Dually Eligible People with Medicare and Medicaid — At the Center of the Next Debate:
Because of their medical frailty, their social and racial demographics, their great expense, and their expanding growth rate, dually eligible people — “the elderly and disabled poor” — will occupy a central position in the upcoming debates over national healthcare financing and disparities in health care in the 21st century.
Sheldon M Hersh, MD
Louisiana Geriatrics Society Annual Meeting
New Orleans, Louisiana, 2003
Excerpts from the Paper
Providing the least Medicare access for the most disabled people …
“Providing the least Medicare access for the most disabled people violates the Americans with Disabilities Act.”
A legal, de jure segregated medical system.
“For dually eligible people, the Balanced Budget Act turned an informal, de facto segregated medical system, into a legal, de jure segregated medical system.”
Payment for a home visit collapsed to 19% of the Medicare payment …
“When Louisiana Medicaid payment for a home visit collapsed to 19% of the Medicare payment, I stopped making house calls to new dually eligible patients.”