there some requirement, shouldn t there be some requirement handy for personal responsibility? of course there should be, but i have to be honest. with all due respect, i disagree with that characterization entirely. if you think about what medicaid does, 70% of medicaid funds take care of people who are living with disabilities or a nursing homes. there is a not irresponsible people. half the people in the programmer kids. some kids are lazy and do take advantage of their parents, they re not taking advantage of the health care system. want them to be healthy. to say we have a bunch of takers and the medicaid system is not fair. i agree with your point, but don t forget that it expanded to 130% of the poverty level. some of those people i don t want them to not quit their jobs and say i don t want to give up my medicaid. jon: is a reasonable discussion and it s good to hear some solid proposals from each
to use an emergency room other than going to the states that had medicaid expansion. and the opioid epidemic can also be linked to the overuse of medicaid. 15% of medicaid patients have a substance abuse problem. anyway, it s enabling the opioid academic. jon: is that medicaid essentially on a growth pattern right now that is unsustainable? no, first of all, this is in a bill that does anything to reform medicaid. generally speaking, democrats will want to talk about improving coverage and it will probably be generally wanting to talk about how to control costs. they are both doable goals. the problem with this bill as it doesn t do it either. it takes 22 million people and adds them to the roles and on the other problem is it increases costs. for a person who is buying a silver plan today under
that this bill would gut medicaid, is that accurate? no, it s not accurate, there needs to be some compromise on medicaid. you have to understand that switching to block grants through the states may actually be a way to introduce tightening the belt on medicaid. let s talk about that. look at the overuse of medicaid. as a physician, i want to tell you that 30% of doctors won t see medicaid patients, they come in without a co-pay, without a deductible. a lot of times, they ll ask for things they already have like a wheelchair. they ll ask for another thing in two years. all of that is great, but it s such an overused system that when we expanded it, and expanded into a population who could have gotten a job. a lot of people will say to me, i can t give up my medicare and take the job. as a job killer. that s number one. in this study over the last year of emergency medicine show that there were more than 9% likely
obamacare, and buy it today under trump care, and will cost 70% more. the problem is, this is a half-baked plan. it doesn t please either side and when it comes to medicaid, if you are talking about really good improvement to care, that would be one thing. we re talking about taking 26% of the program out and we haven t had a national debate about it. we ve had a national debate and it will keep supporting medicaid. to form, yes. strip 26% of the money that goes to take care of families, i don t think that s a good idea. jon: douglas holtz aiken was on our program yesterday. one of the things that he says is that the senate bill would not change any of obamacare in 2018 except telling people they no longer have to buy insurance.
but the belt has to be tightened. democrats have to be willing to do that. if we have open hearings, will we have experts like yourself talk about making improvements to medicaid. instead of candidly a handful of senior staffers and closed rooms trying to revamp medicaid on their own, i think we would have a very different outcome and i completely agree. this health care system is something that everybody needs to own. as long as it s owned by either democrats or republicans, we are going to continue to play this game where each party the system can t handle that. premium bryans for more expensive services are scaled-back products. jon: what about personal responsibility? if dr. siegel is right and essentially medicaid becomes carte blanche for somebody to go to a hospital or emergency room to get whatever pills or medical devices they want, without having to pay for it out-of-pocket at all, isn t