does not expand Medicaid, doesn’t mean that more people will not have Medicaid coverage. We will be implementing the exchange program which will allow many North Carolinians to buy-into Medicaid at very little cost.

    Thanks again for your comments!

    • I hope something happens because if a small piece of my vertebrae breaks off, it could puncture spinal cord membrane. That would cause me to lose spinal cord fluid and possibly cause me to become paralyzed.

  5. Chris, I am so happy that you are under doctor care. I truly hope only the best for you!

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