And excluding certain small ones from the recording requirements which might be a pathway. That is nothing the Commission Recommended but there is a discussion to that effect in our report. I appreciate that. 1sizefitsall approach is not always helpful. It rarely is. We face these challenges and i hope you will keep in mind the flexibility that often needs to occur and i appreciate your efforts. Unless we are done i want to say in our recommendations, the principle i tried to save in the introduction, if youre going to provide rural providers, it is about targeting, not duplicating, not supporting two providers next door to each other may be in effect, not covering fixed costs, subsidize both of them. In the ambulance situation we took one of the add ons targeted to redistribute and targeted to counties that had low population density. You end up covering 70 , 75 of the same areas but they can provide a larger subsidy. And removing subsidy away from places that are near metropolitan ar
The state up north, from ohio, mr. Levin. Youre still bitter about some of the back and forth between our two states. I dont think ron kind was here when we introduced judy chu. And earl was here part of the time. So dr. Miller, welcome. As i read your report, your testimony, and also the executive summary, i was just struck by the thoroughness of the work you do. A lot of the issues are controversial. I remember when we first talked about controlling payments to physicians and the heck that we received and how much controversy there was. And you thought the sky was falling and it would never work out. And i mention that because i really think your report, and it has areas where there are difference of opinion, your report shows how successful this has been, this program, that is, in some respects a public but not only public, but public and private partnership. And with a lot of back and forth from the private sector as reflected in your report. And i just want to comment for each of
The state up north, from ohio, mr. Levin. Youre still bitter about some of the back and forth between our two states. I dont think ron kind was here when we introduced judy chu. And earl was here part of the time. So dr. Miller, welcome. As i read your report, your testimony, and also the executive summary, i was just struck by the thoroughness of the work you do. A lot of the issues are controversial. I remember when we first talked about controlling payments to physicians and the heck that we received and how much controversy there was. And you thought the sky was falling and it would never work out. And i mention that because i really think your report, and it has areas where there are difference of opinion, your report shows how successful this has been, this program, that is, in some respects a public but not only public, but public and private partnership. And with a lot of back and forth from the private sector as reflected in your report. And i just want to comment for each of
Took the first big step of his presidency in terms of dealing with the crisis. Saying he would declare it an emergency, saying he wanted to dedicate time and resources and money to this crisis. Because we havent seen the actual declaration yet, it is hard to say what this will do. Thingeral, the number one you can say is that this will mean a lot more awareness and attention on the issue. The easiest thing to say, this will put a spotlight on what is going on around the country when it comes to the crisis. From there we are looking at what the laws are that govern Emergency Declarations, to get a clue towards what he might do. Usedneral these things are for Something Like a hurricane or flood or a tangible event that is concrete. Public Health Emergencies are declared when it comes to Communicable Disease like influenza or the h1n1 virus. This is a novel use. We have not seen emergency for a broad used and multifaceted thing like the opioid crisis. Host when will this become official a
Didnt. I dont think it is good or bad. I am a fan of Medicaid Expansion. A lot of Southern States didnt take it. This will be much more state versus state. When you get into medicaid, it is more about what happens in your state and protecting what you have. Whats happened in the last 25 years due to a disproportionate share of taxes, is that the states have largely cashed out their money. There is not one state that can tell you that. All the money is fake. It is all phantom matches. Now, you are going to get to the point where i dont think they will do a block grant but a per capita cap, because it has more bipartisan support. Lets say you go to every state and say, were going to give you a per cap amount that adjusts to the inflation for the disabled population, anyonged population women and kids. Look at what new york spends versus what alabama spends. Alabama and new york did the expansions and alabama didnt. Are you going to cap everybody where they are . The republicans control t