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Also what -- the governors do about health care.
Including the expansion of Medicaid the governors of Iowa and Florida telling FOX News Sunday that they will not embark on something they can't lot of forward.
And may possibly not even need.
I think if you look at it realistically and you look at what they ought to be doing -- quit digging and -- a deeper hole we've got to reform these hole.
Entitlement programs we've got the same concern the federal -- can afford this we can't afford it.
I didn't make any sense to do this expansion this is just another government program where this program -- long run out of money.
And they'll put it on the states again are right so do they have a point she'll never the -- medical eighteen professor of medicine at NYU lined a medical center hey Dylan marking good morning to you doctor and -- bill what do you think about the arguments the governors of Iowa and -- making.
I think they're making a very interest -- arguments focused consider this the Medicaid expansion is gonna cover of people that make a 133%.
Of the poverty level.
But the question is you know what does it actually -- -- cost the states.
And if the states decide that they aren't -- -- -- -- at a certain point like -- like we're already word with positions they're gonna pay primary care physicians.
The next two years more but they can pull the plug on that in 2014 congress could make it an unfunded mandate and another thing why is a Medicaid patient.
Need the same exact service when they make a little more money in other words a 133%.
Of the poverty level bill is not the same thing as the poverty level so some governors are saying.
Why not some -- -- so yeah I don't quite understand a couple of things there first of all you're expanding the pool right -- which requires more money to cover them correct exactly and and built not only money.
From Medicare itself which is billions of dollars even the five to 10% that the states may end up paying is in the billions plus administrative cost of Medicaid expansion.
That are not covered by the feds over ten years in New York State for example that's estimated to be a billion dollars so you're talking billions the states are going bank.
You know the the other big point you mentioned there -- your first answer is that that they they have fear you believe.
I think that if they commit to -- that Washington -- change the rules on the road.
Well it's not just fear even President Obama has come out and set on a couple of occasions you know we may cut Medicaid funding so imagine the State's expanding Medicaid.
The citizens get used to it and then they they turn -- they say we're sorry you're used to it but we can't reported in the feds are not paying us.
The states traditionally will then go ahead and cut the hospitals and so then another talking point that hospitals are better off with.
More Medicaid patients rather than the uninsured may not work out who is their bottom line may go down as the hospitals are cut.
By states who are not receiving money from the fat -- wanna show our viewers the states that are considering.
And then there are eleven others that are considering it a lot of these Republican governors but apparently said democratic governors are quite sure what they will do either.
And reelection in November could change all of this to we've heard that from governors of waiting to see the outcome -- guy like Scott Walker Wisconsin made a reference that recent.
-- they'll tell took two quick points on a real one is some of the Republican governors are asking for block grants and that's interesting because they may end up being able to do something in the private sector with a money that might work -- And the point I mentioned before I want to emphasize which is about co pays and deductibles.
Some Republican governors are saying why aren't we using health savings accounts for people who are more but might have some money that might be able to get a tax break.
For paying out of pocket.
Bill I have always believed strongly that if a patient pays out of pocket they're more aware of what they're getting so they have a -- -- Or they have a deductible even if it's Medicaid they may not use -- -- insurance unnecessarily.
And it's interesting point effort you make up before two quick questions here.
As a doctor -- is gonna change the perfection.
While I think this is an enormous pressure on doctors and I'm glad you brought that up because.
All up to fifty present -- -- right now are not taking new Medicaid patients.
And many specialties are not involved.
And even if I see a Medicaid patient I might not be able to find.
The network of doctors to take care of these patients so how can you -- sixteen million -- in Medicaid patients to the coffers.
Without considering the doctor shortage.
And the -- under Medicaid that sort right now it if you're living in one of these eight or eleven states that I just mentioned.
Is your health care going to be better or worse if you're governor says hey I'm not gonna expand Medicaid while -- -- to be -- to be quite a gap.
And it's true the same thing with the exchange would have your state is not putting in the state exchanges of equipment gap where you're under a mandate.
A federal mandate now an individual mandate to get health insurance but you can't -- it.
Because your state is an expanding Medicaid or your state doesn't have the exchange you can be caught with -- tax problem.
And and don't have that availability and I actually am very sympathetic to states who are saying that Florida -- and -- out at Texas we're not going to be able to do this summer waiting till after the -- I.
Think the bottom line is that this is still developing.
Want to -- -- get a continue develop for months if not even years beyond this point given the last record month.
Bill the states just as you said the states are waiting and many of them are saying now what conditions are we gonna have to do this make it workable for us and it doesn't look like it is for sharks -- now for viewers and Soledad got questions for you about health -- and email address -- foxnews.com.
We're -- on Twitter at Bill Hemmer just need one line right there because you were asked.
-- and we talk about more about this later in the week mark thank you Mark Siegel right here in New York market --
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