John O'Connor

Dr. Tom Price recently became Secretary of the Department of Health and Human Services.

Long-term care operators should cast a wary eye for two reasons: Medicaid and Medicare. By all accounts, Price plans to make changes to both programs that might pose an existential threat.

Let’s start with Medicaid. The Trump administration is hoping to save billions of tax dollars by incorporating a block-grant approach to payments. To understand why this shift would be bad for you, please revisit the previous sentence.

Block grants are not being put in place to help you deliver better, more efficient care. They are a budget-trimming tool. In their most basic form, they work like this: The federal government gives states a set amount of dollars for a specific purpose, such as Medicaid. Once the money is gone, it’s gone. You happen to still be in line for payments behind other deserving groups, or those with more political clout? Too bad. You don’t get nearly enough to cover your actual caregiving costs? Tough.

To be sure, many operators have trimmed their Medicaid-payment reliance during the past decade or so. However, Medicaid still remains a major funding source. For many operators, block grants may translate to “Goodbye, Medicaid funding, hello, Mr. Bankruptcy Attorney.”

Then there’s Medicare. If past performance is any indication, the forecast here also is disturbing.

When he was chairman of the House Budget Committee, Price was a frequent supporter of measures that enact beneficiary payment limits. Is there any reason to believe his opinion has changed?

What is going to happen under this scenario when a maxed-out resident enters your facility? As long as you are willing to deliver free care, everything’s fine. That’s not going to be a problem, is it?

Price is an orthopedic surgeon. As such, he surely must be familiar with the Hippocratic oath, which calls on doctors first and foremost to “do no harm.”

Yet he’s going to actively push for “reforms” that may prevent many thousands of people from getting the care they need? Looks like the good doctor may have pledged allegiance elsewhere.